Yeoungjee Cho1, Aminu K Bello2, Adeera Levin3, Meaghan Lunney4, Mohamed A Osman2, Feng Ye2, Gloria E Ashuntantang5, Ezequiel Bellorin-Font6, Mohammed Benghanem Gharbi7, Sara N Davison2, Mohammad Ghnaimat8, Paul Harden9, Htay Htay10, Vivekanand Jha11, Kamyar Kalantar-Zadeh12, Peter G Kerr13, Scott Klarenbach2, Csaba P Kovesdy14, Valerie Luyckx15, Brendon Neuen16, Donal O'Donoghue17, Shahrzad Ossareh18, Jeffrey Perl19, Harun Ur Rashid20, Eric Rondeau21, Emily J See22, Syed Saad2, Laura Sola23, Irma Tchokhonelidze24, Vladimir Tesar25, Kriang Tungsanga26, Rumeyza Turan Kazancioglu27, Angela Yee-Moon Wang28, Chih-Wei Yang29, Alexander Zemchenkov30, Ming-Hui Zhao31, Kitty J Jager32, Fergus J Caskey33, Kailash K Jindal34, Ikechi G Okpechi35, Marcello Tonelli36, David C Harris37, David W Johnson38. 1. Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia. Electronic address: yeoungjee.cho@health.qld.gov.au. 2. Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 3. Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 4. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 5. Faculty of Medicine and Biomedical Sciences, Yaounde General Hospital, University of Yaounde I, Yaounde, Cameroon. 6. Division of Nephology and Hypertension, Department of Medicine, Saint Louis University, Saint Louis, MO. 7. Urinary Tract Diseases Department, Faculty of Medicine and Pharmacy of Casablanca, University Hassan II of Casablanca, Casablanca, Morocco. 8. Nephrology Division, Department of Internal Medicine, The Specialty Hospital, Amman, Jordan. 9. Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. 10. Department of Renal Medicine, Singapore General Hospital, Singapore. 11. George Institute for Global Health, UNSW, New Delhi, India; George Institute for Global Health, University of Oxford, Oxford, United Kingdom; Manipal Academy of Higher Education, Manipal, India. 12. Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA. 13. Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Victoria, Australia; Department of Medicine, Monash University, Clayton, Victoria, Australia. 14. University of Tennessee Health Science Center, Memphis, TN. 15. Institute of Biomedical Ethics and the History of Medicine, University of Zurich, Zurich, Switzerland; Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 16. George Institute for Global Health, UNSW, New Delhi, India. 17. Salford Royal NHS Foundation Trust, Salford, United Kingdom; University of Manchester, Manchester, United Kingdom. 18. Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran. 19. Division of Nephrology, St. Michael's Hospital and the Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 20. Department of Nephrology, Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh. 21. Intensive Care Nephrology and Transplantation Department, Hopital Tenon, Assistance Publique-Hopitaux de Paris, Paris, France; Sorbonne Université, Paris, France. 22. Department of Intensive Care, Austin Health, Melbourne, Australia; School of Medicine, University of Melbourne, Melbourne, Australia. 23. Dialysis Unit, CASMU-IAMPP, Montevideo, Uruguay. 24. Nephrology Development Clinical Center, Tbilisi State Medical University, Tbilisi, Georgia. 25. Department of Nephrology, General University Hospital, Charles University, Prague, Czech Republic. 26. Department of Medicine, Faculty of Medicine, King Chulalong Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; Bhumirajanagarindra Kidney Institute, Bangkok, Thailand. 27. Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey. 28. Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong. 29. Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 30. Department of Internal Disease and Nephrology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; Department of Nephrology and Dialysis, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia. 31. Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Key Lab of Renal Disease, Ministry of Health of China, Beijing, China; Key Lab of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China; Peking-Tsinghua Center for Life Sciences (CLS), Beijing, China. 32. ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands. 33. Population Health Sciences, University of Bristol, Bristol, United Kingdom; Renal Unit, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom. 34. Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. 35. Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa; Department of Medicine, University of Calgary, Calgary, Alberta, Canada. 36. Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada; University of Leicester, Leicester, United Kingdom. 37. Centre for Transplantation and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia. 38. Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia.
Abstract
RATIONALE & OBJECTIVE: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. STUDY DESIGN: A cross-sectional survey. SETTING & PARTICIPANTS: Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018. OUTCOMES: PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. ANALYTICAL APPROACH: Descriptive statistics. RESULTS: Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes. LIMITATIONS: Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data. CONCLUSIONS: Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia. Crown
RATIONALE & OBJECTIVE: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. STUDY DESIGN: A cross-sectional survey. SETTING & PARTICIPANTS: Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018. OUTCOMES: PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. ANALYTICAL APPROACH: Descriptive statistics. RESULTS: Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes. LIMITATIONS: Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data. CONCLUSIONS: Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia. Crown
Keywords:
Epidemiology; RRT modality; access to health care; affordability of health care; end-stage renal disease (ESRD); global survey; health care delivery; health care disparities; health policy; home dialysis; international differences; kidney failure; peritoneal dialysis (PD); renal replacement therapy (RRT)
Authors: Elliot A Baerman; Jennifer Kaplan; Jenny I Shen; Wolfgang C Winkelmayer; Kevin F Erickson Journal: J Am Soc Nephrol Date: 2022-03-21 Impact factor: 14.978
Authors: Melissa S Cheetham; Yeoungjee Cho; Rathika Krishnasamy; Arsh K Jain; Neil Boudville; David W Johnson; Louis L Huang Journal: Kidney Int Rep Date: 2021-12-01
Authors: Aminu K Bello; Ikechi G Okpechi; Mohamed A Osman; Yeoungjee Cho; Brett Cullis; Htay Htay; Vivekanand Jha; Muhammad A Makusidi; Mignon McCulloch; Nikhil Shah; Marina Wainstein; David W Johnson Journal: Nat Rev Nephrol Date: 2022-09-16 Impact factor: 42.439