Anita van Eck van der Sluijs1, Brigit C van Jaarsveld2,3, Jennifer Allen4, Karmela Altabas5, Clémence Béchade6, Anna A Bonenkamp2, Felix Burkhalter7, Anne-Lorraine Clause8, Richard W Corbett9, Friedo W Dekker10, Gabriele Eden11, Karlien François12, Helga Gudmundsdottir13, Ulrika Hahn Lundström14, Louis de Laforcade15, Mark Lambie16, Heike Martin17, Jernej Pajek18, Vincenzo Panuccio19, Silvia Ros-Ruiz20, Dominik Steubl21, Almudena Vega22, Ewa Wojtaszek23, Simon J Davies16, Wim Van Biesen24, Alferso C Abrahams1. 1. Department of Nephrology and Hypertension, 8124University Medical Centre Utrecht, the Netherlands. 2. Department of Nephrology, 522567Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, the Netherlands. 3. Diapriva Dialysis Centre, Amsterdam, the Netherlands. 4. Renal and Transplant Unit, 9820Nottingham University NHS Trust, UK. 5. Division of Nephrology and Dialysis, Clinical Hospital Centre Sestre Milosrdnice, Zagreb, Croatia. 6. Service Néphrologie-Dialyse-Transplantation, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France. 7. Division of Nephrology, University Clinic of Medicine, 367307Kantonsspital Baselland, Liestal, Switzerland. 8. Department of Nephrology and Dialysis, 390088Epicura Hospitals, Mons, Belgium. 9. Renal and Transplant Centre, Hammersmith Hospital, 8946Imperial College Healthcare NHS Trust, London, UK. 10. Department of Clinical Epidemiology, Leiden University Medical Centre, the Netherlands. 11. Medical Clinic V (Nephrology, Rheumatology, Blood Purification), Academic Teaching Hospital Braunschweig, Germany. 12. Division of Nephrology and Hypertension, Vrije Universiteit Brussel, 60201Universitair Ziekenhuis Brussel, Belgium. 13. Department of Nephrology, Oslo University Hospital, Norway. 14. Division of Renal Medicine, 206106Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. 15. Service d'Endocrinologie-Néphrologie, 377376Centre Hospitalier Pierre Oudot, Bourgoin-Jallieu, France. 16. Faculty of Medicine and Health Science, Keele University, Stoke on Trent, UK. 17. Centre for Nephrology Zwickau, Germany. 18. Department of Nephrology, University Medical Centre Ljubljana, Slovenia and Medical Faculty, University of Ljubljana, Slovenia. 19. Nephrology, Dialysis and Renal Transplant Unit, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy. 20. Department of Nephrology, Elche University General Hospital, Alicante, Spain. 21. Faculty of Medicine, Klinikum rechts der Isar, Technical University Munich, Germany. 22. Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 23. Department of Nephrology, Dialysis & Internal Diseases, The Medical University of Warsaw, Poland. 24. Department of Nephrology, Ghent University Hospital, Belgium.
Abstract
BACKGROUND: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. METHODS: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. RESULTS: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07-10.68), non-academic centres (OR: 2.01; 95% CI: 1.09-3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35-6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21-3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76-4.47) of patients on home dialysis. CONCLUSIONS: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.
BACKGROUND: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. METHODS: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. RESULTS: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07-10.68), non-academic centres (OR: 2.01; 95% CI: 1.09-3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35-6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21-3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76-4.47) of patients on home dialysis. CONCLUSIONS: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.
Entities:
Keywords:
Assisted peritoneal dialysis; end-stage kidney disease; home dialysis; practice variation
Authors: Filipe M O Silva; Priscila O Carvalho; Elerson C Costalonga; Rafael Pepineli; Raul C Maranhão; Irene L Noronha Journal: PLoS One Date: 2022-05-06 Impact factor: 3.752