The Current Status and Future of Peritoneal Dialysis in Japan

2019 ◽  
pp. 78-86
Author(s):  
Hidetomo Nakamoto
Keyword(s):  
Peritoneal Dialysis ◽  
Current Status

National Comparisons: Optimal Peritoneal Dialysis Outcomes among Japanese Patients

1999 ◽  
Vol 19 (3_suppl) ◽  
pp. 9-16 ◽  
Author(s):  
Yoshindo Kawaguchi
Keyword(s):  
Peritoneal Dialysis ◽  
Positive Selection ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Therapeutic Intervention ◽  
Scoring System ◽  
Japanese Patients ◽  
Current Status ◽  
Technique Survival ◽  
Ultrafiltration Failure ◽  
Dialysis Outcomes

This paper describes the current status of chronic dialysis in Japan and the guidelines used to initiate dialysis (scoring system), and reports the outcome of continuous ambulatory peritoneal dialysis (CAPD), focusing upon our center's experience. Fifty percent of CAPD technique survival was 6.9 ± 1.3 years among those patients classified as “positive selection.” The major causes of withdrawal from CAPD were ultrafiltration failure, the patients’ inability to continue on CAPD by themselves, and peritonitis. The clinical issues that most concern nephrologists in CAPD management are prevention and management of ultrafiltration failure, prevention/therapeutic intervention in encapsulating peritoneal sclerosis, catheter-related infections, and prevention of underdialysis.

Initiatives in Peritoneal Dialysis: Where Do We Go from Here?

1991 ◽  
Vol 11 (3) ◽  
pp. 274-278 ◽  
Author(s):  
Fredric a. Finkelstein ◽  
Michael Sorkin ◽  
Christina W. Cramton ◽  
Karl Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Psychosocial Factors ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Drop Out ◽  
Current Status ◽  
Dialysis Catheter ◽  
Technique Survival

In 1989, a conference was held to discuss the current status of technique survival for patients treated with continuous ambulatory peritoneal dialysis (CAPO). Major reasons for patient drop -out from CAPO -peritonitis, inadequate dialysis, catheter-related problems and psychosocial factors -were reviewed, as were constructive techniques for dealing with these problems and areas for future investigation.

Current Status of Peritoneal Dialysis in Korea: Efforts to Achieve Optimal Outcome

1999 ◽  
Vol 19 (3_suppl) ◽  
pp. 17-25 ◽  
Author(s):  
Dae-Suk Han ◽  
Jae-Ha Hwang ◽  
Duk-Hee Kang ◽  
Hyun-Yong Song ◽  
Hyunjin Noh ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
Control Measures ◽  
Current Status ◽  
Lower Percentage ◽  
Korean Patients ◽  
Important Barrier ◽  
Expected Benefits ◽  
Stage Renal Disease ◽  
End Stage

Since its introduction in 1981, peritoneal dialysis (PD) has become firmly established as an effective mode of renal replacement therapy and serves an increasing patient population in Korea. The latest registry data indicate that about 3700 end-stage renal disease patients are maintained on chronic PD, representing 24.1% of the country's dialysis population. The majority (93.3%) of these patients are on continuous ambulatory peritoneal dialysis (CAPD) using the two-bag disconnect system, while only 3.3% are on automated PD. Under current renal reimbursement policies, most dialysis patients have to pay 20% of dialysis fees. Thus CAPD patients on 4 x 2-L daily exchanges pay about US$200 per month, not including medication and travel costs. Traditionally, most PD centers in Korea have used the “standard” prescription of 4 exchanges of 2 L of solution for most of their patients. A recent survey of 1467 patients who commenced CAPD in 1997 revealed that 84% of these patients were initially prescribed 4 x 2-L exchanges, while 12% were given a daily volume of 6 L. With this standard prescription, the percentages of Korean CAPD patients initially achieving the adequacy target of Kt/V urea ≥ 2.0 and standardized creatinine clearance (SCCr) ≥ 60 L/week/ 1.73 m2, were 74.4% and 82.1%, respectively. It is likely that, among current Korean CAPD patients, a much lower percentage will achieve the clearance targets compared to this initial outcome, but the precise data are not available. However, it is not clear whether the levels of small-solute clearance recommended for optimal PD outcomes, and proposed by the NKF-DOQI guidelines, will bring the expected benefits to Korean patients. Overall survival of Korean PD patients appears to be as good as, or even better than, that in most other countries. Recently, a single large PD center reported patient survival of 92.1%, 85.6%, 81.4%, and 67.6% at 1, 2, 3, and 5 years respectively. Other centers also reported similar outcomes. As in other countries, cardiovascular deaths predominate among Korean patients: death was due to cardiac causes in 29%, to vascular causes in 21%, and to infectious causes in 24%. Peritonitis is the most important barrier to prolonged use of CAPD in Korea, and more PD patients transfer to hemodialysis because of peritonitis than in other countries. To further reduce the morbidity and mortality of Korean PD patients, various control measures need to be implemented that can reduce or prevent peritonitis and other infectious complications. Also, to further improve long-term patient outcome, Korean nephrologists need to establish and practice optimal clearance targets in the chronic care of these patients.

scholarly journals Haemodialysis vascular access: current practices amongst Indian nephrologists

2018 ◽  
Vol 19 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Dinesh Bansal ◽  
Vijay Kher ◽  
Krishan Lal Gupta ◽  
Debasish Banerjee ◽  
Vivekanand Jha
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Transplantation ◽  
Renal Replacement Therapy ◽  
Vascular Access ◽  
Average Cost ◽  
Online Survey ◽  
Current Status ◽  
Dialysis Patients ◽  
Conservative Care ◽  
Access Services

Introduction: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. Methods: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. Results: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care. Forty-eight percent of patients were self-paying, 26% had employee reimbursement and 23% had insurance. According to 59% of responders, more than three-quarters of patients started dialysis with uncuffed catheter, less than one-quarter started dialysis with fistula; and very few used grafts or tunnelled catheters. Among prevalent HD patients, over half were dialysing with fistula (79% nephrologists), rather than uncuffed catheters (15% nephrologists) or grafts (<1% nephrologists). Sixteen percent reported at least one catheter-related sepsis in more than half of patients. Placement of uncuffed catheters cost US$160 in 92% facilities, whereas tunnelled catheters cost US$320 in 46% of facilities. An arteriovenous fistula (AVF) could be created for US$160 in 40%, and US$320 in 90% of centres. Thirty-five percent of nephrologists reported that grafts were not placed at their institute and where they were available, the average cost was over US$480. Forty-six percent of nephrologists had access to pre-dialysis clinics, <30% to vascular access programmes, and <17% conducted regular vascular access audits. Conclusions: The survey provides a snapshot of the current status of vascular access care in HD patients and highlights need for pre-dialysis clinics, vascular access services and registry audits.

scholarly journals Annual dialysis data report 2018, JSDT Renal Data Registry: dialysis fluid quality, hemodialysis and hemodiafiltration, peritoneal dialysis, and diabetes

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kosaku Nitta ◽  
◽  
Masanori Abe ◽  
Ikuto Masakane ◽  
Norio Hanafusa ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Current Status ◽  
Patient Questionnaire ◽  
Diabetic Patients ◽  
Dialysis Fluid ◽  
Annual Survey ◽  
Data Registry ◽  
Glycemic Indices ◽  
Dialysis Facilities ◽  
Survey Questionnaires

AbstractThe annual survey questionnaires of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) were sent to 4458 dialysis facilities at the end of 2018; 4402 facilities (98.7%) responded to the facility questionnaire, and 4222 facilities (94.7%) responded to the patient questionnaire. This paper reports the results obtained in regard to several issues: dialysis fluid quality, prescription of hemodialysis and hemodiafiltration, current status of peritoneal dialysis, and glycemic indices and treatment of diabetic patients.

Current Status of Children on Peritoneal Dialysis in Korea: A Cross-Sectional Multicenter Study

2009 ◽  
Vol 13 (2) ◽  
pp. 176 ◽  
Author(s):  
Ji-seok Youn ◽  
Joo Hoon Lee ◽  
Young Seo Park ◽  
Hyung-Eun Yim ◽  
Kyung-Hoon Paik ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Multicenter Study ◽  
Current Status ◽  
Cross Sectional

Peritoneal Dialysis: Current Status and Future Applications

1964 ◽  
Vol 11 (3) ◽  
pp. 593-609 ◽  
Author(s):  
Kevin G. Barry ◽  
Franklin D. Schwartz
Keyword(s):  
Peritoneal Dialysis ◽  
Current Status

Peritoneal Dialysis in India: Current Status and Challenges

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 36-41 ◽  
Author(s):  
Vivekanand Jha
Keyword(s):  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Government Policies ◽  
Current Status ◽  
End Stage Kidney Disease ◽  
Dialysis Dose ◽  
Integrated Therapy ◽  
Number Of Patients ◽  
End Stage ◽  
The Ideal

With its ambulatory nature and freedom from complicated and expensive technology, chronic peritoneal dialysis (PD) is the ideal renal replacement therapy for resource-poor India. Despite being available for more than 15 years, PD has been limited in its growth because of economic factors, inadequate government policies, nephrologist bias, and lack of adequate pre-dialysis care. The number of patients initiated on therapy has increased in recent years, but the number of early dropouts remains high. Single-center studies suggest that contributors to poor outcome include gram-negative peritonitis, malnutrition, and failure to increase the dialysis dose as residual renal function declines. Development of a national PD registry and increased educational activities to position PD as part of integrated therapy for end-stage kidney disease would improve utilization of the PD modality.

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