Peritoneal Dialysis Access -- Results from a UK Survey.

摘要

OBJECTIVE: To obtain information about peritoneal dialysis (PD) access practices in the United Kingdom. METHODS: During July of 2007, a PD access survey was circulated to 80 clinical directors of renal units in the UK. RESULTS: Returns were received from 43 units; annual catheter insertion numbers ranging from 5 to 100 (median 34, mean 38) were reported. The majority of responding centers (30/43) reported a waiting time for catheter insertion of 1 week to 1 month; primary patency rates were reported as >90% in 26 and 60%-90% in 16 centers. Day case catheter insertion was reported by 19 of the 43 respondents. Most centers (40) reported that catheters could be removed in 2 days or sooner when required. The majority of surgical problems (hernia, leaks, or catheter malfunction) were reported as being managed in 1 - 4 weeks. A variety of catheter insertion techniques were reported: 22 centers used surgical insertion alone; 13 used a combination of surgical and medical percutaneous techniques; 4 reported using a combination of surgical and peritoneoscopic insertion; 2 centers reported using combinations of all 3 techniques; 1 center used only a radiographic technique and another used only the peritoneoscopic technique. Catheters were most often inserted by consultant surgeons (71.7%), followed by consultant nephrologists (19.3%), trainee nephrologists (2.9%), trainee surgeons (2.4%), associate specialists (2.4%), or a nurse specialist (1.2%). Two thirds of respondents indicated that they would be interested in attending a medical catheter-insertion training program. CONCLUSION: In the UK, reducing waiting times for PD catheter insertion may have an important role in increasing patient access to the technique.