Old and New Perspectives on Peritoneal Dialysis in Italy Emerging From the Peritoneal Dialysis Study Group Census

Perit Dial Int. Sep-Oct 2012;32(5):558-65. doi: 10.3747/pdi.2011.00112. Epub 2012 Mar 1.

Abstract

Background: To understand how peritoneal dialysis (PD) was being used in Italy in 2005 and 2008, a census of all centers was carried out.

Methods: In 2005 and 2008, data were collected from, respectively, 222 and 223 centers, with respect to 4432 and 4094 prevalent patients.

Results: In the two periods, the PD incidence remained stable (24.3% vs 22.9%), varying from center to center. Continuous ambulatory PD (CAPD) was the main initial method (55%), but APD was more widespread among prevalent patients (53%). Among patients returning to dialysis from transplantation (Tx), PD was used in 10%. The use of incremental CAPD increased significantly from 2005 to 2008, in terms both of the number of centers (27.0% vs 40.9%) and of patients (13.6% vs 25.7%). Late referrals remained stable at 28%, with less use of PD. The overall drop-out rate (episodes/100 patient-years) remained unchanged (31.0 vs 32.8), with 13.1 and 12.9 being the result of death, and 11.8 and 12.4 being the result of a switch to hemodialysis, mainly after peritonitis. A dialysis partner was required by 21.8% of the PD patients. The incidence of peritonitis was 1 episode in 36.5 and 41.1 patient-months, with negative cultures occurring in 17.1% of cases in both periods. The incidence of encapsulating peritoneal sclerosis (episodes/100 patient-years) was 0.70, representing 1.26% of patients treated. The catheter types used and the sites and methods of insertion varied widely from center to center.

Conclusions: These censuses confirm the good results of PD in Italy, and provide insight into little-known aspects such as the use of incremental PD, the presence of a dialysis partner, and the incidence of encapsulating peritoneal sclerosis.

MeSH terms

  • Censuses
  • Humans
  • Incidence
  • Italy
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / methods
  • Peritoneal Dialysis / statistics & numerical data*
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects
  • Peritoneal Dialysis, Continuous Ambulatory / methods
  • Peritoneal Dialysis, Continuous Ambulatory / statistics & numerical data*
  • Peritoneal Fibrosis / drug therapy
  • Peritoneal Fibrosis / epidemiology*
  • Peritoneal Fibrosis / surgery
  • Peritonitis / epidemiology*
  • Surveys and Questionnaires
  • Survival Rate