PD in Italy: The 4th GSDP-SIN census 2012

Abstract

OBJECTIVES To know PD modalities and results in Italy.

METHODS The Census was carried out by means of an on-line questionnaire in all the 224 non-pediatric public centers which performed PD in 2012. The results were compared with those of previous Censuses.

RESULTS

Incidence. In 2012 PD was begun (first treatment for ESRD) by 1,433 pts (CAPD: 54.3%) and HD by 4,700 pts (%PD-incidence= Cs-12: 23.4%; Cs-10: 23.3%; Cs-08: 22.8%; Cs-05: 24.2%; p=NS), with a further increase in incremental PD (Cs-12: 28.8%; Cs-10: 22.8%; Cs-08: 18.3%; Cs-05: 11.9%; p<0.001).

Prevalence. At 31/12/12 there were 4,299 patients on PD (CAPD: 46.1%) (%PD-prevalence= Cs-12: 17.1%; Cs-10: 16.6%; Cs-08: 16.7%; Cs-05:16.8%; p=NS), 24.5% of whom were on assisted PD (family members: 82.3%; paid caregivers: 12.4%; nurses: 0.7%;  NH: 3.0%).

Out. In 2012 there was no change in the PD drop-out rate (30.9 ep/100yrs-pt) (death: 481; transplant: 290; switch to HD: 511 pts). The main reason for transferring to HD remained peritonitis (28.2%).

Peritonitis. The peritonitis rate (1,179 episodes) was 0.284 ep/yrs-pt.

EPS. The incidence of new cases of EPS in 2011-12 (43 cases=0.505 ep/100yrs-pt) remained unchanged (2009-10= 0.529; 2004-08= 0.701 ep/100-yrs-pt).

Other results. Compared to 2010, in 2012 the number of Centers using 3.86% for PET increased (30.8% vs 15.6%-p<0.001), while the number carrying out home visits remained unchanged (56.3 vs 59.4%).

CONCLUSIONS Cs-12 confirms the extensive use, stability and good results of PD in Italy. Incremental PD is on the increase. EPS remains a rare event.

Key words: Assisted Pd, Home Visit, Incremental Peritoneal Dialysis, Peritoneal Dialysis, Peritonitis, Technique Failure

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INTRODUZIONE

L’utilizzo della dialisi peritoneale (DP) in Italia è risultato confinato, nel 2012, ad una incidenza del 12,8% ed una prevalenza del 9,8% (1) se si considerano tutti i Centri Dialisi, anche quelli che non utilizzano la metodica, ed è rimasta sostanzialmente stabile negli ultimi anni, sempre comunque con una notevole variabilità da regione a regione e da centro a centro (2). L’utilizzo della DP viene rilevato dal Gruppo di Studio della DP (GSDP) della Società Italiana di Nefrologia (SIN) mediante un Censimento, condotto ogni 2 anni, di tutti i Centri che utilizzano la DP.

In questo report sono presentati i risultati dell’edizione condotta nel 2013-14 e relativa all’anno 2012 (Cens-12), confrontati con quelli degli anni precedenti: 2005 (Cens-05) e 2008 (Cens-08) (3), 2010 (4) e con i dati internazionali.
 

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