Introduction

The Peritoneal Dialysis Project Group (GPDP) of the Italian Society of Nephrology (SIN) investigates the state of Peritoneal Dialysis (PD) in Italy periodically by means of a Census carried out in the Centers which use it [1–7]. The last edition, relating to 2022 [7], showed a reduction in the incidence and prevalence of PD compared to 2016 (the 2019 edition was incomplete, conducted as it was at the height of the COVID pandemic).

As with the previous 2022 edition, all the Centers using PD took part in the current edition – the Ninth – relating to 2024. It should be remembered, however, that these Centers represent around two-thirds of public Centers (PD is not available as a service in the remainder). When it is considered also that PD is not used in private Centers, the method is actually provided in a minority of Italian Dialysis Centers, and used by less than 10% of patients on Dialysis. The reasons for such a disheartening picture were investigated in the very first Census carried out by SIN in 2004 [8] and by the Questionnaire conducted by the GPDP in 2007 [9], and though they are likely to partly still be the same, new factors seem to be hindering a more widespread use of PD.

The current edition raises several points of interest and new aspects. First of all, it is the second “post COVID” edition. The number of Centers taking part increased significantly with the use of a new data collection system introduced during the pandemic [6], allowing for greater precision in the data collected. For the second time, not only the incidence, but also the etiology of peritonitis were investigated thoroughly, as well as certain structural aspects of PD Centers, such as the dedicated personnel and training, while a full analysis was possible for the first time of the patients who were started on PD due to cardiopathy rather than ESRD, and this will be the subject of a forthcoming detailed analysis.

This report presents the results of the 9th edition, conducted over the first few months of 2025 and relating to 2024, compared with those of the previous years.

Completing the report are the results of the first National Peritoneal Dialysis Audit in which some of the more discussed PD practices have been considered (in preparation).

 

Materials and methods

The GPDP Census collects aggregate data relating to PD, and is targeted at all the non-pediatric Centers which used PD in the year in question.

Data collection

As for 2022 [7], the aggregate data were collected in two different ways. The first was analytical, using specially designed software: a sort of medical record in which individual patients are entered systematically, and the data are exported for the Census in aggregate form. For the protection of privacy the program was developed without a cloud component, so all the data collected are stored locally and the possibility of backup to server is delegated to the operator. This system has several limitations in terms of logistics and calculation, the main one being the need to update the software – version 4.0 in 2024 – to the information to be “extracted”.

The number of Centers using this system in 2024 remained substantially unchanged from 2022 (Cs-19: 110 Centers; Cs-22: 175 Centers; Cs-24: 170 Centers). The method used by the remaining 58 Centers was the traditional collection of data by filling in the online questionnaire used for previous editions.

In total, the Census reports data from 228 Centers, which is 100% of Italian PD Centers. Of the 9 editions so far, only the Census relating to 2019 was incomplete (198 Centers).

Participating Centers

The initial list of public Centers using PD established in the first SIN Census conducted for 2004 [8] has been updated over the years through attendances at Congresses, Conferences and subsequent SIN Censuses, with a further verification carried out for 2024 by GDPD’s regional contacts based on local knowledge.

The number of Centers which treated at least 1 patient with PD in 2024 was 228. While all the Centers responded to the questions on the incidence and prevalence of PD, 46 Centers provided no data on the incidence and prevalence of HD (Figure 1).

Information

The structure of the Census provides for a series of repeated pieces of information – unchanged since the first edition in 2005 [1] – relating to incidence, prevalence, method change or interruption, assisted PD, peritonitis and non-renal PD. Encapsulating peritoneal sclerosis (EPS) has been added since 2008, and home visits and the peritoneal equilibration test (PET) since 2010 [2]. The questions on catheters resumed in the 2016 edition [5]. Furthermore, with the analytical data collection method, which was first used in 2019 and has been improved in this edition, information is available on the causes of Renal Insufficiency, causes of death, certain organizational aspects such as training methods and available resources, and the etiology of peritonitis, and for the first time it has been possible to fully analyze the patients started on PD on non-renal grounds separately.

Data verification and comparison

The data collected were initially subjected to congruence analysis. Any inconsistent data were corrected wherever possible by follow-up phone call, or were considered missing or incomplete, as appropriate. Any corrections and the number of Centers involved are reported in detail in the presentation of the single results.

Definitions and calculations

All the patients who started as first treatment on PD and HD from 01/01/2024 to 31/12/2024 were considered incident. Of these, the patients on ≤2 exchanges/day or ≤4 sessions/week with CAPD (Incr-CAPD) and APD (Incr-APD) respectively were considered as on incremental PD (Incr-PD). Prevalence refers to patients on dialysis at December 31st. For these, a need for assistance refers to the involvement of a caregiver in the performance of the dialysis procedures. For the first time it was possible to analyze the patients started on PD on non-renal grounds separately, though as mentioned only for the Centers which used the analytical system to send the data. Non-renal reasons for PD were heart and liver conditions.

The calculation of the follow-up to relate events to represents the critical aspect of the Census. With it being impossible to calculate the actual data (the sum of the periods all patients spent on PD in 2024) the follow-up has always been estimated by taking the mean of prevalent patients at the beginning and the end of the year, a method which has also recently been validated [10]. The prevalent patients at the beginning of the year were calculated by taking the prevalent patients at the end of the year, adding drop-outs for all causes, and subtracting new patients to PD (information available). This year it was possible to calculate the follow-up precisely for the 170 Centers which used the “4.0” program. In these Centers, the comparison between the two methods showed that “traditional” follow-up underestimates the “actual” follow-up by 1.7%, so it overestimates by an equivalent amount the incidence of the events considered. As the data collection system was still mixed for 2024, the traditional method was used to calculate follow-up for all 228 Centers in order to be able to compare current results with previous years. The drop-outs from PD recorded in the year were related to 100 patient-years of follow up, while for peritonitis the incidence was calculated as episodes/patient-years (ep/pt-year). Episodes of EPS refer to the entire 2023-24 two-year period.

The Census is a “photograph” of the current situation, so statistical analysis was limited to looking for any differences with the Chi square test. Incremental PD and PD for heart failure will be the subjects of two forthcoming analyses.

 

Results

Incidence and initial method

In 2024, PD was started on as first treatment by 1398 patients, with 770 using CAPD and 628 APD. The Centers with no incidence in PD in 2024 numbered 18.

HD incidence and prevalence data were provided by 182 Centers, where 1132 patients started on PD as first treatment, and 4734 on HD, giving a percentage PD incidence of 19.3% (19.8% in 2022) (Table I) (Figure 2).

This PD incidence percentage is clearly overestimated, because it refers to the minority of public and private Italian dialysis Centers which use the method. To attempt to estimate the actual incidence of PD in Italy correctly, we have used the Italian Dialysis and Transplant Registry (RIDT) incidence per million population (pmp), which was 168 pmp for 2023 (data kindly provided in advance by Dr. Maurizio Nordio). As a proportion of the population of Italy as of 31/12/2023 (available National Institute of Statistics ISTAT data), 23.7 pmp of patients therefore started on PD, in other words 14.1% of all incident Dialysis patients (Figure 3). This can be considered stable compared to previous years.

The most widely-used initial PD method remains CAPD (55.1%), closely related to incremental prescription (Figure 4).

For the second time, basic nephropathy data are available, though only for the 170 Centers which sent data using the 4.0 system. The conditions in which PD is most used are Nephroangiosclerosis (24.2%) and chronic Glomerulonephritis (21.7%). The cause of ESRD is diabetic nephropathy in 14.4% of cases and ADPKD in 7.6% of cases, while in 17.2% it is not known (Figure 5).

The mean age of incident patients on PD, calculated as the weighted average of the aggregate average of the 165 Centers which provided congruent data, was 64.3 years (Figure 5).

Finally, for the first time it was possible to estimate the number of patients who were incident for non-renal causes (heart and liver failure). Out of the 1398 incident patients, 72 (5.2%) started on PD due to heart failure and 3 (0.2%) liver failure.

Placement of the peritoneal catheter

All insertions were considered for the placement of the catheter. Excluding 49 patients due to incongruent or no data, in the 1349 patients who started on PD in 2024, there was a further increase in placements by a surgeon alone, the number of placements by a surgeon and a nephrologist together was stable, and placements by a nephrologist alone diminished (Figure 6) (Figure 7).

VLS was used in 9.5% of cases (Figure 7).

Initial dialysis dose – incremental peritoneal dialysis

PD was started on in 2024 using the incremental method (Incr-PD) by 562 patients, equalling 40.2% of total incident patients (Figure 8); it was used for at least 1 patient by 155 Centers, equalling 68.0% of the 228 Centers (73.8% when excluding the 18 Centers with no incidence), increasing compared to previous years.

For the patients who started PD with an incremental dose, the most widely-used method – as in previous years – was CAPD (84.5%), as opposed to the patients who started with a full-dose prescription, for whom APD is significantly more widely-used (66.3% – p<0.0001) (Figure 8). CAPD is a PD method which is increasingly associated with the incremental prescription and the Centers that perform it. Over the years, the number and percentage of incident patients on Incr-PD have been rising constantly, from the 11.9% of 2005 to the current 40.2% (Figure 9). The increase recorded in 2024 can be attributed to both a rise in the number of Centers prescribing it (73.8% in 2024 and 63.0% in 2022, while in 2005 it was 29.2%), and the increased number of patients for whom it is prescribed in those Centers (50.9% in 2024 vs 47.8% in 2022). The incremental prescription will be the subject of a forthcoming detailed analysis.

Patients from other treatments

In 2024, 201 patients transferred from HD to PD (Table II) (Figure 10).

	1st TREAT.	FROM HD	FROM TX	NEW TO PD	FROM HD (%)	FROM Tx (%)
2005	1443	89	25	1557	5.7	1.6
2008	1379	82	32	1493	5.5	2.1
2010	1429	126	36	1591	7.9	2.3
2012	1433	113	50	1596	7.1	3.1
2014	1652	161	46	1859	8.7	2.5
2016	1595	119	50	1764	6.7	2.8
2019	1363	125	44	1532	8.2	2.9
2022	1350	178	48	1576	11.3	3.0
2024	1398	201	57	1656	12.1	3.4

Table II. Patients (absolute value and percentage of all new patients to PD) from HD and return post-Transplant.

As expected, this data is decidedly lower than the number of patients switching from PD to HD (527 drop-outs in 2024), but higher in both absolute and percentage terms: indeed, in 2024 it represents 12.1% of all new patients to PD, compared to 5.7% in 2005 (Figure 11). While for every 100 patients who transferred from PD to HD in 2005 there were 17 took the reverse path, in 2024 the latter figure was 38.

As regards a return to PD post-Transplant, the numbers and percentages have remained substantially unchanged over time (Figure 12), although the percentage value compared to return to HD is made more uncertain by the increasingly low number of Centers sending the data (66.2% in 2024, Figure 12). As expected, for the probable lower RRF the most widely-used PD modality used initially in these patients is APD, contrary to what is observed in incident patients (Figure 4).

Change of PD method

Information on the change of method was available for 221 Centers. In these Centers, 203 patients transferred from CAPD to APD in 2024, while 41 transferred from APD to CAPD (Figure 13).

As in previous years, the reason for the change in around half of cases was patient and/or caregiver choice. Other grounds were insufficient clearance / UF for the switch from CAPD to APD, and catheter malfunction for the switch from APD to CAPD.

Prevalence and PD method

At December 31st 2024 there were 4322 patients on PD, with 1890 on CAPD and 2432 on APD. Compared with 2022, an increase of 4.1% was recorded in the prevalent population (Figure 14) (Table III).

In the 182 Centers with complete incidence and prevalence data for HD as well, there were 3526 patients on PD and 19,397 on HD, with a 15.4% PD prevalence. Like the incidence, in Figure 3 is reported the “real” PD prevalence in Italy.

The most widely-used PD method among prevalent patients is APD (56.3%) (Figure 4), with a further increase compared to previous years (Table III).

The turnover calculated as the ratio of prevalent patients to the total of new patients on PD in 2024 was 31.3 months, substantially unchanged compared to previous years (it was 32.9 months in 2008). The trend in turnover over the years is given in detail in Figure 15.

Assisted PD

In Cs-24 a caregiver (assisted PD) was required by 904 prevalent patients in the 221 Centers with data available (21.4% of all prevalent patients on PD in these Centers) (Figure 16), almost identical to the data recorded in 2022. Compared to 2019 (976 patients on Assisted PD in an incomplete Census), this confirms a significant reduction (p<0.005).

The caregiver is a family member in 86.2% of cases (Figure 17), a live-in carer in 8.1% and a home nurse in 3.0%; finally, 2.8% (25 patients) perform PD in facilities for the elderly (Figure 18).

Change of method and drop-out

Figure 19 shows both overall drop-out and drop-out due to transfer to HD, death and transplant, expressed as both number of patients and events/100 pt-years.

The number of deaths recorded in 2024 was 400 (9.7 ep/100 pt-years), with 527 patients transferring to HD (12.7 ep/100 pt-years) and 351 to transplants (8.5 ep/100 pt-years). A reduction in mortality was confirmed for 2024 compared to 2022 and 2016. Other causes of drop-out from PD in 2022 were voluntary refusal to continue dialysis (burn out) for 7 patients, Recovery of Residual Renal Function (RFRR) in 12 patients and “other” grounds for 22 patients.

With regard to drop-out to HD (Figure 20), the single main cause remains peritonitis (21.8%), but its reduction over the course of the years was confirmed (2005: 37.9%; 2008: 36.7%; 2010: 30.4%; 2012: 28.2%; 2014: 24.8%; 2016: 23.8%; 2022: 23.5%). The second cause – on the increase constantly since 2016 (8.5%) – is the catheter (16.9%), followed by UFF (13.5%) and dialysis adequacy (13.1%), while impossibility to continue on PD (9.5%) – which represented 22.4% of all drop-outs in 2022 – is falling sharply. This is most probably because the definition of “impossibility to continue” was limited in 2024 to cases of self-management of PD (loss of independence or caregiver), whereas in the past it referred to events that rendered the patient no longer suitable for the performance of dialysis procedures due to the onset of barriers to independence (physical, psychological, cognitive) in the event of absence or loss – if already on assisted PD – of the caregiver. In the past, in the absence of a precise indication other clinical events – such as mechanical (pleuroperitoneal communication, for example) or surgical complications – may also have been attributed to this cause. The increase in other causes of interruption” from 3.0 to 17.6% confirms this interpretation.

The main cause of death is heart disease (42.3%), while peritonitis represents 0.9% of deaths (Figure 21).

Peritonitis

The number of episodes of peritonitis recorded in 2024 was 647 in 213 Centers (93.4% of Centers with data available), which for a total follow-up of 3937.5 years is equivalent to 0.164 episodes per patient-year, or in other terms 1 episode every 73.0 patient-months, a lower incidence than recorded in previous years (Table IV). The peritonitis trend is given in both Table IV and Figure 22.

		INCIDENCE
	PERITONITIS	ep/pt-year	pt-month/ep	NEGAT (%)
2005	1026	0.329	36.5	17.1
2008	1171	0.292	41.1	17.1
2010	1209	0.296	40.5	18.5
2012	1179	0.282	42.5	15.9
2014	953	0.224	53.5	19.9
2016	939	0.212	56.6	17.3
2019	667	0.189	63.5	18.7
2022	696	0.176	68.0	19.3
2024	647	0.164	73.0	17.9

Table IV. The episodes of peritonitis recorded by 73% of surveyed Centers are given for 2005, while not all recorded them in 2019 (and 4 did not report the data). For 2022 the data refer to all the Centers, except 1 which was unable to retrieve it. The calculation is taken from the overall number. Any discrepancy with the number of etiological agents has not been taken into account for standardization with the previous years (in which the etiology was not investigated). For 2024 the data were provided by 93.4% of the Centers (213).

As regards the etiology, around half (46.8%, 303 episodes) of the 116 negative cultures (17.9%) were caused by Gram positives and 28.6% (185 episodes) by Gram negatives (Figure 23).

SA (30.7%), SE/CoNS (24.8%) and Streptococcus (19.1%) are the most frequently isolated Gram positive bacteria (Figure 24), while PA, Escherichia and Klebsiella represent 53%  of Gram negative etiological agents (Figure 25).

Encapsulating peritoneal sclerosis (EPS)

Of the 9 new episodes of EPS reported during the period 2023-24 (0.106 ep/100 pt-year), 6 were diagnosed in the course of PD and 3 following transfer to HD. No cases were reported following a transplant (Figure 26).

PET

Peritoneal permeability is assessed by most of the Centers (97.4%). PET with 3.86% is the preferred modality (58.1% of Centers) (Figure 27). Most centers assess peritoneal permeability as needed (48.6%) or once a year (38.9%) (Figure 28).

PD for heart failure

For the first time, in the 170 “4.0 Centers” it has been possible to consider separately the use of PD for heart failure defined by diuretic therapy-resistant hydrosaline retention (the classic “single exchange”) or by type II cardiorenal syndrome. Overall, 72 (5.2%) of the 1398 incident patients started on PD for heart failure. This could only be fully analyzed however for the 170 Centers which sent aggregate data using the 4.0 system. In these Centers, the number of incident and prevalent patients for heart failure were 47 and 72 respectively, with 38 (22.4%) treating at least 1 patient for heart failure with PD in 2024. The mean age on admission was 74.4 years (decidedly higher than that of the overall population), and the most widely-used method was CAPD (79%), in incremental modality in 57% of cases  (Figure 29).

Of the 72 prevalent patients, 62% were on assisted PD, and the mean duration of the PD was 18.4 months, with a mortality rate of 38.7 ep/100 pt-yrs. The incidence of peritonitis was 0.097 episodes/patient-year (Figure 30).

Training and Home Visits

For the 220 Centers (96.5%) which responded to the questions on Training, the trainer was in-Center in 56.4%, external in 12.7%, and in the remainder either internal or external (Figure 31-A) in forms which were not investigated further.

As regards the venue for the training, in 49.1% of cases it was performed in-Center, in 11.4% of the Centers only at home, and in 39.5% of  the Centers partly in-Center and partly at home (Figure 31-B). When the trainer is internal, in 83.8% of cases it is performed in-Center, when the trainer is external it is performed in 64.3% of cases at home, and when the training is performed by either an internal or an external trainer in 85.3% of cases it takes place partly in-Center and partly at home (Figure 32).

Following the start of PD, home visits are only carried out by a minority of the Centers (101 Centers = 45.7% of the 221 Centers which responded), confirming the 2022 proportion but less than in the previous years (59.4% in 2010). The number of Centers performing them regularly – already small – has declined slightly (7.2%). The remainder only carry out home visits during the first few months (7.2%) or in case of necessity (31.2%) (Figure 33).

In all cases, the nurse is involved, either alone (45.5% of cases) or with a doctor in varying ways, but it is never the doctor alone (Figure 34-A). The involvement of a doctor increases as the VD program becomes more intense (Figure 34-B).

Analysis of the Centers

Mean prevalence was 19.0±16.9 patients per Center, with considerable variability between one Center and another (Figure 35).

Most of the Centers involved and of the prevalent patients are concentrated in the North (46.5% of Centers, 55.8% of PD patients) (Figure 36). Figure 37 shows the geographical distribution of prevalence pmp.

 

Discussion

The limitations of the Census

Launched in 2005, over these 20 years the PD Census has represented the result of a constant organizational effort by GPDP-SIN and all its PD contacts in the Centers using PD in Italy. Following the difficulties in the 7th edition due to the pandemic, as in 2022 100% of PD Centers took part once again in this 9th edition in 2024.

The real limitation of the Census lies in its very nature of being simply a “snapshot” – however detailed it may be – of just the Centers that use PD, which – as is known – are a minority of the Dialysis Centers in Italy. This limitation has been accentuated in the last few editions by the growing difficulty for Center contacts to send even basic information relating to patients on HD in their Centers. Recorded for the first time in 2016, the percentage of Centers not sending HD data is similar in 2024 to 2022 (21.8%).

The most important new feature is represented by the new system for collecting the data by means of a dedicated program that facilitates the sending of the data in aggregate form alone. This system has greatly reduced data incongruence and has increased the information available. However it is still not used by a sizeable number of Centers, so traditional calculation and processing methods have been applied to all the Centers in this edition too, in particular in regard to the follow-up to relate events to. Assessed in this way, the follow-up is an underestimation, and as a result overestimates the incidence of events.

The use of PD

The number of incident and prevalent patients on PD has increased slightly: +3.6% and +4.1% respectively. The number of patients on PD at 31/12/2024 remains the highest in Europe [11]. For the Centers which also provided HD data, compared to 2022 the percentage incidence and prevalence (compared to total number of patients on dialysis) were slightly lower (from 19.6% to 19.3%) and slightly higher (from 14.9% to 15.4%) respectively. Considered in relation to the population in Italy, the percentage incidence and prevalence of PD remain limited to 14.1% and 9.5%  of the patients on dialysis.

Incremental Dialysis has been investigated since the first edition of the Census [1, 12], and increased further in 2024 in terms of both number of Centers prescribing it and greater use in the single Centers. The advantages of this prescriptive modality are increasingly clear [13, 14], and it will be subject to more in-depth processing.

The reduced use recorded in 2022 of assisted PD – strictly linked to the support of family members (in over 80% of cases) – is confirmed for 2024.

In short, in Italy PD concerns patients who are younger, mostly early referral and started on the incremental modality using CAPD.

Drop-out from PD and peritonitis

The improvement in the mortality rate was confirmed in 2024, while drop-out for transfer to HD and transplant increased. Overall, the mean duration of a patient on PD remained unchanged (31.3 months). Peritonitis is falling constantly for transfer to HD, while catheter malfunction is increasing. The reduction in “interruptions due to impossibility to continue” recorded in 2024 compared to 2022 (from 22.4% to 9.5%) is due to the redefinition of this cause, limiting it to loss of suitability for self-management alone.

The incidence of peritonitis dropped further in 2024 to 0.164 episodes/patient year. Essentially, the reduction in peritonitis from the 5 episodes per patient-year of the ‘80s to less than 1 episode every 6 year represents the method’s most notable success. In particular, from the first Census in 2005 (1 episode every 36.5 months) to today (1 episode every 73.0 months) the incidence of peritonitis has halved. This is one of the lowest recorded in the western world, and decidedly less than the maximum target value recommended by the ISPD guidelines in 2022 [15], and it is in line with the worldwide trend for this complication [16].

The reduction in the incidence of peritonitis is confirmed by the reduction in drop-out for peritonitis.

Also as regards the etiology, which has been fully investigated for the first time, the Census data are in line with what has been observed by other Registers and multi-center papers [17, 18]: a half gram positive, a fourth gram negative and a fifth culture negative. The last are in any case down compared with 2022.

Finally, the 2024 data on EPS confirm the major reduction in this complication in PD, which is limited to just a few cases occurring in PD and HD.

As in the previous edition, it is be underlined that while on the one hand it is likely that the incidence of EPS is underestimated (not communicated following transfer to HD or Tx), there are several factors which may have contributed to its actual reduction, including greater biocompatibility of the solutions used for years, incremental dialysis and the reduction in peritonitis.

Particular aspects

The monitoring of peritoneal permeability, and the way in which it is performed, is an important PD program quality indicator. The Census data show a constant increase over the years in the use of 3.86% PET from the 15.6% of Centers in 2010 to the 58.1% in 2024, but above-all a reduction in 2024 in the Centers not assessing peritoneal permeability to just 2.6% of the total number.

For the first time it was possible to analyze PD for heart failure separately. The results seem to be positive, both in terms of survival and of complications linked to dialysis. This is the first nationwide investigation of this issue, and is to be the subject of a dedicated detailed analysis.

Training is performed with the contribution of “external” personnel in 43.6% of the Centers, in-Center only in half of cases (49.1%). In alignment with training is the observation that home visits following the start of PD are still only carried out in a minority of the Centers.

The number of PD Centers and their characteristics have remained substantially the same, in particular the lower use of PD in the South of the country, though with extreme variability between regions and from Center to Center.

 

Conclusions

The PD Census relating to 2024 confirms the quality of PD in Italy in terms of elasticity of the prescription, reduction in the mortality rate, reduction in peritonitis and EPS, widespread – though diminishing – use of assisted PD, and monitoring of the peritoneal membrane.

Nevertheless, overall it is still used for less than 10% of prevalent patients undergoing dialysis treatment in Italy. The 2024 Census allows us to posit some of the reasons underlying the limited use of PD. In particular, the age of the patients, which is significantly lower than the mean age of the patients being admitted today to dialysis with an increasing number of particularly cardiovascular comorbidities and care needs. On the other hand, the use of assisted PD (limited to one-fifth of patients and largely assisted by family members), the difficulty involved in starting a home follow-up program and the need for external trainers are likely to be organizational issues which need to be addressed to enable more widespread use of the method.

 

Appendix 1: Acknowledgements 

Special thanks to the contacts in the Centers taking part in the Census, whose commitment has made the collection of the data and this report possible.

Albrizio Paolo (Voghera)

Alessandrello Ivana (Modica)

Alfano Gaetano (Modena)

Amar Karen (Cernusco sul Naviglio)

Ambrogio Antonina (Rovigo)

Ancarani Paolo (Sestri Levante)

Angela Maria Dinnella (Anzio)

Angelo Maria Letizia (Camposampiero)

Ansali Ferruccio (Civitavecchia)

Apponi Francesca (Frosinone)

Argentino Gennaro (Napoli)

Barattini Marina (Massa)

Barbera Vincenzo (Colleferro)

Basso Anna (Padova)

Bellizzi Vincenzo (Caserta)

Bellotti Giovanni (Sapri)

Benozzi Luisa (Borgomanero)

Bermond Francesca (Torino)

Bianco Beatrice (Verona)

Bigatti Giada (Desio)

Bilucaglia Donatella (Torino)

Boccadoro Roberto (Rimini)

Bonesso Cristina (San Dona’ di Piave)

Bonincontro Maria Luisa (Bolzano)

Bonvegna Francesca (Verbania)

Borettaz Ilaria (Vizzolo Predabissi)

Borrelli Silvio (Napol)

Bosco Manuela (Gorizia Monfalcone)

Bottai Anna (Pisa)

Braccagni Beatrice (Poggibonsi)

Brocca Jessica (Cinisello Balsamo)

Bruno Paolo Ferdinando (Cesena)

Budetta Fernando (Eboli)

Cabibbe Mara (Milano)

Cabiddu Gianfranca (Cagliari)

Cadoni Maria Chiara (San Gavino Monreale)

Cannarile Daniela Cecilia (Bologna)

Cannavo’ Rossella (Firenze)

Canonici Marta (Fabriano)

Cantarelli Chiara (Parma)

Capistrano Maria (Montichiari)

Caponetto Carmelo (Siracusa)

Cappadona Francesca (Genova)

Cappelletti Francesca (Siena)

Capurro Federica (Novara)

Capurso Domenico (Putignano)

Caria Simonetta (Cagliari)

Carta Annalisa (Nuoro)

Caselli Gian Marco (Firenze)

Casuscelli di Tocco Teresa (messina)

Cataldo Emanuela (Altamura)

Centi Alessia (Roma)

Cerami Caterina (Pavullo)

Cernaro Valeria (Messina)

Cerroni Franca (Rieti)

Ciabattoni Marzia (Savona)

Cianfrone Paola (Catanzaro)

Cimolino Michele (Pordenone)

Ciurlino Daniele (Sesto San Giovanni)

Comegna Carmela (Tivoli)

Congiu Giovanni (Asti)

Consaga Marina (Livorno)

Contaldo Gina (Monza)

Conti Paolo (Arezzo)

Cornacchia Flavia (Cremona)

Cosa Francesco (Lodi)

Cosentini Vincenzo (San Bonifacio)

Costantino Ester Grazia Maria (Manerbio)

D’Alonzo Silvia (Roma)

D’Altri Christian (Martina Franca)

D’Amico Maria (Erice Casa Santa)

De Mauri Andreana (Pavia)

D’Elia Filomena (Bari)

Della Gatta Carmine (Nola)

Della Rovere Francesca Romana (Civita Cast)

Di Franco Antonella (Barletta)

Di Liberato Lorenzo (chieti)

Di Loreto Ermanno (Atri)

Di Pietro Fabio (Caltanissetta)

Di Renzo Brigida (Brindisi)

Di Somma Agnese (San Marco Argentano)

Di Stante Silvio (Fano)

Dian Silvia (Schiavonia)

Domenici Alessandro (Roma)

Esposito Samantha (Grosseto)

Esposito Vittoria (Pavia)

Fancello Sabina (Tempio Pausania)

Fantinati Concetta (Imola)

Feliciani Annalisa (Seriate)

Ferrando Carlo (Cuneo)

Ferrara Gaetano (Foggia – S Giovanni Rotondo)

Fiederling Barbara (Latina)

Figliano Ivania (Vibo Valentia)

Figliola Carmela (Gallarate)

Filiberti Olivierio (Vercelli)

Filippini Armando (Roma)

Finazzi Silvia (Rozzano)

Finocchietti Daniela (Chieri)

Gabrielli Danila (Aosta)

Gai Massimo (Torino)

Galderisi Cristina (Albano Laziale – Ariccia)

Garofalo Donato (Fermo)

Gazo Antonietta (Vigevano)

Gennarini Alessia (Bergamo)

Gherzi Maurizio (Ceva)

Giancaspro Vincenzo (Molfetta)

Gianni Glauco (Prato)

Giozzet Morena (Feltre)

Giozzet Morena (Belluno)

Giuliani Anna (Vicenza)

Giunta Federica (Macerata)

Grazi Francesca (Montepulciano)

Graziani Romina (Ravenna)

Grullo Maurizio (Lamezia Terme)

Guizzo Marta (Castelfranco Veneto)

Heidempergher Marco (Milano)

Iadarola Gian Maria (Torino)

Iannuzzella Francesco (Reggio Emilia)

Iannuzzi Maria Rosaria (Napoli)

Incalcaterra Francesca (Palermo)

Kalikatzaros Ileana (Ciriè)

Kanaki Angeliki (Pontedera)

La Milia Vincenzo (Lecco)

Laudadio Giorgio (Bassano Del Grappa)

Lenci Federica (Ancona)

Leonardi Sabina (Trieste)

Lepori Gianmario (Olbia)

Lidestri Vincenzo (Chioggia)

Lisi Lucia (Vimercate)

Lo Cicero Antonina (San Daniele)

Lommano Nicola (Civitanova Marche)

Luciani Remo (Roma)

Lupica Rosaria (Taormina)

Maggio Milena (Crema)

Magnoni Giacomo (Bologna)

Malandra Rosella (Teramo)

Mancuso Verdiana (Agrigento)

Mangano Stefano (Tradate)

Mannucci Claudia (Pescia)

Marchetti Valentina (lucca)

Martelli Luca (Pinerolo)

Masa Alessandra (Sondrio)

Mastrippolito Silvia (Lanciano)

Mastrosimone Stefania (Treviso)

Mazzola Giuseppe (Mantova)

Messina Antonella (Catania)

Miglio Roberta (Busto Arsizio)

Miniello Vincenzo (Pistoia)

Mollica Agata (Cosenza)

Montemurro Vincenzo (Firenze)

Nardelli Luca (Milano)

Nava Elisa (Varese)

Neri Loris (Alba)

Nicolai Giuli Adriana (Conegliano)

Nicosia Valentina (Formia)

Ocello Alessandra (Sciacca)

Oliva Barbara (palermo)

Olivi Laura (Trento)

Paganizza Luca (Roma Tor Vergata)

Palmiero Giuseppe (Napoli)

Pani Alessandra (Acireale)

Panuccio Vincenzo (Reggio Calabria)

Panzino Antonio (Catanzaro)

Paola Nazzaro (Campobasso)

Papantonio Domenico (Foggia)

Paribello Giuseppe (Napoli)

Parodi Denise (Genova – Arenzano)

Pastorino Nadia (Novi Ligure)

Perez Giuseppina (Dolo)

Perilli Angela (Vasto)

Pezone Ilaria (Legnano)

Pieracci Laura (Imperia)

Pignone Eugenia (Rivoli)

Piraina Valentina (Ivrea)

Piscitani Luca (Avezzano – Sulmona – L’Aquila)

Piscopo Giovanni (Bari)

Pogliani Daniela Rosa Maria (Garbagnate)

Porcedda Claudia (Oristano)

Portale Grazia (Catania)

Previti Antonino (Santorso)

Puliatti Daniela (Catania)

Puliti Marialaura (Palestrina)

Re Sartò Giulia Vanessa (Milano)

Restivo Giuseppe (Enna)

Ria Paolo (Lecce)

Ricciatti Anna Maria (Ancona)

Rocca Anna (Roma)

Roccetti Stefano (La Spezia)

Romano Paolo (Venezia Mestre)

Romano Giuseppina (Avellino)

Romano Paolo (Venezia)

Rossi Natalia (Casale Monferrato)

Sabatino Stefania (Udine)

Sacco Colombano (Biella)

Sammartino Fulvio Antonio (Pescara)

Sansone Gennaro (Lauria)

Santarelli Stefano (Jesi)

Santese Domenico (Taranto)

Santinello Irene (Piove di Sacco)

Santirosi Paola (Foligno)

Santoni Stefania (Todi)

Saraniti Antonello (Milazzo)

Savignani Claudia (Città di Castello)

Scarfia Rosalia Viviana (Caltagirone)

Serriello Ilaria (Roma)

Silvestri Simona (San Benedetto del Tronto)

Somma Giovanni (Castellammare di Stabia)

Sorice Mario (Senigallia)

Spissu Valentina (Sassari)

Stacchiotti Lorella (Giulianova)

Stanzione Giovanna (Salerno)

Stucchi Andrea (Milano)

Taietti Carlo (Treviglio)

Tettamanti Maria Giulia (Como)

Tomaselli Martine (Roma Ostia)

Toriello Gianpiero (Polla)

Torre Aristide (Nocera Inferiore)

Trepiccione Francesco (Napoli)

Trubian Alessandra (Legnago)

Vaccaro Valentina (Alessandria)

Valsania Teresa (Piacenza)

Vecchi Luigi (Terni)

Veronesi Marco (Ferrara)

Visciano Bianca (Magenta)

Viviana Finato (San Miniato)

Vizzardi Valerio (Brescia)

Zambianchi Loretta (Forlì)

Zeiler Matthias (Ascoli Piceno)

 

Bibliografia

1. Marinangeli G, Cabiddu G, Neri L et al; Italian Society of Nephrology Peritoneal Dialysis Study Group. Old and new perspectives on peritoneal dialysis in Italy emerging from the Peritoneal Dialysis Study Group Census. Perit Dial Int 2012; 32:558-65.
2. Marinangeli G, Cabiddu G, Neri L et al; Italian Society of Nephrology Peritoneal Dialysis Study Group. Andamento della DP in Italia nei Centri pubblici non pediatrici. Risultati del censimento GSDP-SIN 2010 e confronto con i censimenti 2008 e 2005. G Ital Nefrol 2014; 31(4).
3. Marinangeli G, Cabiddu G, Neri L et al; Italian Society of Nephrology Peritoneal Dialysis Study Group. Peritoneal Dialysis in Italy: the fourth GSDP-SIN census 2012. G Ital Nefrol 2017; 34(2).
4. Marinangeli G, Neri L, Viglino G; Peritoneal Dialysis Study Group of Italian Society of Nephrology.PD in Italy: the 5th GSDP-SIN Census 2014. G Ital Nefrol 2018;35(5).
5. Neri L, Viglino G, Marinangeli G, et al; Peritoneal Dialysis Study Group of the Italian Society of Nephrology. [Peritoneal Dialysis in Italy: the 6th GSDP-SIN census 2016]. G Ital Nefrol. 2019 Jun 11;36 (3).
6. Neri L, Viglino G, Vizzardi V, et al; Peritoneal Dialysis Study Group of the Italian Society of Nephrology. [Peritoneal Dialysis in Italy: the 7th GPDP-SIN census 2019]. G Ital Nefrol. 2022 May 11;36 (3).
7. Neri L, Viglino G, Vizzardi V, Porreca S, Mastropaolo C, Marinangeli G, Cabiddu G. Peritoneal Dialysis in Italy: the 8th GPDP-SIN census 2022. G Ital Nefrol. 2023 Jun 29;40(3):2023-vol3. PMID: 37427898.
8. Viglino G, Neri L, Alloatti S et al. Analysis of the factors conditioning the diffusion of peritoneal dialysis in Italy. Nephrol Dial Transpl 2007; 22:3601-5.
9. Neri L, Viglino G, Vizzardi V, Porreca S, Mastropaolo C, Marinangeli G, Cabiddu G. Role of the Opinions of the Nephrologist and Structural Factors in Dialysis Modality Selection. Results of a Peritoneal Dialysis Study Group Questionnaire. G Ital Nefrol. 2024 Feb 28;41(1):2024-vol1. PMID: 38426674.
10. Marshall MWG and Verger C. Peritoneal dialysis associated peritonitis rate – validation of a simplified formula. Bull Dial Domic 2012; 4(4): 245–257.
11. Rianne Boenink, Marjolein Bonthuis, Brittany A Boerstra et al. The ERA Registry Annual Report 2022: Epidemiology of Kidney Replacement Therapy in Europe, with a focus on sex comparisons, Clinical Kidney Journal, 2024; https://doi.org/10.1093/ckj/sfae405.
12. Neri L, Viglino G, Marinangeli G, et al; Peritoneal Dialysis Study Group of Italian Society of Nephrology. Italian Society of Nephrology Peritoneal Dialysis Study Group. Incremental start to PD as experienced in Italy: results of censuses carried out from 2005 to 2014. J Nephrol. 2017; 30:593-599.
13. Nicdao MA, Wong G, Manera K, et al. Incremental compared with full-dose peritoneal dialysis: A cost analysis from a third-party payer perspective in Australia. Peritoneal Dialysis International. 2025;0(0). doi:1177/08968608251326329
14. Cheetham MS, Cho Y, Krishnasamy R, et al. Multicentre registry analysis of incremental peritoneal dialysis incidence and associations with patient outcomes. Peritoneal Dialysis International. 2023;43(5):383-394. doi:1177/08968608231195517
15. Li PK-T, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Peritoneal Dialysis International. 2022;42(2):110-153. doi:10.1177/08968608221080586 – open access
16. Marshall MR. A systematic review of peritoneal dialysis related peritonitis rates over time from national or regional population-based registries and databases. Perit Dial Int 2022; 42(1): 39–47.
17. Perl J et al. Peritoneal Dialysis-Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). AJKD 2020.
18. Al Sahlawi M. et al. Variation in Peritoneal Dialysis-Related Peritonitis Outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). AJKD 2022.