Peritoneal Dialysis in Italy: the 7th GSDP-SIN census 2019

Abstract

Objectives: Analysis of the results of the 7th National Census (Cs-19) of Peritoneal Dialysis in Italy, conducted in 2020-21 by the Peritoneal Dialysis Project Group of the Italian Society of Nephrology, for the year 2019.
Materials and methods: The data was initially collected using specially designed software, which after entering the data of individual patients allows the aggregate extraction of the necessary information. The difficulties due to the COVID pandemic made it necessary to also use the traditional on-line questionnaire used previously. Of the 237 Centers envisaged, 198 responded, of which 177 with complete data for HD also in 2016.
Results: Overall incidence and prevalence (31/12/2019) were respectively 1,363 (CAPD/APD = 741/622) and 3,922 (CAPD/APD = 1,857 / 2,065) patients. The percentage incidence and prevalence (177 Centers) decreased compared to 2016, respectively, from 23.8% to 22.1% and from 17.3% to 16.6%. 31.4% started PD incrementally in 60.3% of the Centers. The catheter is placed by the Nephrologist alone in 19.7%. Assisted PD is used by 24.5% of the prevalent patients, mostly (83.8%) by a family member. In 2019, the exit from PD (ep/100 years-pts: 11.6 in HD; 8.9 death; 6.0 Tx) is decreasing for all causes. The main cause of transfer to HD remains peritonitis (26.8%). The incidence of peritonitis in 2019 dropped further to 0.190 ep/year-pts as well as the incidence of new cases of EPS (0.103 ep/100 years-pts).
Conclusions: The Cs-19 confirms the good results of the DP in Italy.

Keywords: Peritoneal Dialysis, technique failure, incremental Peritoneal Dialysis, peritonitis, home visits, peritoneal equilibration test (PET)

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Introduzione

L’utilizzo della Dialisi Peritoneale (DP) viene rilevato dal Gruppo di Progetto di Dialisi Peritoneale della Società Italiana di Nefrologia (SIN) mediante un Censimento, condotto ogni 2-3 anni, dei Centri che utilizzano la DP. In questo report sono presentati i risultati della 7° edizione, condotta nel 2020-21 e relativa all’anno 2019 (Cs-19), confrontandoli con quelli degli anni precedenti: 2005 (Cs-05), 2008 (Cs-08) [1], 2010 (Cs-10) [2], 2012 (Cs-12) [3], 2014 (Cs-14) [4] e 2016 (Cs-16) [5].

Per quest’ultima edizione era stato introdotto un nuovo sistema di raccolta dati ma la coincidenza con la pandemia COVID-19 ha impedito il raggiungimento dell’obiettivo principale del Censimento, la copertura del 100% dei Centri DP.

 

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Peritoneal Dialysis in Italy: the 6th GSDP-SIN census 2016

Abstract

Objectives. We report here the results of the 6th National Census (Cs-16) of Peritoneal Dialysis in Italy, carried out in 2017-18 by the Italian Society of Nephrology’s Peritoneal Dialysis Study Group and relating to 2016.

Methods. The Census was conducted using an on-line questionnaire administered to the 237 non pediatric centers which did perform Peritoneal Dialysis (PD) in 2016. The results have been compared with the previous Censuses carried out since 2005.

Results. Incidence: In 2016, 1,595 patients (CAPD=56.1%) started on PD (1st treatment for ESRD) and 4,607 on hemodialysis (HD). PD was started incrementally by 32.5% in 144 Centers. 15.6% were late referrals, and 5.1% began within 48-72 hours of insertion. The catheter was positioned exclusively by a Nephrologist in 24.3% of cases. Prevalence: Patients on PD on 31/12/2016 were 4,607 (CAPD=46.6%), with 22.2% of prevalent patients on assisted PD (family member caregiver: 80.5%). Out: In 2016, PD dropout rate (ep/100 pt-yrs: 12.5 to HD; 11.8 death; 7.0 Tx) has not changed. The main cause of transfer to HD remains peritonitis (23.8%), although it is still decreasing (Cs-05: 37.9%). Peritonitis/EPS: The incidence of peritonitis in 2016 was 0.211 ep/pt-yr (939 episodes). The incidence of new cases of EPS in 2015-16 is diminishing too (16 cases=0.176 ep/100 pt-yrs). Other results: In 2016 the number of Centers using 3.86% for the peritoneal equilibration test (PET) (49.8%) increased, and the Centers carrying out home visits diminished (51.5%).

Conclusions. Cs-16 confirms that PD in Italy is having good results.

Keywords: Peritoneal Dialysis, technique failure, incremental Peritoneal Dialysis, peritonitis, home visits, peritoneal equilibration test (PET)

Sorry, this entry is only available in Italian. For the sake of viewer convenience, the content is shown below in the alternative language. You may click the link to switch the active language.

Introduzione

L’utilizzo della dialisi peritoneale (DP) in Italia nel 2015 è ancora limitato ad una prevalenza del 9,5%, con un ulteriore calo nel 2016 [1], se si considerano tutti i Centri Dialisi, anche quelli che non utilizzano la metodica. Sempre presente anche la notevole variabilità da regione a regione e da Centro a Centro [26]. 

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