| Sub-title | |
| Author | E Farrugia |
| Abstract | Peritoneal dialysis (PD) is a well-established form of renal replacement therapy in uraemic patients. Within the Department of Medicines Renal Unit, a multidisciplinary team composed of physician/surgeon/specialised nurses frequently succeed in employing PD as the first-choice modality in patients admitted to dialysis. However, despite continuous yearly improvements in every aspect of care of the PD patient, high drop-out rates still represent a major problem. This report, examining the causes of permanent drop-out from PD, is a single institution, single-physician experience with a large and complete set of patients over a 15-year period (1993 - Sept 2006). All former PD patients (n=198) who for any reason stopped PD were retrospectively studied. Data was available and complete in every single patient. Of the study cohort, 42 patients died from various causes, mostly cardiac deaths, whilst still adequately performing PD. 29 patients received a functioning kidney transplant, and a further 5 witnessed a useful return of renal function. Naturally, in both instances, PD was discontinued. In the remaining 122 patients, the causes of permanent PD drop-out (obviously necessitating a switch to chronic haemodialysis) were as follows: first but severe peritonitis (n =33), recurrent peritonitis (n=28), ultrafiltration failure and/or lack of solute clearance (n=26), necessary abdominal surgery (n= 7), PD catheter problems (n=11), inability to cope (n=8), and other (n=9). Conclusion: PD-related infections and complications account for 50% of permanent PD drop-outs in the Maltese Islands. This report enhances our understanding of how best to improve PD patient care in the local setting. Optimal long-term management of the PD patient hinges on achievement of best demonstrated practices and prevention of complications, particularly infectious, associated with PD. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
| Page | |
| Date | |
| Link to journal | |
| Key words | audit, drop out, peritoneal dialysis |