Abstract
Introduction: Home over center-based dialysis may minimize SARS-CoV2 exposure risks. We explored how the pandemic may have introduced challenges related to peritoneal dialysis (PD) supply availability, routine patient care, and how facility practices changed during this time.
Methods: The Peritoneal Dialysis/Dialysis Outcomes and Practice Patterns Study (PDOPPS/DOPPS) and International Society of Nephrology (ISN) administered a web-based survey (November 2020 – March 2021). Medical director responses were compared across 10 ISN regions.
Results: 165 PD facilities (51 countries) returned surveys. During the initial COVID-19 wave, the reported frequency of in-person patient visits decreased in 9 of 10 ISN regions. Before the pandemic, most facilities required a mask during PD exchanges which continued over the course of the pandemic. Although most facilities in different regions did not report PD supply disruptions, sites in Africa and South Asia reported major disruptions. Reductions in laparoscopic surgical procedures for PD catheters were reported by facilities in 9 out of 10 regions while non-surgical percutaneous procedures increased in facilities in 6 regions. Training of new PD patients declined in facilities in each region. Increased use of remote technology by patients to communicate with clinics was observed in all regions compared to pre-pandemic levels.
Conclusion: Marked within- and across-region variability was noted in PD facility burden, clinical practice, and adaptation to the COVID-19 pandemic. This study highlights opportunities to improve routine PD care, adapt to the ongoing pandemic, and increase preparedness for potential future interruptions in PD care.
Methods: The Peritoneal Dialysis/Dialysis Outcomes and Practice Patterns Study (PDOPPS/DOPPS) and International Society of Nephrology (ISN) administered a web-based survey (November 2020 – March 2021). Medical director responses were compared across 10 ISN regions.
Results: 165 PD facilities (51 countries) returned surveys. During the initial COVID-19 wave, the reported frequency of in-person patient visits decreased in 9 of 10 ISN regions. Before the pandemic, most facilities required a mask during PD exchanges which continued over the course of the pandemic. Although most facilities in different regions did not report PD supply disruptions, sites in Africa and South Asia reported major disruptions. Reductions in laparoscopic surgical procedures for PD catheters were reported by facilities in 9 out of 10 regions while non-surgical percutaneous procedures increased in facilities in 6 regions. Training of new PD patients declined in facilities in each region. Increased use of remote technology by patients to communicate with clinics was observed in all regions compared to pre-pandemic levels.
Conclusion: Marked within- and across-region variability was noted in PD facility burden, clinical practice, and adaptation to the COVID-19 pandemic. This study highlights opportunities to improve routine PD care, adapt to the ongoing pandemic, and increase preparedness for potential future interruptions in PD care.
| Original language | English |
|---|---|
| Pages (from-to) | 2196–2206 |
| Number of pages | 11 |
| Journal | Kidney international reports |
| Volume | 7 |
| Issue number | 10 |
| Early online date | 3 Aug 2022 |
| DOIs | |
| Publication status | Published - 1 Oct 2022 |
Bibliographical note
Funding Information:The authors thank the national society and registry countries and ISN regional board leaders who provided the lists of dialysis centers that we were then able to contact. Supplementary Appendix S2 lists these contributors and surveyed respondents who wished to be acknowledged (NB, we are unable to link respondents with individual responses). We are grateful to Charu Malik and Paul Laffin at ISN for their support and Silvia Salaro at ISN who assisted with contacting the country leaders and deploying the survey. We are grateful to staff at Arbor Research Collaborative for Health for supporting survey development and deployment. This research has previously been reported at Kidney Week 2021 (American Society of Nephrology). Global support for the ongoing DOPPS Programs is provided without restriction on publications by a variety of funders. For details see https://www.dopps.org/AboutUs/Support.aspx. RAl, BB, RA, FC, GD, RE, MG, RPF, RLP, BMR, ET, AL, JP, VJ, VL, CP, and DSS conceived and/or designed the work that led to the submission.RAl, BB, RA, RPF, BMR, AL, JP and acquired data, and/or played an important role in interpreting the results. RAl, BB, FC, RE, RPF, RLP, BMR, ET, AL, and JP drafted or revised the manuscript. RAl, BB, RA, FC, GD, RE, MG, RPF, RLP, BMR, ET, AL, JP, VJ, VL, CP, and DSS approved the final version. JP confirms that he has had full access to the data in the study and final responsibility for the decision to submit for publication.
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© 2022 International Society of Nephrology