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Perit Dial Int 27(Supplement_3): 15- 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Experience

Building a Successful Peritoneal Dialysis Program: a Rural Center's Experience

A. Hamad1, M.S. Nassri1, J.B. Durham1, P. Still2, M. Goodwin2 and R. Poole2

Palmetto Nephrology1 ; Davita Dialysis,2 Orangeburg, South Carolina, USA.

Objective: To evaluate the reasons for an increase in the number of patients choosing peritoneal dialysis (PD) in a rural practice. The number of dialysis patients continues to rise with over 500000 expected in 2010. Most of the increase is in hemodialysis (HD) while PD lags behind with <10% of dialysis patients on PD. Many factors are attributed to that, including physicians' training and attitudes, patients' physical and mental condition, and financial factors. Methods: Data concerning the number of HD and PD patients were collected in our rural practice between 2003 and 2006. The practice contains 3 nephrologists (2 of them joined July of 2003). An education program (includes hands on experience) about dialysis options was provided by Gambro (now Davita Dialysis) starting November of 2003. A new PD nurse joined in 2003 with a second nurse in 2006. Results: There were 28 PD patients in 2006 compared to 7 patients in 2003, which represent 400% increase. In HD there was not any significant change (255 in 2006 vs 240 in 2003). The difference between the increases in PD versus HD patients was statistically significant with p value of <0.005. Table 1 shows the increase in the number PD versus HD patients.

Number of PD Versus HD Patients over 4-Year Observation Period Year 2003 2004 2005 2006 PD 7 14 22 28 HD 240 247 260 255

Conclusions: We have found that an increase in the number of patients choosing PD over that of HD occurred after 3 major changes in the practice. In our opinion, physician interest and commitment to PD, the introduction of a predialysis education program and dedicated nursing staff all contributed to this successful experience. Applying such a model could lead to major increase in patients choosing PD nationwide.






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