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THE STATUS OF, AND OBSTACLES TO, CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN THAILAND

Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Correspondence to: Kriang Tungsanga, Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok 10330 Thailand.
fmedkts{at}md2.md.chula.ac.th

The prevalence of dialysis in Thailand is 282 per million population, and utilization of peritoneal dialysis (PD) is only 4.6% of the utilization of hemodialysis (HD). The causes of low PD utilization include

• a relatively higher cost of PD care, especially from the patient's perspective;
  
• less incentive for PD care on the part of health care providers and hospitals;
  
• fewer continuing medical and nursing education programs in PD;
  
• unavailability of certified PD nurses;
  
• lack of confidence in the quality of PD care;
  
• fewer offers of PD as a renal replacement therapy option during pre-dialysis counseling;
  
• fear of peritonitis on the part of the patient, and also fear of burdening family members;
  
• a less stringent government policy regarding the "PD first" strategy.
  

KEY WORDS: Continuous ambulatory peritoneal dialysis; obstacles to PD utilization.

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