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Part 2: Optimization Of PD in Asia |
Nephrology-Urology-Transplantation Center, Hospital Popular 115, University Training Center for Health Care Professionals, Ho Chi Minh City, Vietnam
Correspondence to: Pham Van Bui, Nephrology-Urology-Transplantation Center,
Hospital Popular 115, University Training Center for Health Care
Professionals, Ho Chi Minh City,
Vietnam.
bui0755{at}hcm.vnn.vn,
buiphamvan{at}yahoo.com
In Vietnam, continuous ambulatory peritoneal dialysis (CAPD) with a
straight line and one bag was first used in 1998. Because the complication
rate, mainly as a result of catheter obstruction and peritonitis, was very
high (50%), treatment was stopped after the first 10 cases. Use of the
modality resumed only in 2001. However, because of skepticism and concern on
both the part of physicians and patients about the effectiveness of peritoneal
dialysis (PD) and about the infection risk, CAPD developed very slowly. Until
late 2004, patient numbers were very limited, and there was only one PD unit
in the entire country.
Since then, CAPD using Y-set and two-bag system—plus routine
omentectomy during catheter insertion and better patient selection and
training in bag exchange—has resulted in much better outcomes with fewer
complications, and the technique has been developing far faster. This success,
together full insurance coverage of both dialysis and erythropoietin since
2005, has led to a steep rise in the number of patients on PD and the number
of PD units. As a result, despite the initial difficulty, the number of PD
patients increased to nearly 700 in just 3 years (2004 - 2007), while it took
more than 20 years before more than 3000 patients were receiving hemodialysis.
Automated PD and icodextrin are not yet available in Vietnam.
KEY WORDS: Hemodialysis; transplantation.
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