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SHORT REPORTS |
Sheffield Kidney Institute1 Northern General Hospital, Sheffield Baxter Healthcare2 Compton, United Kingdom
a The Renal Association Working Party on Peritoneal Access comprised Jonathan Barratt, Robert Diament, Stephen Holt, Helen Hurst, Badri Shrestha, and Christopher Winearls.
* e-mail: martin.wilkie{at}sth.nhs.uk
Objective: To obtain information about peritoneal
dialysis (PD) access practices in the United Kingdom.
Methods: During July of 2007, a PD access survey was
circulated to 80 clinical directors of renal units in the UK.
Results: Returns were received from 43 units; annual
catheter insertion numbers ranging from 5 to 100 (median 34, mean 38) were
reported. The majority of responding centers (30/43) reported a waiting time
for catheter insertion of 1 week to 1 month; primary patency rates were
reported as >90% in 26 and 60%–90% in 16 centers. Day case catheter
insertion was reported by 19 of the 43 respondents. Most centers (40) reported
that catheters could be removed in 2 days or sooner when required. The
majority of surgical problems (hernia, leaks, or catheter malfunction) were
reported as being managed in 1 – 4 weeks. A variety of catheter
insertion techniques were reported: 22 centers used surgical insertion alone;
13 used a combination of surgical and medical percutaneous techniques; 4
reported using a combination of surgical and peritoneoscopic insertion; 2
centers reported using combinations of all 3 techniques; 1 center used only a
radiographic technique and another used only the peritoneoscopic technique.
Catheters were most often inserted by consultant surgeons (71.7%), followed by
consultant nephrologists (19.3%), trainee nephrologists (2.9%), trainee
surgeons (2.4%), associate specialists (2.4%), or a nurse specialist (1.2%).
Two thirds of respondents indicated that they would be interested in attending
a medical catheter-insertion training program.
Conclusion: In the UK, reducing waiting times for PD
catheter insertion may have an important role in increasing patient access to
the technique.
KEY WORDS: Peritoneal dialysis access; catheter insertion techniques; survey.
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