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Perit Dial Int. 2020 Jan 17:896860819895356. doi: 10.1177/0896860819895356. [Epub ahead of print]

International comparison of peritoneal dialysis prescriptions from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

Author information

1
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
2
Arbor Research Collaborative for Health, Ann Arbor, MI, USA.
3
Deparment of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
4
Sheffield Teaching Hospitals, Sheffield, UK.
5
Middlemore Hospital, Auckland, New Zealand.
6
Tsuchiya General Hospital, Nakaku, Hiroshima, Japan.
7
St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
8
Faculty of Medicine and Health Sciences, Keele University and University Hospitals of North Midlands, Stoke-on-Trent, UK.

Abstract

BACKGROUND:

We describe peritoneal dialysis (PD) prescription variations among Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) participants on continuous ambulatory PD (CAPD) and automated PD (APD; n = 4657) from Australia/New Zealand (A/NZ), Canada, Japan, Thailand, United Kingdom (UK), and United States (US).

RESULTS:

CAPD was more commonly used in Thailand and Japan, while APD predominated over CAPD in A/NZ, Canada, the US, and the UK. Total prescribed PD volume normalized to the surface area was the highest in Thailand and the lowest in Japan (for both APD and CAPD) and the UK (for CAPD). PD patients from Thailand had the lowest residual urine volume and residual renal urea clearance, yet achieved the highest dialysis urea clearance. Japanese patients had the lowest dialysis urea clearances for both APD and CAPD. Despite having similar urine volumes to patients in A/NZ, Canada, Japan, and the UK, US CAPD and APD patients used 2.5% and 3.86% glucose PD solutions more frequently, whereas fewer than 25% of these patients used icodextrin. Over half of the patients in A/NZ, Canada, the UK, and Japan used icodextrin, whereas it was hardly used in Thailand. Japan and Thailand were more likely to use 1.5% glucose solutions for their PD prescription.

CONCLUSIONS:

There are considerable international variations in PD modality use and prescription patterns that translate into important differences in achieved dialysis clearances. Ongoing recruitment of additional PDOPPS participants and accrual of follow-up time will allow us to test the associations between specific PD prescription regimens and clinical and patient-reported outcomes.

KEYWORDS:

International comparisons; peritoneal dialysis; prescription patterns

PMID:
32063209
DOI:
10.1177/0896860819895356

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