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Strategies to overcome an undertaking of peritoneal dialysis as an option of chronic replacing kidney therapy

Abstract

The prevalence of dialysis patients in Brazil has increased in recent years, having doubled in the last decade and has become a major public health problem. Peritoneal dialysis (PD) is an important treatment option for patients with end-stage renal disease (CKD) requiring renal replacement therapy (RRT), as it offers patients the convenience of home treatment and increased perception of freedom, with consequent better quality of life. However, the percentage of patients treated with PD is still low, ranging from 4 to 11% in Europe and the USA. In Brazil, according to the Dialysis Census of the Brazilian Society of Nephrology of 2016, only 8.1% of patients on dialysis are treated for PD, which corroborates the national shortage of hemodialysis (HD) vacancies. And how to explain this low penetration of PD, since the clinical results obtained with PD show that the survival of patients is even better than that obtained with HD in the first years of the program? This project analyzes the various reasons for the underutilization of PD in Brazil and proposes the implementation of strategies to overcome its underutilization, through the development of four subprojects ranging from full care of the patient with CKD in primary care, with emphasis to the reference allowing the opportunity to optimize measures to mitigate the progression of CKD and the appropriate choice of the mode of planned start-up TRS; the implantation of DP from an urgent and unplanned start; until the creation of a referral center in DP in the city of Bauru, which will have the mission of training health professionals from all over the country to perform planned and unplanned PD in patients undergoing dialysis, including those who are fragile and dependent (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FALBO DOS REIS, PAMELA; BARRETTI, PASQUAL; MARINHO, LAUDILENE; BALBI, ANDRE LUIS; AWDISHU, LINDA; PONCE, DANIELA. Pharmacokinetics of Intraperitoneal Vancomycin and Amikacin in Automated Peritoneal Dialysis Patients With Peritonitis. FRONTIERS IN PHARMACOLOGY, v. 12, . (18/13690-9, 19/02116-2)
DIAS, DAYANA BITENCOURT; MENDES, MARCELA LARA; CARAMORI, JACQUELINE TEIXEIRA; DOS REIS, PAMELA FALBO; PONCE, DANIELA. Urgent-start dialysis: Comparison of complications and outcomes between peritoneal dialysis and haemodialysis. PERITONEAL DIALYSIS INTERNATIONAL, v. 41, n. 2, p. 244-252, . (19/02116-2)
MENDES, MARCELA LARA; ALVES, CAMILA ALBUQUERQUE; MARINHO, LAUDILENE CRISTINA REBELLO; DIAS, DAYANA BITENCOURT; PONCE, DANIELA. Unplanned vs. planned peritoneal dialysis as initial therapy for dialysis patients in chronic kidney replacement therapy. INTERNATIONAL UROLOGY AND NEPHROLOGY, . (19/02116-2)

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