A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients
Abstract
:1. Introduction
2. Methods
2.1. Service Offered Prior to Reconfiguration
2.2. Service Reconfiguration Bundle
2.3. Technical Details
2.3.1. Laparoscopic Surgical PD Catheter Insertion
2.3.2. Percutaneous PD Catheter Insertions
2.3.3. Peri-Procedural Care
2.4. Data Collection and Analysis
3. Results
3.1. Introduction of a Wider Portfolio of PD Catheter Insertion Techniques
3.2. Offering PD to a Wider Group of Patients, Including Those Considered High-Risk for General Anaesthesia and with Extensive Previous Surgery
3.3. Offering Urgent and Early Start PD
3.4. Performing Elective PD Catheter Insertions in Multiple NHS and Independent Sector Sites
3.5. Outcomes
4. Discussion
4.1. Staffing Expertise and Training
4.2. Introducing a Wider Portfolio of PD Catheter Insertion Techniques
4.3. Being Able to Facilitate Urgent and Early Start PD
4.4. Use of Elective Hubs
4.5. Future Considerations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Median (Range) or n (%) |
---|---|
Age | 67 (18–88) |
Sex | |
Female | 23 (35%) |
Male | 43 (65%) |
BMI | 26 (19–43) |
Primary renal disease | |
Diabetic nephropathy | 20 (30%) |
IgA nephropathy | 5 (8%) |
Polycystic kidney disease | 4 (6%) |
Focal segmental glomerulosclerosis | 3 (5%) |
Other (including unknown) | 34 (52%) |
Pre-procedure glomerular filtration rate | 10 (5–15) |
Switching from haemodialysis | 11 (17%) |
Outcome | n (%) |
---|---|
Completed 1-year follow-up on Peritoneal Dialysis | 36 (55%) |
Transplanted | 14 (21%) |
Died * | 7 (11%) |
Switch to Haemodialysis ** | 9 (14%) |
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Corr, M.; Hunter, C.; Conroy, D.; McGrogan, D.; Fogarty, D.; O’Neill, S. A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients. Healthcare 2023, 11, 1654. https://doi.org/10.3390/healthcare11111654
Corr M, Hunter C, Conroy D, McGrogan D, Fogarty D, O’Neill S. A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients. Healthcare. 2023; 11(11):1654. https://doi.org/10.3390/healthcare11111654
Chicago/Turabian StyleCorr, Michael, Carolyn Hunter, Daniel Conroy, Damian McGrogan, Damian Fogarty, and Stephen O’Neill. 2023. "A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients" Healthcare 11, no. 11: 1654. https://doi.org/10.3390/healthcare11111654