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If you haven’t renewed your ISPD membership for 2022 yet, you can do it here to continue enjoying the benefits.

The Saving Young Lives program is a partnership between ISPD, EuroPD, IPNA, and ISN which aims to develop sustainable programs in LMIC’s to treat acute kidney injury in children and adults using acute PD. The program started in 2012 and to date has trained over 470 doctors and nurses in 26 countries on how to manage critically ill patients, manage AKI, and how to insert PD catheters at the bedside.

A database has been maintained for SYL sites to record outcomes and although many have not been able to collect data due to resource constraints, results show over 500 patients treated, many with makeshift catheters and locally mixed fluids, and despite late presentation and resource limitations, they have a 61% survival to discharge with the recovery of kidney function.

The majority of SYL training has focussed on countries in Africa; however in 2019 educational courses were expanded to include India, Bhutan, and Myanmar. The COVID pandemic has severely curtailed hands-on training (a key feature of the SYL program); since then, it has adapted to a virtual platform with online workshops training delegates in PD for AKI and PD access. Previous delegates have been included in these courses which have presented small group discussions facilitated by SYL committee members and advisors, which allowed mentoring to continue, a key requirement for the sustainability of the program.

The SYL program is hoping that the opening of travel restrictions will allow for exponential growth of the program, with the focus over the next 5 years on expansion into Latin America, South and Southeast Asia, and Oceania. In October 2021 the SYL team embarked on the first Latin American workshop, in conjunction with ALANEPE, which was attended by 240 pediatric nephrologists from the region.

This will be followed up with a hands-on training session in Bogota, Columbia in mid-2022. There will also be a high-level strategic meeting hosted by SYL at the ISPD meeting in Singapore, which will bring together key nephrologists from South and Southeast Asia to identify key sites and develop partnerships, in order to roll out training courses in the region. This will also be followed by a hands-on session for potential champions to attend.

SYL is completely run by volunteers and the steering committee wishes to thank all the advisors and trainers who have continued to give up their valuable time to assist with training and mentoring of all our centers.

Brett Cullis is the Chairperson of the SYL Steering Committee.

The International Society for Peritoneal Dialysis (ISPD) welcomes research proposals that are of importance to the international peritoneal dialysis community. The study should require international collaboration.

Submission Deadline
31 January 2022

Eligibility Criteria
Members and non-members of the ISPD may submit proposals.
Proposals should require international collaboration and focus on problems that are relevant to PD on an international level.

How to Prepare your Application
Please read the application guidelines carefully, available here:
APPLICATION GUIDELINES

Applicants are encouraged to discuss the proposal informally with Dr Thyago Proenca De Moraes, Chair of the ISPD International Studies Committee, by emailing admin@ispd.org before finalising and submitting the application.

Finalised applications should be submitted to admin@ispd.org by January 31st 2022.

Funding
Small grants (typically up to $10,000 USD) may be awarded at the discretion of the ISPD Council to help enable these projects.

The research project: “International Peritoneal Dialysis Exercise Practices and Perceptions (IPEP)” was selected for endorsement and financial support by the ISPD in 2021’s Call for research projects.

You can contribute to this project by completing the Peritoneal Dialysis (PD) Exercise and Physical Activity Clinician Survey: This is the first worldwide survey exploring clinician’s PD exercise and physical activity practices and perceptions in order to inform PD exercise recommendations.

The survey was approved by the University of South Australia Human Research Ethics Committee, and it consists of only 13 questions taking only 8 minutes.

The survey is available in several languages:
English – https://www.surveymonkey.com/r/DPQDVD9
Spanish (Español) – https://www.surveymonkey.com/r/DPRLXCY
Portuguese (Português) – https://www.surveymonkey.com/r/3ZKV8CX
Thai (ไทย)  https://www.surveymonkey.com/r/YL3HSV8

The ISPD is pleased to announce the 2021 call for applications to the ISPD Fellowship Program. The deadline to submit applications is 30th September, 2022.

This year, because of travel restrictions due to COVID-19, we decided to make one single call for applications in September, for fellowships set to start in 2022. This means, the ISPD Scholarship and Awards Committee will be selecting up to 12 applicants for an ISPD Fellowship.

Click here to view full details about the program, the eligibility, and the application process; including how the ISPD Fellowship Program will adapt to the COVID-19.

Since the call for applications is open to both members and non-members of our society, we invite you to share this information with your colleagues.

Do you want to know how this experience can be? Read this article about two ISPD fellows from Nigeria getting trained in Colorado.

For any questions, please contact our Society Coordinator admin@ispd.org

The International Society for Peritoneal Dialysis (ISPD) opened a call for Research Proposals at the end of 2020, aiming to support research projects to advance the knowledge of PD fostering international cooperation.

We received only two applications, probably because of the COVID-related extreme pressure for nephrologists all over the world. These two projects were evaluated by a board of experts of the International Studies Committee. The result of this evaluation process was submitted to the Council, together with a recommendation for funding.

We are excited to announce that the ISPD Council and the International Studies Committee have decided to endorse and support financially both projects!

1.- Rachael Walker et al – Patient perspectives and involvement in co-design of a trial evaluating interventions to improve gut health in peritoneal dialysis – GUT PD Study

2.- Paul Bennet et al – International Peritoneal Dialysis Exercise Practices and Perceptions (IPEP)

We would like to thank both teams for their well-thought project proposals. We hope that the respective teams succeed in implementing these two projects with ISPD support.

There will be a new Call for Research Projects at the end of 2021 or the first weeks of 2022.

1) Mayoor V Prabhu, MD,DNB(Neph), FASN
Associate Professor of Nephrology
Kasturba Medical College & KMC Hospital, Dr. Ambedkar Circle, Mangalore, India (Manipal Academy of Higher Education, Manipal, India)
Contact the author

2) Sreedhar Reddy,DNB(Neph)
Consultant Nephrologist
Krishna Institute of Medical Sciences, Hyderabad, India
.

COVID-19, caused by the SARS-Coronavirus 2 has been sweeping across the globe since 2020 (it was declared a global pandemic by WHO in March 2020). No nation large or small, developed or underdeveloped, rich or poor has been spared from its relentless march. Ranging from an asymptomatic infection to severe respiratory distress, the infection is still a matter of much debate and research, as the medical profession toils day and night to contain it. One year down the line while the disease is still very much being understood and its long-term effects still a matter of conjecture, there is general agreement that patients with systemic illnesses and comorbidities are at higher risk of symptomatic and severe disease, and higher morbidity and mortality. In this regard, patients with kidney disease on dialysis pose a unique challenge to the medical teams. Dialysis requires frequent hospital visits, close interaction with several medical staff, frequent sampling and monitoring, prolonged in-hospital stay in case of Hemodialysis (HD), tend to have more frequent hospitalization, and this poses a high risk of COVID infection. Peritoneal Dialysis (PD) has the unique advantages of being a home-based therapy thereby obviating the need for hospital visits and automatically ensuring social distancing- the cornerstone of breaking the chain of spread of COVID-19. With many parts of the world including India witnessing travel bans and lockdowns, home-based therapies are definitely safer and convenient to the patients and their families. Patients on PD require less exposure to medical personnel, less travel to dialysis facilities thus less need to depend on public transportation, all decreasing the chance of being exposed to the disease. Further encouraging PD as a modality of Renal Replacement Therapy (RRT) in ESRD patients may help preserve supplies and manpower, for patients who require haemodialysis , as explained by Eapen JJ (1). Further, barring the most critically ill patients, PD is also a valid option for AKI in the setting of COVID-19. On 28 March 2020, the International Society of Peritoneal Dialysis published its strategy regarding COVID-19 prevention in PD patients. This statement endorses the strategy of keeping people on PD at home and suggests that hospital visits should be minimized for only urgent indications (such as suspected peritonitis or fluid overload), and that consultations should otherwise be conducted by telehealth (2). In the UK, by 29 April 2020, 2.9% of patients on PD were reported to have contracted COVID-19, compared with 9% of patients on HD (3). As more literature accumulates over time, we might be able to comment more conclusively on these issues.

India is one of the most severely affected countries in the world. Even though India rolled out the world’s largest COVID-19 vaccination programme and covered most of the healthcare workers in early 2020, it still saw a second wave of infections which peaked at more than 400,000 cases per day and a cumulative number of 28 million-plus at the time of writing. The number of daily cases is now around 120,000 per day. This crisis overwhelmed the healthcare system leading to increased mortality. There were infections in healthcare workers which stressed an already overburdened healthcare workforce. Without a doubt, kidney and dialysis care bore the brunt of hospital bed shortages, oxygen shortages, travel restrictions, supply chain interruption, and other logistical issues. Kidney care in India tends to be mostly available in the larger cities and in the private sector. Most patients (more than a quarter) requiring dialysis live as far as 100 km away, and up to 60% live more than 50 km from these centers according to a 2017 study. Prasad N. et al (4) published a paper in KI Reports, which attempted to
evaluate and quantify the morbidity and mortality in ESRD patients who were impacted by COVID-19 pandemic-related service disruptions in public and private hospitals in India. They found that 28% of patients missed one or more sessions of HD, many without informing the Unit. Some patients were advised by the treating nephrologists to reduce dialysis frequency because of accommodating potential dialysis required for the COVID-19–positive patients and curbs imposed by the hospitals. Complete drop-out was noted in up to 4% of patients. This drop-out was more in patients receiving dialysis at public sector hospitals. In some cases, large public sector hospitals were converted in their entirety into COVID care facilities, virtually shutting down long-running dialysis centers temporarily. It was a herculean task to overnight accommodate these patients into other dialysis centers, most of which were in the private sector. Impact on PD services was comparatively less, with very few centers reporting difficulties in procuring essential PD supplies. Unfortunately, PD penetrance in India remains very low compared to HD. India’s IT hubs Bangalore and Hyderabad were among the worst hit by the pandemic. Dr. P Vidyashankar, Head of Nephrology and Transplantation services at Bangalore’s Aster CMI hospital, has completed 150 CAPD catheter insertions under local anesthesia without complications and a cosmetically acceptable technique. He says during the pandemic period he found patients more willing to accept CAPD as therapy given its inherent advantage as a home-based treatment. Many patients (up to 20%) were in NYHA Class 4 and benefited from avoiding general anesthesia (in publication, personal communication). Kidney transplantation services, especially deceased donor transplants, came to a grinding halt in the early days of the pandemic, only to restart gradually over a few months. Many transplant recipients contracted COVID-19 over the past year, but data remains sparse as to the outcomes seen in this subset. Renal care teams including Nephrologists, postgraduates/fellows, dialysis and transplant unit staff also saw infections among themselves, fortunately with low morbidity and mortality.

The COVID-19 Working Group of the Indian Society of Nephrology came up with working guidelines to help PD practitioners in India to handle COVID-19 patients on PD. (5). This included guidelines for PD in AKI, in CKD, and comprehensive guidance for patients, caregivers, hospital visits, supplies, effluent disposal and treatment of COVID-19 in PD patients. As data and experience accumulate, these strategies might be refined further; however, this serves at present as an excellent tool to guide clinicians and patients alike. Going ahead, and with the hindsight gained from our experiences during this pandemic, encouraging PD as a modality of RRT should gain more traction. The inclusion of PD in the National Dialysis Programme is a welcome step in this direction. More public sector hospitals should be encouraged to set up PD programs to help cater to the ever-increasing case load. With the incorporation of remote monitoring technology, quality PD can be offered to patients at an affordable cost with Governmental/ NGO support. PD appears to be a therapy much more convenient and safe during a crisis like this and can help healthcare systems around the world deal better with patients needing RRT in these demanding times.

Competing Interests : None

References
(1)Eapen JJ. Peritoneal dialysis – ideal renal replacement therapy during coronavirus (COVID-19) pandemic. Indian J Perit Dial 2020;38:11-2.
(2) Cozzolino M,et al. COVID-19 pandemic era: is it time to promote home dialysis and peritoneal dialysis?, Clinical Kidney Journal, Volume 14, Issue Supplement_1, March 2021, Pages i6–i13, https://doi.org/10.1093/ckj/sfab023
(3) UK Renal Registry: Weekly COVID-19 Surveillance. Report for Renal Centres in the UK. Bristol: UK Renal Registry,2020
(4) Prasad N et al. The Adverse Effect of COVID Pandemic on the Care of Patients With Kidney Diseases in India .Kidney International Reports. Volume 5, Issue 9, September 2020, Pages 1545-1550
(5) Jeloka T, Gupta A, Prasad N, Varughese S, Mahajan S, Nayak K S, Agarwal SK, Abraham G, On behalf of COVID-19 Working Group of Indian Society of Nephrology. Peritoneal dialysis patients during COVID 19 pandemic. Indian J Nephrol 2020;30:171-3

GOING VIRTUAL! Due to the ongoing COVID situation,  the joint  ISPD and EuroPD congress will be held as a fully virtual meeting over new dates Sunday 28th February – Tuesday 2nd March 2021.

The new programme can be consulted HERE and it has been updated with the latest content. Our registration fees have been significantly discounted to enable as many of our colleagues around the world to participate. Delegates who had already registered and paid  for the original dates have been  refunded the difference in fees.

More information: www.ispd-europd2021.com

Do you have any questions? Please contact us and we will be pleased to help you.

Dear members,

Click here to read more.

If you haven’t renewed your ISPD membership yet, you can do it here to continue enjoying the benefits.

At the beginning of 2020 the publishing contract for Peritoneal Dialysis International was taken over by SAGE and you will have noted the new look and website – https://journals.sagepub.com/home/ptd. ISPD members get access to the full Journal through the ISPD website after log in (the old site www.pdiconnect.com has been discontinued, so please update your bookmarks to the new site).

Unsurprisingly COVID-19 featured strongly through the year and we published several papers on that topic including reports from Sichuan Province China, use of remote patient management during the pandemic from Italy, PD for COVID associated acute kidney injury, as well as a report of paediatric inflammatory multisystem syndrome (PIMS) from South Africa. Reports on the Saving Young Lives program continued to feature strongly in the journal. For more details of the most read articles from PDI in 2020, please visit the PDI Journal website.

In May we published a Special issue: Prescribing High Quality Goal-Directed Peritoneal Dialysis – a new guideline from the International Society for Peritoneal Dialysis. This comprehensive series of paper examined the topic from a range of perspectives and if you have not read it already it is to be recommended.

Our most read articles continue to be the important guidelines from the ISPD – with infection, access and prescribing guidelines being an important resource for clinical teams around the world. I am pleased to share that in the near future there will be updated guidelines on acute kidney injury for adults and children as well as a detailed guideline on the evaluation of peritoneal membrane dysfunction.

Our most cited papers have been Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update (John Crabtree et al); Standardized Outcomes in Nephrology—Peritoneal Dialysis (SONG-PD): Study Protocol (Karine Manera et al; and Advanced Laparoscopic Peritoneal Dialysis Catheter Insertion: Systematic Review and Meta-Analysis (Badri Shrestha et al).

I will be handing over as Editor in Chief to Jeff Perl on January 1st 2021. He is going to take the journal to a new level with his boundless energy and well proven scientific and editorial skills. He will be supported by an excellent editorial team and our publisher SAGE. I intend to remain accessible to the journal to provide support during the transition. It has been my privilege to work with PDI over the last 8 years, to work with wonderful people from our society from across the world and to have been able to take a role in supporting the dissemination of high quality information to support patient care. I am grateful to everyone who supports PDI and its objectives including our authors, dedicated reviewers, readers, editors and publisher. I have every confidence that it will continue to enable clinical teams in their important work of caring for people who require peritoneal dialysis for decades to come.