The role of PD in saving COVID lives
The novel coronavirus disease COVID-19 emerged in December 2019 and within 6 months has developed into a pandemic with more than 5 million people affected globally. This has had a major impact on the peritoneal dialysis world. The disease focus shifted from China to Europe and North America by March. Theoretically, people doing PD in their own homes should fare better than those cohorted on HD units. In March, as the COVID epidemic escalated in Europe and N America, there was no guidance how PD units should operate. Amazingly, considering the simultaneous clinical pressures for the individuals in the ISPD guidelines and standards committee, we managed to produce a document “Strategies regarding COVID-19 in PD patients” within a couple of weeks. This document can be found in our website The translations into French, Spanish, Chinese, Polish, Hungarian, Portuguese and Japanese that were then spontaneously offered and completed by members of the ISPD demonstrate the truly global nature of COVID-19. The strategy is simple – keep people doing PD in their own home and away from renal units and hospitals.
The next PD-related crisis was the unexpected demand for renal support in ICUs. Around 25% of patients on ventilators for COVID-19 develop AKI. International focus had been on acquiring large numbers of ventilators. Suddenly there was a shortage of the hardware for renal support in ICU – machines and filters – exacerbated by a clotting problems. There was therefore an urgent need for alternative ways to deliver renal replacement in the ICU setting – and this led to a demand in many centres to explore PD. There are, of course, many hurdles – most centres have no experience of PD in ICU, never mind the challenges of catheter insertion, developing appropriate prescriptions, finding staff to manage the PD in the ICU – just to mention a few. Fortunately, there were a few centres in the UK and US who had started doing PD for these patients, and the ISPD guideline for PD in AKI which had been published in 2014 was in the process of being updated with a final version almost ready. Given the urgency of the situation, the ISN and the ISPD collaborated in putting together a webinar on PD in COVID-related AKI highlighting the new guideline and UK and US experience – it can be found at this link. This was so popular (almost 1000 people ‘attended’), that a 2nd webinar was run 2 weeks later (link). The COVID experience has taught us that PD is a viable renal replacement option for AKI in ICU. The COVID era is with us for some time ahead – perhaps an opportunity for an international multicentre randomised study with haemofiltration?
And now, in many countries we are beyond the peak. Certainly, in the UK, at least, the experience of COVID-19 in HD units has resulted in an awareness that dialysis at home has many advantages. There has been a dramatic increase in people choosing PD, even patients with functioning fistulas who were about to start HD. There will therefore be many clinicians needing PD education. It is fortuitous that the two most recently published are related to PD access and PD prescribing.
Edwina Brown, Chair of ISPD guideline and standards committee
Hammersmith Hospital, London, UK
ISPD Online General Assembly 2020 Notice
GENERAL ASSEMBLY NOTICE
The ISPD General Assembly 2020 will take place on an online format, due to the postponement of the ISPD-EuroPD Congress 2020 to March 2021.
A private link to access the General Assembly will be sent to the members a few days before the meeting together with any last minute information.
You can download the agenda here.
You can download the minutes of the ISPD General Assembly 2018 here.
Please note that only members can attend the ISPD General Assembly. Please visit the corresponding sections of our website to renew your membership or become a member easily.
ISPD Fellowship Program – Round 1 of 2020 is now open!
The Scholarship and Awards Committee will receive applications for the second round of ISPD Fellowships until 31 March 2020.
The ISPD Council decided last November to increase the number of grants 20%. This means that, from 2020, 12 nephrologists and nurses travel abroad every year to get the best training available at one of the Reference Centers that have joined our program. Each one of them receives up to $5000 USD to cover the costs associated with their stay. We aim to select 6 candidates in this round of applications.
Find more information on the ISPD Fellowships application page, including eligibility, detailed instructions on how to apply, and the links to download the application form.
Please share this information with other colleagues who may be eligible. It is not necessary to be an ISPD member to apply for the ISPD Fellowship.
If your hospital would like to be included in the List of Reference ISPD Fellowship Centers, please contact our office at admin@ispd.org.
News from the North America Chapter (March 2020)
ISPD-NAC at the Annual Dialysis Conference
The ISPD-NAC held its one-day educational session at the Annual Dialysis Conference in Kansas City, Missouri. The theme of the day was “Turning down the Churn of PD”. Expert speakers focused on management strategies to reduce complications, reduce technique failure and increase time on the therapy. The session included outstanding talks on PD related complications, challenging PD cases, and quality improvement efforts to grow PD. The sessions were very well attended which demonstrated the growing interest in PD in the United States. The ISPD-NAC is actively pursuing partnerships with the National Kidney Foundation and the American Society of Nephrology to help address educational gaps in peritoneal dialysis.
Research – Improving the outcomes of PD catheter insertion
The North American PD catheter registry continues to collect prospective data for the study entitled “Improving the outcomes of PD catheter insertion”. This study received $1.38 M of funding from the Canadian institutes of Health Research. The study has previously been supported by Baxter Healthcare, Medtronic, and the Ontario Renal Network. The first manuscript from this study has been published in Peritoneal Dialysis International.
Of the 500 individuals who underwent laparoscopic PD catheter insertion in this first report, the cumulative risk of insertion-related complications 6 months from the date of insertion was 24%. The risk of flow restriction, exit-site leak, and pain at 6 months was 10.2%, 5.7%, and 5.3%, respectively. PD was never started or terminated in 6.4% of patients due to an insertion-related complication. The study framework is also being used to report PD related complications by the Ontario Renal Network in Ontario, Canada.
Other studies
The Optimizing Prevention of PD-Associated Peritonitis in the US (OPPUS) study has been launched as an ancillary study of Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). The Co-Principal Investigators are Dr. Jeffery Perl and Dr. Ronald Pisoni. This study aims to identify high-risk patients and clinical practices associated with peritonitis risk to help further inform evidence-based practice guidelines.
Policy work
On July 10, 2019, President Trump signed the executive order on Advancing American Kidney Health. One of the aims of the Initiative is have 80% of new American ESRD patients in 2025 receiving either home dialysis or a kidney transplant. This Initiative has created substantial new interest in
Peritoneal Dialysis which remains the most prevalent form of home dialysis. The ISPD-NAC continues to work with stakeholders to improve the outcomes of peritoneal dialysis. This includes supporting Home Dialysis Alliance and the KDOQI Home Dialysis Quality Improvement Initiative Roadmap.
News from the Asia Pacific Chapter
Scholarship and fellowship
Dr. Vaishnavi Raman from India has just completed her ISPD fellowship program hosted by the Royal Brisbane & Women’s Hospital and Queensland Children’s Hospital, both at Queensland, Australia, under the supervision of Dr. Dwarakanathan Ranganthan and Dr. Peter Trnka, respectively. We look forward to seeing her contribution to the International Society for Peritoneal Dialysis in the near future.
Future Meetings and Conferences
We are proud to announce the 10th Asia Pacific Chapter Meeting of the International Society of Peritoneal Dialysis (APCM-ISPD 2021) will held at the Bali Nusa Dua Convention Center (BNDCC), Bali, Indonesia, on 21 to 23 October 2021. The meeting will be hosted by the Indonesian Society of Nephrology. Professor Aida Lydia Sutranto, President of Indonesian Society of Nephrology, will be in charge of the organization.
Looking towards 2023. the ISPD Asia Pacific Chapter will call the bidding for hosting the 11th Asia Pacific Chapter Meeting of the International Society of Peritoneal Dialysis, which is expected in 2023. The formal announcement will be posted in the April 2020 issue of the ISPD Asia Pacific Chapter newsletter, that you can find on the ISPD website.
Adrian Liew wins the John Maher award 2020
John Francis Mayer was president of the ISPD between 1983 ad 1987, and a great contributor to the advance of haemodialysis and peritoneal dialysis. He directed several Nephrology divisions in universities such as the University of Missouri, the University of Connecticut, or the Uniformed Services University of the Health Sciences. His contribution to books and publications, and his education dedication and skills led to his work being recognised in different countries during his life. After his sudden death in 1990 the ISPD decided to recognise his legacy with the John Maher award, honouring young individuals who have contributed substantially to the field of peritoneal dialysis. Candidates must be younger than 45 years old and have demonstrated expertise in either the scientific, medical or nursing aspects of PD.
Dr Adrian Liew is the recipient of the 2020 ISPD Congress John Maher Award. His list of merits is explained below, in words of Dr Mayoor Prabhu.
Dr Liew is a Senior Consultant Nephrologist and Associate Professor of Medicine with the LKC School of Medicine at the Nanyang Technological University-Imperial College London in Singapore. Dr Liew has made far reaching contributions to PD, especially in the South East Asian Region. He was the founding Chief of Nephrology of the Department of Renal Medicine at Tan Tock Seng Hospital in Singapore and is the program director for the Chronic Peritoneal Dialysis program, and during his
tenure as Chief of Nephrology, had developed various subspecialty programs in the department. It is notable that he had spearheaded several national programs in Singapore including the peritoneal dialysis preferred initiative and the national HALT-CKD program.
Dr Liew’s contribution towards the growth and promotion of PD in South East Asia is laudable, especially since this region is mainly a resource limited region grappling with an increasing CKD burden. He has brought together committed nephrologists from each member country of ASEAN in early 2017 to form the ASEAN PD Network which he continues to chair. Under his leadership, the 8 countries have developed the study design and concept for the PROMiSE Study (PD pRactices and Outcomes in Multiple SouthEast Asian Countries), a PD registry of incident PD patients in all 8 countries of Southeast Asia with the aim of reviewing differences in PD care and improving PD outcomes in the region. As part of the collaboration between ISN and the Indonesian Society of Nephrology (PERNEFRI), Dr Liew has helped develop the blueprint for expanding the utilization of peritoneal dialysis in Indonesia. He also is actively assisting units in Myanmar, Brunei, and the Philippines in improving outcomes and increasing utilization of PD. In addition, he has been heavily involved in the training of nephrologists to perform peritoneal dialysis catheter insertion in several Southeast Asian countries. Dr Liew is also an elected Executive and Secretary of the International Society for Peritoneal Dialysis (ISPD) and is the Co-Chair of the Local Organizing Committee for the ISPD Congress 2022 in Singapore.
This impressive PD curriculum, together with other contributions in other fields of nephrology, makes Dr Adrian Liew a worthy recipient of the John Maher Award, just like the illustrious predecessors who were bestowed this honour:
- 2018 Jie Dong (ISPD Congress Vancouver, Canada)
- 2016 Jeffrey Perl (ISPD Congress Melbourne, Australia)
- 2014 Karen Yeates (ISPD Congress Madrid, Spain)
- 2012 CC Szeto (ISPD Congress Kuala Lumpur, Malaysia)
- 2010 Qiang Yao (ISPD Congress Mexico City, Mexico)
- 2008 Roberto Pecoits Filho (ISPD Congress Istanbul, Turkey)
- 2006 Angela Yee-Moon Wang and Rajnish Mehrothra (ISPD Congress Hong Kong, China)
- 2004 Ann De Vriese (ISPD Congress Amsterdam, The Netherlands)
- 2001 Tao Wang (ISPD Congress Montréal, Canada)
- 1998 Nicholas Topley (ISPD Congress – Seoul, Korea)
- 1995 Andrzej Breborowicz and Barbara Prowant (ISPD Congress – Stockholm, Sweden)
Dr Adrian Liew, as winner of the John Maher award 2020, will give a presentation at the opening plenary of the ISPD-EuroPD 2020 Congress in Glasgow next May. The title of this session will be: Peritoneal Dialysis in Southeast Asia – The Start of a PROMiSE
Have you registered for the ISPD-EuroPD Joint Congress next May 1-5 in Glasgow (UK) yet? Register here.
Prof. Fred Finkelstein wins the Dimitrios Oreopoulos award 2020
Dr Dimitrios Oreopoulos was a major force in the development of peritoneal dialysis, through his contributions in research, development of methodologies and techniques, and even founding the publication PD Bulletin, which led to Peritoneal Dialysis International, our Society journal. The ISPD honours him by recognising the lifetime PD achievements of one of its members (in terms of delivering care to patients, research, teaching and /or advocacy) with the Dimitrios Oreopoulos Award every two years, at our Congress.
Prof. Edwina E. Brown explains a few of the reasons why Prof Fred Finkelstein deserves the Oreopoulos award in 2020.
Fredric Finkelstein is Clinical Professor of Medicine, Yale University Medical School. He has been one of the key proponents of patient-centred care, the importance of considering patient reported outcomes and how to do this. His research work has highlighted the psychosocial problems experienced by many people with end-stage kidney disease and that these need to be addressed by dialysis programmes.
His greatest contribution to peritoneal dialysis has been the development of PD in lower income countries. He has worked extensively in low resource countries and was instrumental in setting up the Saving Young Lives Program enabling PD for AKI (currently the deputy-chair); was chair of the Peritoneal Dialysis Committee, International Society of Nephrology 2006-2009, co-chair of the dialysis committee of the ISN, chair of CME programs for ISN (2009-17), co-chair of the North American Chapter of ISPD 2008-11, chair of the international liaison committee of the ISPD 2006-19 and is currently on the steering committee of the ISN ESKD initiative, which is promoting PD as the most cost-effective way of increasing access to dialysis in low resource countries.
He has been involved in many international guidelines, most recently in the development of the 2020 ISPD clinical recommendations for prescribing high quality goal-oriented PD. The PD community in its broadest sense – people with ESKD and the PD healthcare team – have benefited immensely from Fred’s extraordinary amount of energy and devotion.
Prof Fred Finkelstein joins the list of Oreopoulos awardees:
- 2018 Simon Davies (ISPD Congress Vancouver)
- 2016 Peter Blake (ISPD Congress Melbourne)
- 2014 Georgi Abraham (ISPD Congress Madrid)
Have you registered for the ISPD-EuroPD Joint Congress next May 1-5 in Glasgow (UK) yet? Register here.
ISPD Call for Research Proposals extended!
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 extended: Monday Feb 3 2020
Eligibility Criteria
Members and non-members of the ISPD may submit proposals.
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 February 3 2020.
Funding
Small grants (up to $10,000 USD) may be awarded at the discretion of the ISPD Council to help enable these projects.
ISPD President’s Message – January 2020
Click here to read Prof Johnson’s message to the members of the society, and learn more about what’s happening at the society.
