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.