Ryckelynck Jean-Philippe, Abbadie Odette, Castrale Cindy, Lavainne Frédéric, Fakhouri Fadi, Lobbedez Thierry
CHU Clemenceau, service de néphrologie-dialyse-transplantation rénale, 14033 Caen, France.
Presse Med. 2011 Nov;40(11):1053-8. doi: 10.1016/j.lpm.2011.06.021. Epub 2011 Sep 15.
The prevalence of peritoneal dialysis in France remains one of the lowest in Europe in spite of official recommendations in 2008. Progress in peritoneal catheter placement and a good knowledge of the management of catheter complications are essential. A more frequent use of biocompatible solutions should achieve a better preservation of the peritoneal membrane. Such physiological peritoneal fluids seem to decrease morbidity and mortality. Best peritoneal dialysis indications are mainly young patients waiting for a kidney transplantation, old patients without malnutrition and patients with cardiac insufficiency. Objective and complete information dedicated to both peritoneal dialysis and hemodialysis is necessary, even for patients seen in emergency or unplanned or late referral patients. A pre-end-stage renal disease education program has to be mandatory. Non-medical obstacles, mainly financial, are still common so that economic incitations are necessary for the development of peritoneal dialysis. A university formation of nephrologists is now available.
尽管2008年有官方建议，但法国腹膜透析的普及率仍是欧洲最低的之一。腹膜导管置入技术的进步以及对导管并发症管理的充分了解至关重要。更频繁地使用生物相容性溶液应能更好地保护腹膜。这种生理性腹膜液似乎能降低发病率和死亡率。最佳的腹膜透析适应证主要是等待肾移植的年轻患者、无营养不良的老年患者以及心力衰竭患者。即使对于急诊患者、计划外转诊患者或延迟转诊患者，提供关于腹膜透析和血液透析的客观完整信息也是必要的。必须强制实施终末期肾病前期教育项目。非医学障碍，主要是经济障碍，仍然很常见，因此发展腹膜透析需要经济激励措施。现在有针对肾病学家的大学培训课程。
