UOC di Nefrologia e Dialisi, Ospedale Maria SS dello Splendore, Giulianova, Italy.
Perit Dial Int. 2012 Sep-Oct;32(5):558-65. doi: 10.3747/pdi.2011.00112. Epub 2012 Mar 1.
To understand how peritoneal dialysis (PD) was being used in Italy in 2005 and 2008, a census of all centers was carried out.
In 2005 and 2008, data were collected from, respectively, 222 and 223 centers, with respect to 4432 and 4094 prevalent patients.
In the two periods, the PD incidence remained stable (24.3% vs 22.9%), varying from center to center. Continuous ambulatory PD (CAPD) was the main initial method (55%), but APD was more widespread among prevalent patients (53%). Among patients returning to dialysis from transplantation (Tx), PD was used in 10%. The use of incremental CAPD increased significantly from 2005 to 2008, in terms both of the number of centers (27.0% vs 40.9%) and of patients (13.6% vs 25.7%). Late referrals remained stable at 28%, with less use of PD. The overall drop-out rate (episodes/100 patient-years) remained unchanged (31.0 vs 32.8), with 13.1 and 12.9 being the result of death, and 11.8 and 12.4 being the result of a switch to hemodialysis, mainly after peritonitis. A dialysis partner was required by 21.8% of the PD patients. The incidence of peritonitis was 1 episode in 36.5 and 41.1 patient-months, with negative cultures occurring in 17.1% of cases in both periods. The incidence of encapsulating peritoneal sclerosis (episodes/100 patient-years) was 0.70, representing 1.26% of patients treated. The catheter types used and the sites and methods of insertion varied widely from center to center.
These censuses confirm the good results of PD in Italy, and provide insight into little-known aspects such as the use of incremental PD, the presence of a dialysis partner, and the incidence of encapsulating peritoneal sclerosis.
为了了解 2005 年和 2008 年意大利腹膜透析（PD）的使用情况，对所有中心进行了普查。
2005 年和 2008 年，分别从 222 个和 223 个中心收集了 4432 名和 4094 名患者的数据。
在这两个时期，PD 的发病率保持稳定（24.3%对 22.9%），且各中心之间存在差异。持续性不卧床腹膜透析（CAPD）是主要的初始方法（55%），但在现患患者中，自动化腹膜透析（APD）更为广泛（53%）。在从移植（Tx）返回透析的患者中，PD 的使用率为 10%。从 2005 年到 2008 年，增量 CAPD 的使用显著增加，无论是中心数量（27.0%对 40.9%）还是患者数量（13.6%对 25.7%）。晚期转诊率（每 100 患者年的发生次数）保持稳定，为 28%，PD 的使用率较低。总的失访率（每 100 患者年的发生次数）保持不变（31.0 对 32.8），其中 13.1 和 12.9 是死亡的结果，11.8 和 12.4 是转为血液透析的结果，主要是由于腹膜炎。21.8%的 PD 患者需要透析伴侣。腹膜炎的发生率为每 36.5 和 41.1 患者月发生 1 次，两期均有 17.1%的病例培养阴性。包裹性腹膜硬化症（每 100 患者年的发生次数）的发生率为 0.70，占治疗患者的 1.26%。所用导管类型以及置管部位和方法在各中心之间差异很大。
这些普查证实了 PD 在意大利的良好效果，并深入了解了增量 PD 的使用、透析伴侣的存在以及包裹性腹膜硬化症的发生率等鲜为人知的方面。
