Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Arbor Research Collaborative for Health, Ann Arbor, MI, USA.
Perit Dial Int. 2020 May;40(3):310-319. doi: 10.1177/0896860819895356. Epub 2020 Jan 17.
We describe peritoneal dialysis (PD) prescription variations among Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) participants on continuous ambulatory PD (CAPD) and automated PD (APD; = 4657) from Australia/New Zealand (A/NZ), Canada, Japan, Thailand, United Kingdom (UK), and United States (US).
CAPD was more commonly used in Thailand and Japan, while APD predominated over CAPD in A/NZ, Canada, the US, and the UK. Total prescribed PD volume normalized to the surface area was the highest in Thailand and the lowest in Japan (for both APD and CAPD) and the UK (for CAPD). PD patients from Thailand had the lowest residual urine volume and residual renal urea clearance, yet achieved the highest dialysis urea clearance. Japanese patients had the lowest dialysis urea clearances for both APD and CAPD. Despite having similar urine volumes to patients in A/NZ, Canada, Japan, and the UK, US CAPD and APD patients used 2.5% and 3.86% glucose PD solutions more frequently, whereas fewer than 25% of these patients used icodextrin. Over half of the patients in A/NZ, Canada, the UK, and Japan used icodextrin, whereas it was hardly used in Thailand. Japan and Thailand were more likely to use 1.5% glucose solutions for their PD prescription.
There are considerable international variations in PD modality use and prescription patterns that translate into important differences in achieved dialysis clearances. Ongoing recruitment of additional PDOPPS participants and accrual of follow-up time will allow us to test the associations between specific PD prescription regimens and clinical and patient-reported outcomes.
我们描述了来自澳大利亚/新西兰（A/NZ）、加拿大、日本、泰国、英国（UK）和美国（US）的腹膜透析（PD）结局和实践模式研究（PDOPPS）中持续非卧床 PD（CAPD）和自动化 PD（APD）参与者（=4657）之间的 PD 处方差异。
CAPD 在泰国和日本更为常见，而 APD 在 A/NZ、加拿大、美国和英国则优先于 CAPD。标准化到表面积的总 PD 容积在泰国最高，在日本（APD 和 CAPD 均如此）和英国（仅 CAPD）最低。来自泰国的 PD 患者的残余尿量和残余肾尿素清除率最低，但透析尿素清除率最高。日本患者的 APD 和 CAPD 透析尿素清除率均最低。尽管与 A/NZ、加拿大、日本和英国的患者尿量相似，但美国 CAPD 和 APD 患者更频繁地使用 2.5%和 3.86%葡萄糖 PD 溶液，而这些患者中使用艾考糊精的不到 25%。A/NZ、加拿大、英国和日本超过一半的患者使用艾考糊精，而泰国几乎没有使用。日本和泰国更有可能在 PD 处方中使用 1.5%葡萄糖溶液。
PD 模式的使用和处方模式存在相当大的国际差异，这转化为实现的透析清除率的重要差异。持续招募更多的 PDOPPS 参与者并积累随访时间，将使我们能够检验特定 PD 处方方案与临床和患者报告结果之间的关联。
