Treamtrakanpon Worapot, Kanjanabuch Talerngsak, Nopsopon Tanawin, Chuengsaman Piyatida, Dandecha Phongsak, Boongird Sarinya, Khositrangsikun Kamol, Wongluechai Laddaporn, Tatiyanupanwong Sajja, Puapatanakul Pongpratch, Srisawat Nattachai, Eiam-Ong Somchai, Johnson David W, Sritippayawan Suchai, Kantachuvesiri Surasak
Department of Medicine, Chaophraya Abhaibhubejhr Hospital, Prachinburi, Thailand.
Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.
Perit Dial Int. 2022 Jan;42(1):92-95. doi: 10.1177/0896860821989878. Epub 2021 Feb 16.
This national survey of barriers to and constraints of acute peritoneal dialysis (aPD) in acute kidney injury (AKI) was performed by distributing an online questionnaire to all medical directors of public dialysis units registered with the Nephrology Society of Thailand during September-November 2019. One hundred and thirteen adult facilities responded to the survey covering 75 from 76 provinces (99%) of Thailand. aPD was performed in 66 centres (58%). In facilities where aPD practice was available, the utilization rate was relatively low (<10 cases/year) and limited to specific conditions, including HIV seropositive patients, previous receiving dialysis education and plan and difficult vascular access creation. Only 9% of facilities performed aPD routinely, but interestingly all such units permitted bedside catheter insertion by the nephrologists or internists. The major constraints placed on aPD practice were PD catheter insertion competency, timely catheter insertion support and the medical supporting team's knowledge/competency deficits. aPD for AKI is underutilized in Thailand and limited by the inability to undertake timely PD catheter insertion and knowledge and competency deficits.
2019年9月至11月期间，通过向泰国肾脏病学会注册的所有公共透析单位的医学主任发放在线问卷，对急性肾损伤（AKI）患者进行急性腹膜透析（aPD）的障碍和限制因素开展了这项全国性调查。113个成人透析机构回复了调查，覆盖泰国76个省份中的75个（99%）。66个中心（58%）开展了aPD。在有aPD实践的机构中，利用率相对较低（每年<10例），且仅限于特定情况，包括HIV血清学阳性患者、先前接受过透析教育和计划以及血管通路建立困难的患者。只有9%的机构常规开展aPD，但有趣的是，所有这些单位都允许肾病科医生或内科医生在床边插入导管。aPD实践的主要限制因素是腹膜透析导管插入能力、及时的导管插入支持以及医疗支持团队的知识/能力不足。泰国AKI患者的aPD未得到充分利用，且受到无法及时进行腹膜透析导管插入以及知识和能力不足的限制。
