Wong Shannon N, Turnbull Linda, Saunders Sushila, Er Lee, Bevilacqua Micheli U, Levin Adeera, Singh Rajinder S
Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
British Columbia Provincial Renal Agency, Vancouver, BC, Canada.
Perit Dial Int. 2024 May;44(3):177-184. doi: 10.1177/08968608221149546. Epub 2023 Feb 7.
In 2016, Peritoneal Dialysis Assist (PDA) was implemented in British Columbia, Canada, as a pilot program to allow patients with physical, cognitive and social impairments to access an independent dialysis modality. This is a presentation of the usage and 5-year clinical outcomes of our provincial assisted peritoneal dialysis (PD) program.
Patients who utilised long-term or respite PDA services in British Columbia, Canada, from 2016 to 2021 were included in this program evaluation. Incident and prevalent patient numbers were characterised annually as well as indications for PDA and patient demographics both annually and over time. Outcomes of interest included death, transfer to haemodialysis, transplantation and cessation of the PDA program but retention on PD.
Three hundred twenty-two total patients received services through the PDA program. The percentage of PD patients supported by long-term PDA service has grown to 11.2% in the most recent year. Patients spend a median of 13.6 (95% CI: 11.0, 16.1) months on long-term PDA, prolonging overall patient duration on PD by a little over a year. Of the patients who exited the long-term PDA program, 73 (37.4%) were able to utilise the service until they died.
PDA is an accessible, patient-centric service with clear and standardised referral criteria. Through the implementation of a local PDA program, patients have accessed PD and may have extended their PD life span, through avoidance of in-centre haemodialysis, by over 13 months during this 5-year study period. A significant proportion of patients on long-term PDA were able to use their preferred kidney replacement modality at home until they reached end of life.
2016年，腹膜透析辅助（PDA）在加拿大不列颠哥伦比亚省作为一项试点项目实施，旨在让有身体、认知和社会障碍的患者能够使用独立的透析方式。本文介绍了我省辅助腹膜透析（PD）项目的使用情况和5年临床结果。
纳入2016年至2021年在加拿大不列颠哥伦比亚省使用长期或临时PDA服务的患者进行项目评估。每年对新发病例和现患病例数量进行统计，并对PDA的适应证以及患者人口统计学特征进行年度和长期分析。关注的结局包括死亡、转为血液透析、移植以及终止PDA项目但仍保留腹膜透析。
共有322名患者通过PDA项目接受服务。长期PDA服务支持的腹膜透析患者比例在最近一年已增长至11.2%。患者在长期PDA上的中位时间为13.6（95%CI：11.0，16.1）个月，使患者总体腹膜透析时间延长了一年多。在退出长期PDA项目的患者中，73名（37.4%）能够一直使用该服务直至死亡。
PDA是一项可及的、以患者为中心的服务，具有明确和标准化的转诊标准。通过实施本地PDA项目，患者能够接受腹膜透析，并且在这项为期5年的研究期间，通过避免中心血液透析，腹膜透析寿命可能延长了13个月以上。相当一部分长期接受PDA服务的患者能够在家中使用他们首选的肾脏替代方式直至生命结束。
