JMIR Publications

ABSTRACT

Background:

Peritoneal dialysis (PD) care in Chinese mainland has been progressing in the recent ten years.

Objective:

To investigate the current infrastructure and management of PD care at hospitals of different tiers, a large-scale nationwide survey was conducted.

Methods:

Through the National Center for Nephrology Medical Quality Management and Control, an online multiple-choice questionnaire was distributed to PD centers at secondary and tertiary hospitals in October 2020. A total of 788 surveys from 746 hospitals were returned.

Results:

The survey covered 101,537 PD patients, with 95% in the tertiary hospitals. The median patient number per PD center was 60 (interquartile range [IQR] 21-152), which was 32 (8-65) for secondary hospitals and 70 (27-192) for tertiary hospitals. Continuous ambulatory PD was the most common PD type (85%), which was followed by intermittent PD (69%). There was a discrepancy in the availability of designated physical areas for different functions of PD care between the secondary and tertiary hospitals. The proportion of tertiary hospitals with PD training, storage, procedure area was higher than that of secondary hospitals (overall P<0.05). Comparing the data from the secondary and tertiary hospitals, there was no significant difference in prophylactic antibiotic use for PD catheter placement and therapeutic use for peritonitis. The first peritoneal equilibrium test (PET) was conducted in 58% patients at 4-6 weeks after initiation of PD, and 91% reported at least one PET per year. Overall, 87% PD patients were followed every one to three months for laboratory and auxiliary examinations.

Conclusions:

This national survey reflects the current disparities status of PD center management in Chinese mainland. The accessibility of PD care needs to be more convenient in secondary hospitals and quality management and staff training in secondary hospitals are in high demand.