Advancing the Use and Quality of Peritoneal Dialysis by Developing a Peritoneal Dialysis Satellite Center Program

Abstract

BackgroundPeritoneal dialysis (PD) is developing rapidly in China, but because there are not enough well-trained PD doctors and nurses in more rural areas, this expansion is occurring mainly in larger cities. To address this imbalance, our center established a PD satellite center program across Guangdong Province, with the aim of extending the use and improving the quality of PD.MethodsSun Yat-sen University PD center is responsible for running the satellite program. The PD satellite centers are selected using specific criteria. The full-time PD physicians and nurses in the satellite centers accept a unified training program and treatment practices, and their clinical outcomes are carefully followed by our center.ResultsThe program began in January 2008, and there are now 12 PD centers from which 26 doctors and 32 nurses received PD training. Several hundred patients are now receiving PD through this program. The total number of PD patients treated by our center and the satellites increased to 1860 from 1010. The number treated in the satellite units increased to 1165 from 601. The annual dropout rate fell to 17.6% from 28.2%, and the average peritonitis incidence fell from 1 episode in 39.4 patient–months to 1 episode in 46.2 patient–months. The 1-year patient and technique survival rates increased to 84.2% from 82.0% and to 93% from 88.7% respectively.ConclusionsOur PD satellite center program is a good model for increasing the use and improving the quality of PD in rural areas. We plan to expand this program to other parts of southern China.