Current Challenges and Opportunities in PD.
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD. Obviously, hemodialysis as another renal-replacement therapy modality also has its own areas that need attention and improvement by nephrologists and nurses. With more clinical and basic science research, outcome studies, and through better education and training, together with the implementation of global PD guidelines for enhancing care of PD patients, it is likely that such problem areas in PD gradually will be resolved and PD patient outcomes will be improved.
CUHK Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong. Electronic address: philipli@cuhk.edu.hk.
Philip Kam-Tao
PK
Li
CUHK Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Vickie Wai-Ki
VW
Kwong
D002318:Cardiovascular Diseases / Q000401:mortality; D003863:Depression / Q000523:psychology; D015314:Dialysis Solutions; D005221:Fatigue / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D044342:Malnutrition / Q000517:prevention & control / Q000628:therapy; D010530:Peritoneal Dialysis / Q000379:methods* / Q000523:psychology; D010538:Peritonitis / Q000517:prevention & control / Q000628:therapy; D017410:Practice Guidelines as Topic; D014883:Water-Electrolyte Imbalance / Q000517:prevention & control / Q000628:therapy
D015314:Dialysis Solutions
Peritoneal dialysis; challenges; global; opportunities