DOPPS: Infection control practices for peritoneal dialysis patients vary by country, peritonitis rates vary greatly between facilities

Researchers from the Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor (DPM) will host a web conference on Thursday, September 21, 2017 at 3 p.m. EDT. The conference will be moderated by Bruce Robinson, MD, MS, FACP, Principal Investigator of the DOPPS Program. Registration for this web conference is available at DOPPS.org/DPM.

Jenny Shen, MD, MS, Chair of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) U.S. Advisory Group, will provide an overview of the PDOPPS and describe recent findings. PDOPPS is a research initiative for understanding and improving application of peritoneal dialysis (PD) therapy for individuals living with kidney failure, as well as to extend PD technique survival and improve survival and quality of life for PD patients. PDOPPS began in 2013 and is currently ongoing in the U.S., Canada, Australia, New Zealand, Japan, the Republic of South Korea, Thailand, and the United Kingdom.

Shen will review data from the PDOPPS, including:

International differences in facility and patient characteristics: In the U.S., PD clinics are less likely to be located within a hospital, and nurses are more likely to treat PD patients exclusively. U.S. PD patients are less likely to be over the age of 75 and more likely to have diabetes, compared to other PDOPPS countries.

International differences in practices and outcomes: Use of Icodextrin among PD patients is much lower in the U.S. than in other PDOPPS countries (37% in the U.S., 70-78% in Australia, New Zealand, Canada, Japan, and the UK). Practices to control infection vary greatly by country, and facility-level variation in peritonitis rates are striking.

Management of anemia: In the US, the use of intravenous iron is more common among PD patients compared to other countries (56% in the US, 5-17% elsewhere), but IV iron use may be overall less in PD patients compared to their HD counterparts.

Researchers will also present an overview of U.S. hemodialysis trends from the DPM through June 2017, including:

Vitamin D route: From December 2014 through June 2017, there has been a rapid increase in the proportion of patients given oral forms of active or analog vitamin D (typically calcitriol, taken at the dialysis unit) alone or in combination with IV forms. Use of oral forms has exceeded 50% for the first time in the DPM study period as of June 2017, compared to 6-8% in 2014 and prior years.

Iron-based phosphate binders: The prescription of new iron-based phosphate binders (ferric citrate and sucroferric oxyhydroxide) has increased steadily among hemodialysis patients, from 2% in 2015 to over 7% in June 2017. Prescription of sevelamer (a non-metal-based phosphate binder) has decreased by a similar amount during the same time period, while prescription of calcium-based phosphate binders have remained unchanged.