UK-PDOPPS (Peritoneal Dialysis Outcomes and Practice Patterns Study)
Dr Martin Wilkie, Sheffield
Start / End:
2013 - 2016
Peritoneal dialysis (PD) and haemodialysis (HD) are the main life-sustaining artificial treatments available to remove waste products from people who have kidney failure and are equally effective. PD involves the exchange of fluid in and out of the abdominal cavity via a catheter that is placed for this purpose. PD has advantages as a home treatment giving the user more personal freedom and flexibility, allowing people to continue to work. It is also less expensive than HD which generally requires patients to attend hospital 3 times per week for treatment lasting 4 hours per session. Despite the advantages of PD, it is used much less than HD in the UK with wide variations in its use between dialysis centres.
One factor that explains the variation in the successful use of PD is the occurrence of early complications such as when the catheter does not work well. If the catheter does not work properly there are significant implications: negative psychological impact, disruption of lifestyle and work, periods of hospitalisation, extra operations and the possible need to change to HD.
This research aims to understand the best practices that exist for PD catheter insertion and the way that services are organised to support them. We are particularly interested in the clinical pathways that are associated with catheters working first time and those which lead to the best outcomes. We think that by understanding these we will be able to recommend optimal practices to improve outcomes, which can then be audited.
Patient benefits of this research will include more consistent and effective placement of PD catheters and a reduction in the occurrence of the complications. Benefits to the broader NHS will include cost savings due to a reduced requirement for repeat procedures, improved patient safety and increased use of PD as a therapy.