Special Report1997 peritoneal dialysis–core indicators study: Dialysis adequacy and nutritional indicators report
Section snippets
Methods
The data contained in this report are available from the Quality Measurement and Health Assessment Group, Office of Clinical Standards and Quality, Health Care Financing Administration (HCFA), US Department of Health and Human Services, 7500 Security Blvd, Baltimore, MD, and are identified as the 1997 Peritoneal Dialysis–Core Indicators Study (1997 PD-CIS). In February 1997, HCFA's Renal Beneficiary Utilization System identified a national random sample of 1,375 adult PD patients (≅5% of the
Results
Completed forms were received for 1,219 subjects (89% of the sample), 57% of whom used continuous ambulatory peritoneal dialysis (CAPD) and 39% automated peritoneal dialysis (APD) in the forms of chronic cycling peritoneal dialysis (CCPD) and PD-Plus therapy. The remaining 4% of patients used intermittent peritoneal dialysis, tidal peritoneal dialysis, or other hybrid dialysis formulae, and these patients are not included in subsequent analyses. There were few differences between the patients
Discussion
General clinical observations substantiate the premise that peritoneal dialysis alters the uremic condition. Acutely uremic individuals become more alert and vital and show improved appetite and weight gain after initiation of PD. The quantity of renal replacement therapy necessary to achieve and maintain this outcome remains incompletely defined, and estimates of a minimal desired renal replacement dose vary. The National Kidney Foundation's DOQI guidelines26 suggest that PD should provide
Conclusion
The data reported here represent a prevalence report and cannot be used to determine causality. Longitudinal follow-up would be necessary to associate patient outcome with the variables measured in this report. Similarly, assessing the effects of any intervention that changes one of the reported variables on patient welfare is not possible with this data set. The information reported here does, however, describe the status of US peritoneal dialysis patients in 1997. These patients exhibit a
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Received December 4, 1998; accepted in revised form February 16, 1999.
Address reprint requests to Michael J. Flanigan, MD, Department of Medicine, T-305-GH, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242-4060. E-mail: [email protected]