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peritoneal dialysis CAPD renal replacement therapy Sudan Africa
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Copyright belongs to The Arab Society of Nephrology and Renal Transplantation (ASNRT)
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The Sudan Peritoneal Dialysis Program: Three Years of Momentum
Abstract
Introduction: End stage renal disease (ESRD) is a significant social and economic burden on Africa. Continuous ambulatory peritoneal dialysis (CAPD) was introduced as a national service in the Sudan three years ago. An overview of the Sudan Peritoneal Dialysis Program is presented.
Review: As a national scheme, the Sudan PD program was sequentially launched in seven centers in Sudan. CAPD was the modality exclusively utilized. The total number of patients enrolled by July 2008 was 232. Patients' mean age was 43 years, 23.5% were children, 63% were males, and 19% were diabetic.
PD was the initial dialysis modality for 54.7% of patients, 43.5% were referred from HD, and 1.9% had a failed kidney transplant. The majority of patients (62.3%) chose PD as the preferred dialysis modality, while the remainder were referred from HD to PD because of vascular access problems or hemodynamic instability. One third of patients required assisted PD, and 17% needed urgent initiation of dialysis.
The cumulative peritonitis rate was one episode per 10.8 patient months. Touch contamination, urgent initiation of dialysis and execution of dialysis by family members other than trained helpers were among the identified predisposing factors.
Conclusion: The establishment and operation of the Sudan PD program over the past three years have indicated that it is a promising project with multifaceted success. There is, however, an ongoing need for retraining of patients and staff. Early selection and careful preparation for potential PD candidates is also of vital importance to reduce the need for urgent dialysis initiation.
Key words: peritoneal dialysis, CAPD, renal replacement therapy, Sudan, Africa
Review: As a national scheme, the Sudan PD program was sequentially launched in seven centers in Sudan. CAPD was the modality exclusively utilized. The total number of patients enrolled by July 2008 was 232. Patients' mean age was 43 years, 23.5% were children, 63% were males, and 19% were diabetic.
PD was the initial dialysis modality for 54.7% of patients, 43.5% were referred from HD, and 1.9% had a failed kidney transplant. The majority of patients (62.3%) chose PD as the preferred dialysis modality, while the remainder were referred from HD to PD because of vascular access problems or hemodynamic instability. One third of patients required assisted PD, and 17% needed urgent initiation of dialysis.
The cumulative peritonitis rate was one episode per 10.8 patient months. Touch contamination, urgent initiation of dialysis and execution of dialysis by family members other than trained helpers were among the identified predisposing factors.
Conclusion: The establishment and operation of the Sudan PD program over the past three years have indicated that it is a promising project with multifaceted success. There is, however, an ongoing need for retraining of patients and staff. Early selection and careful preparation for potential PD candidates is also of vital importance to reduce the need for urgent dialysis initiation.
Key words: peritoneal dialysis, CAPD, renal replacement therapy, Sudan, Africa
