Our hypothesis for this study is that peritoneal dialysis technique failure is determined by centre practice patterns as well as by individual patient characteristics.
The use of peritoneal dialysis has been reducing in recent years despite this treatment being shown to provide similar survival and better quality of life for patients. It is known that wide variation exists between renal centres in terms of PD technique survival (unpublished audit West Midlands) but this has not been explored recently in detail.
We hope to use data on renal centre practice patterns collected in the 2010 UKRR Survey alongside routinely collected UKRR data for the same period to explore the relationship between PD technique survival and renal centre/physician practice patterns.
Factors such as physician enthusiasm, provision of out of hours specialist advice and also PD programme size intuitively suggest a more successful PD programme but this is not known.
Patients choosing to undertake peritoneal dialysis undergo education and preparation for this treatment often making changes within their homes to create space to dialyse. They must undergo PD catheter insertion and then train to use this catheter to perform dialysis exchanges in a safe and sterile manner. Once trained patients would benefit from using this technique for as long as they wish to. Premature failure of the technique would expose patients to extra hospital admissions, clinic visits or procedures to change dialysis type and preventable morbidity related to the failure of their chosen dialysis treatment. The time spent using this form of dialysis therapy may be influenced by how care is delivered by their renal centre and if this study can suggest practice patterns associated with longer technique survival then these interventions can be trialed in a future interventional study to confirm the effect they have on the survival of the dialysis technique.
