Grant: Operating Grant: Industry-partnered Collaborative Research

For the 36000 Canadians living with end stage kidney disease, hospital based hemodialysis (HD) is the most common therapy. Less than 20 percent of patients are treated with home based peritoneal dialysis (PD). PD requires a catheter which is inserted in the patient's peritoneum in the abdomen to allow for the removal of fluid and wastes. Compared to HD, PD is associated with similar survival, superior patient satisfaction, and is administered at home by a patient or caregiver at a lower cost. Increasing the use of PD represents an attractive strategy to improve patient outcomes and minimize healthcare costs of dialysis therapy. Yet, over 30 percent of Canadian patients on PD will ultimately require a transfer to HD after 3 years. The transfer to HD may be related to ongoing infection of the PD fluid, complications of the PD catheter, inability of peritoneal membrane to remove the necessary fluid and toxins needed, and difficulty for patients to manage their treatments at home. Across facilities in Canada and between countries, the rates of these treatment related complications vary significantly. This finding may be the result of differences in patient characteristics across facilities. However, it also may relate to the different ways in which PD patients are cared for. The present study will be the Canadian arm of The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) that will be performed in Canada, Japan, UK and USA. PDOPPS will be one of the largest studies following patients on PD. PDOPPS will collect information on the differences in facility practices, and will follow patients over a 3 year period. The study will provide an opportunity to identify different practices in how patients on PD are cared for within 20 representative facilities within Canada comparing these to those facilities in participating countries. This will allow us to identify practices that minimize the need to transfer to HD and improve outcomes for patients on PD.