Sustainability of the Peritoneal Dialysis-First Policy in Hong Kong
Sustainability of the Peritoneal Dialysis-First Policy in Hong Kong
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DOI：
10.1159/000441580
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发表时间：
2015-01-01
影响因子：
3
通讯作者：
Li, Philip Kam-Tao
中科院分区：
文献类型：
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作者：
Choy, Agnes Shin-Man;Li, Philip Kam-Tao
在香港，每名病人每年接受血液透析的平均成本，较腹膜透析高出一倍以上。随着终末期肾病（ESRD）患者数量的激增，给政府和社会带来了巨大的经济负担。基于成本效益的原则，“个人发展优先”的政策在香港推行了30年，多年来取得了成功的成果。一个成功的PD第一政策需要PD的医学专业知识，专门工作人员的支持和精心设计的患者培训计划。解决患者的PD问题是PD优先政策可持续性的关键。在这篇文章中，我们强调了三个重要的患者群体：那些频繁的腹膜炎，超滤失败或透析不足。将讨论改进这些小组成果的潜在战略。此外，我们亦须加强医院作为后备支援，以及披索器官移植，以维持个人发展优先政策的可持续性。(C)2015 S. Karger AG，巴塞尔
In Hong Kong, the average annual cost of haemodialysis (HD) per patient is more than double of that of peritoneal dialysis (PD). As the number of patients with endstage renal disease (ESRD) has surged, it has posed a great financial burden to the government and society. A PD-first policy has been implemented in Hong Kong for three decades based on its cost-effectiveness, and has achieved successful outcomes throughout the years. A successful PD-first policy requires medical expertise in PD, the support of dedicated staff and a well-designed patient training programme. Addressing patients' PD problems is the key to sustainability of the PD-first policy. In this article, we highlight three important groups of patients: those with frequent peritonitis, ultrafiltration failure or inadequate dialysis. Potential strategies to improve the outcomes of these groups will be discussed. Moreover, enhancing HD as backup support and promoting organ transplantation are needed in order to maintain sustainability of the PD-first policy. (C) 2015 S. Karger AG, Basel