Building an Effective Peritoneal Dialysis Program

Home dialysis is the wave of the future, and the current shift from in-center to home dialysis has been sped up by recent legislation and expert body guidance. Peritoneal dialysis (PD) comes with many physiologic, medical, psychosocial, and lifestyle benefits but with challenges in recruitment and retention as well. The keys to building an effective PD program start with an up-to-date and passionate physician champion of PD and a dedicated team. Education of chronic kidney disease (CKD) patients as they approach stages IV and V is integral in helping recruit patients appropriately. Support of the PD catheter placement team and planning ahead are important to prevent crash hemodialysis starts and to work toward urgent start PD (Abdel-Aal AK, Dybbro P, Hathaway P, Guest S, Neuwirth M, Krishnamurthy V, Perit Dial Int 34:481–493, 2014). Both core and extended teams are vital to create an integrated dialysis network, and as such we review the “team” concept in this chapter. During the Coronavirus-19 (COVID 19) era, the benefits of home dialysis, especially PD, are starting to mandate a paradigm shift in the delivery of care to ESKD patients, and those systems that are most prepared stand to reap the rewards.