QUALITY INDICATORS IN PERITONEAL DIALYSIS AT A MEXICAN CENTER: FIVE YEARS OF EXPERIENCE

 

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QUALITY INDICATORS IN PERITONEAL DIALYSIS AT A MEXICAN CENTER: FIVE YEARS OF EXPERIENCE

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Miguel Angel
Franco
Carlos Eduardo Ortiz Castañeda otizmedico@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Maria Fernanda Saavedra Velez fersaavedravz@gmail.com HRVGFValentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Citlaly Monserrat Villagomez Garcia montse031095@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Alejandra Sanchez Hernandez saher.allen@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Jesus Noe Bailon Contreras noebailoncontreras@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Blanca Alicia Ornelas Barajas blanca_aob@hotmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Juan Carlos Anaya Zamora jkaz1907@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Rodrigo Quintero Solis rodrigoquinterosolis@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Edna Teresa Mendoza Villalobos ednamendozav@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Miriam Gabriela Nava Vargas mgnava93@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Michell Marisol Cedillo Monreal michellemarisol_cm@hotmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Mireya Gonzalez Franco mireyagonzalezfranco@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Francisco Robles Garcia franciscoroblesg96@gmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Hugo Sergio Breien Alcaraz breienh@hotmail.com Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico -
Miguel Angel Franco Barrera Valentin Gomez Farias Regional Hospital Nephrology Guadalajara Mexico *

Peritoneal dialysis (PD) is a modality of renal replacement therapy. Its effectiveness depends on the proper monitoring of clinical and laboratory parameters, as well as the control of infectious and cardiovascular complications. The establishment and evaluation of international targets, such as rates of peritonitis, exitsite infections, hospitalizations, and mortality, allow for the assessment of the quality of care and health outcomes in this population. Peritonitis is one of the main complications associated with PD and can lead to treatment failure, transfer to hemodialysis, or even death, making it one of the primary quality indicators.

A 5-year descriptive observational study was conducted at a peritoneal dialysis center in Guadalajara, Mexico. The entire population enrolled in the peritoneal dialysis program and under follow up was included. Fourteen targets derived from various international consensus statements and guidelines established for PD patient populations were recorded, with the aim of presenting our center’s experience in terms of quality of care.

Data from the years 2017, 2018, 2019, 2023, and 2024 were analyzed. We did not have records for 2020, 2021, and 2022 due to the COVID-19 pandemic. In recent years, the average mortality was 8% and hospitalization was less than 0.8 patients per month, with an average of 0.5 patient hospitalization days per month post pandemic, meeting international targets. Regarding peritonitis goals, during this period there were 0.17 episodes of peritonitis per patient year, with a 4.2% transfer rate to hemodialysis; however, cultures were negative in more than 20% of cases. Hemoglobin (Hb) and erythropoietin (EPO) dosing targets were met intermittently; however, blood pressure targets have not yet been achieved in patients.

Over the years, our center has met the most relevant targets for patients on peritoneal dialysis, such as mortality, hospitalization, peritonitis, and transfer to hemodialysis. This is a result of the standardized protocol of continuous training for patients and caregivers, as well as the availability of immediate care for any eventuality, both by phone and in person.

Kewords