Displaying publications 61 - 80 of 355 in total

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  1. Li PK, Lui SL, Ng JK, Cai GY, Chan CT, Chen HC, et al.
    Nephrology (Carlton), 2017 Dec;22 Suppl 4:3-8.
    PMID: 29155495 DOI: 10.1111/nep.13143
    To address the issue of heavy dialysis burden due to the rising prevalence of end-stage renal disease around the world, a roundtable discussion on the sustainability of managing dialysis burden around the world was held in Hong Kong during the First International Congress of Chinese Nephrologists in December 2015. The roundtable discussion was attended by experts from Hong Kong, China, Canada, England, Malaysia, Singapore, Taiwan and United States. Potential solutions to cope with the heavy burden on dialysis include the prevention and retardation of the progression of CKD; wider use of home-based dialysis therapy, particularly PD; promotion of kidney transplantation; and the use of renal palliative care service.
    Matched MeSH terms: Renal Dialysis/economics*
  2. Roger SD, Tio M, Park HC, Choong HL, Goh B, Cushway TR, et al.
    Nephrology (Carlton), 2017 Dec;22(12):969-976.
    PMID: 27699922 DOI: 10.1111/nep.12940
    AIM: Higher dosages of erythropoiesis-stimulating agents (ESAs) have been associated with adverse effects. Intravenous iron is used to optimize ESA response and reduces ESA doses in haemodialysis patients; this meta-analysis evaluates the magnitude of this effect.

    METHODS: A literature search was performed using MEDLINE, Embase and the Cochrane Collaboration Central Register of Clinical Trials from inception until December 2014, to identify randomized controlled trials of intravenous iron and ESA, in patients undergoing haemodialysis for end-stage kidney disease. Dosing of IV iron in concordance with the Kidney Disease Improving Global Outcomes guidelines was considered optimal iron therapy.

    RESULTS: Of the 28 randomized controlled trials identified, seven met the criteria for inclusion in the meta-analysis. Results of random-effects meta-analysis show a statistically significant weighted mean (95% CI) difference of -1733 [-3073, -392] units/week in ESA dose for optimal iron versus suboptimal iron. The weighted average change in ESA dose was a reduction of 23% (range -7% to -55%) attributable to appropriate dosing of intravenous iron. A comparison of intravenous iron versus oral iron/no iron (five trials) showed a greater reduction in ESA dose, although this did not reach statistical significance (weighted mean difference, 95% CI: -2,433 [-5183, 318] units/week). The weighted average change in ESA dose across the five trials was a reduction of 31% (range -8% to -55%).

    CONCLUSION: Significant reductions in ESA dosing may be achieved with optimal intravenous iron usage in the haemodialysis population, and suboptimal iron use may require higher ESA dosing to manage anaemia.

    Matched MeSH terms: Renal Dialysis/adverse effects*
  3. AlSahow A, AlQallaf A, AlYousef A, Bahbahani H, Bahbahani Y, AlHelal B, et al.
    Int Urol Nephrol, 2023 Mar;55(3):721-727.
    PMID: 36136260 DOI: 10.1007/s11255-022-03368-1
    INTRODUCTION: Hemodialysis (HD) patients are at increased risk of severe COVID-19 infection but infection rates vary. Our objectives are to describe COVID-19 positive HD patients' characteristics, infection rates, and factors associated with mortality in HD COVID-19 cases in Kuwait.

    METHODS: Data on demographics, comorbidities, and treatments received, as well as mortality for HD patients admitted to hospitals for COVID-19, from 1/March to 31/July 2020, prospectively collected and analyzed.

    RESULTS: A total of 141 infected HD patients were admitted (Mean age 58 ± 16.1; Males 56%), representing 7% of the total HD population and 0.2% of all COVID-19 cases during the study period. Of those 141 infected HD patients, 27 (19%) died, and this represents 6% of total COVID-19-related mortality and 27% of the total HD mortality. In contrast, total covid-19-related mortality of all positive cases was only 0.7%, and total HD mortality during the study period was only 5%. COVID-19-positive HD patients who died were older and 59% were males. However, the differences were not statistically significant. Of the 61 infected HD patients who needed to be switched to continuous kidney replacement therapy (CKRT), 34% died, and of the 29 infected HD patients who needed admission to intensive care, 65% died.

    CONCLUSION: HD population represents a small fraction of the total population; however, positive HD COVID-19 cases represent a sizable proportion of COVID-19 cases and a significant percentage of total COVID-19-related mortality, and total HD mortality.

    Matched MeSH terms: Renal Dialysis/adverse effects
  4. Wong WK, Chan WK, Ganapathy S, Lim SK
    Nephrology (Carlton), 2023 Aug;28(8):425-433.
    PMID: 37269220 DOI: 10.1111/nep.14186
    AIM: This study aims to determine if metabolic-dysfunction-associated fatty liver disease (MAFLD) or advanced liver fibrosis is associated with erythropoietin stimulating agent (ESA) hypo-responsiveness in hemodialysis patients.

    METHODS: In a cross-sectional study of 379 hemodialysis patients, FibroTouch transient elastography was performed on all patients. Erythropoeitin resistance index (ERI) was used to measure the responsiveness to ESA. Patients in the highest tertile of ERI were considered as having ESA hypo-responsiveness.

    RESULTS: The percentage of patients with ESA hypo-responsiveness who had MAFLD was lower than patients without ESA hypo-responsiveness. FIB-4 index was significantly higher in ESA hypo-responsive patients. In multivariate analysis, female gender (aOR = 3.4, 95% CI = 1.9-6.2, p < 0.001), dialysis duration ≥50 months (aOR = 1.8, 95% CI = 1.1-2.9, p < 0.05), elevated waist circumference (aOR = 0.4, 95% CI = 0.2-0.8, p = 0.005), low platelet (aOR = 2.6, 95% CI 1.3-5.1, p < 0.01), elevated total cholesterol (aOR = 0.5, 95% CI 0.3-0.9, p < 0.05) and low serum iron (aOR = 3.8, 95% CI = 2.3-6.5, p < 0.001) were found to be independent factors associated with ESA hypo-responsiveness. Neither MAFLD nor advanced liver fibrosis was independently associated with ESA hypo-responsiveness. However, every 1 kPA increase in LSM increased the chance of ESA-hyporesponsiveness by 13% (aOR = 1.1, 95% CI =  1.0-1.2, p = 0.002) when UAP and LSM were used instead of presence of MAFLD and advanced liver fibrosis, respectively.

    CONCLUSION: MAFLD and advanced liver fibrosis were not independently associated with ESA hypo-responsiveness. Nevertheless, higher FIB-4 score in ESA hypo-responsive group and significant association between LSM and ESA hypo-responsiveness suggest that liver fibrosis may be a potential clinical marker of ESA hypo-responsiveness.

    Matched MeSH terms: Renal Dialysis/adverse effects
  5. Adanan NIH, Adnan WAHWM, Khosla P, Karupaiah T, Daud ZAM
    BMC Nephrol, 2021 02 02;22(1):48.
    PMID: 33530941 DOI: 10.1186/s12882-021-02255-8
    BACKGROUND: The festival of Ramadan is a month of spiritual reflection for Muslims worldwide. During Ramadan, Muslims are required to refrain from eating and drinking during daylight hours. Although exempted from fasting, many patients undergoing maintenance haemodialysis (HD) opt to participate in this religious practice. Many studies have explored the effects of Ramadan on health outcomes, however, the exploration from patients' own point of view pertaining to this religious practice is lacking. Thus, we aimed to explore the experiences and perceptions of Muslim HD patients observing Ramadan fasting from three HD centres in Klang Valley, Malaysia.

    METHOD: An exploratory phenomenology qualitative study was conducted whereby subjects were purposively selected based on previous experience in observing Ramadan fasting. Face-to-face in-depth interviews were conducted, and study data were analyzed thematically and iteratively coded using a constant comparison method.

    RESULTS: Four major themes emerged from the data, namely: (i) "fasting experiences", (ii) "perceived side effects of fasting", (iii) "health-seeking behavior" and, (iv) "education and awareness needs". Patients expressed the significance of Ramadan fasting as well as the perceived impact of fasting on their health. Additionally, there is lack of health-seeking behaviour observed among patients thus, raising needs for awareness and education related to Ramadan fasting.

    CONCLUSIONS: Findings of this study shed light on patients' experiences and perceptions regarding Ramadan fasting which warrants the needs for an effective communication between patients and health care practitioners through a structured-Ramadan specific education program.

    Matched MeSH terms: Renal Dialysis/psychology*
  6. Koh KH, Arimuthu DA
    Semin Dial, 2023;36(6):462-467.
    PMID: 37170692 DOI: 10.1111/sdi.13145
    INTRODUCTION: Spontaneous tendon rupture (STR) is one of the complications related to hyperparathyroidism. This study aims to verify this and to elucidate the feasibility of combined incidence rate of STR and bony fracture to assess clinical management of renal bone disease in dialysis cohort.

    METHOD: This is a clinical audit of cases of STR and fracture with 5504 patient-year dialysis vintage over 10 years. In order to verify the risk factor, comparison of cases of tendon rupture, the gender, and dialysis vintage matched patients without tendon rupture were done, followed by comparison with post-parathyroidectomy patients.

    RESULT: Six cases of STR involving eight tendons were identified, including a case of concurrent tendon rupture and bony fracture. These include two cases of double tendons ruptures. During this time, there were 15 cases of bony fracture without tendon rupture. The overall incidence rate for STR and fracture was of 0.0011 and 0.0029 incidence per year of dialysis vintage or one case per 917 and 344 patient-year dialysis vintage, respectively. For patients with PTH ≥ 600 pg/mL, the incidence rate of tendon rupture and fracture was 0.0199 and 0.0430 incidence per person-years or one case per 50 and 23 person-years, respectively. For patients with PTH 5202 and 1734 person-years. There was significant difference for incidence rates of tendon rupture and fracture between these two groups, with six incidences of tendon rupture per 302 patient-dialysis-years of PTH ≥ 600 pg/mL versus 0 incidence per 5202 patient-year dialysis vintage of PTH  600 pg/mL had high risk of tendon rupture and bony fracture. Parathyroidectomy might reduce the risk of tendon rupture and fracture with lowering ALP signifying reduction in bone turn over. Combined incidence rate of tendon rupture and fracture could be used to assess the control of hyperparathyroidism related issues in dialysis center.

    Matched MeSH terms: Renal Dialysis/adverse effects
  7. Lim CT
    Indian J Pharmacol, 2016 May-Jun;48(3):327-8.
    PMID: 27298508 DOI: 10.4103/0253-7613.182875
    Oral sodium phosphate (OSP), an effective bowel purgative, is available over the counter (OTC) and requires a substantially lower volume than polyethylene glycol-based preparative agents. Rarely, OSP consumption has been associated with acute hypocalcemia and hyperphosphatemia. We describe a case of chronic kidney disease patient developing symptomatic hypocalcemia following OTC OSP.
    Matched MeSH terms: Renal Dialysis*
  8. Tallman DA, Latifi E, Kaur D, Sulaheen A, Ikizler TA, Chinna K, et al.
    Nutrients, 2020 Mar 18;12(3).
    PMID: 32197373 DOI: 10.3390/nu12030797
    The association between dietary patterns and health outcomes, such as quality of life (QOL), in maintenance hemodialysis (MHD) patients with certain racial backgrounds has not been studied in detail. QOL is a powerful outcome measure in which dietary patterns could be a modifying factor. This study is a secondary analysis examining the association between dietary patterns and health outcomes in 101 African American (AA) maintenance hemodialysis (MHD) patients participating in the Palm Tocotrienols in Chronic Hemodialysis (PATCH) study. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life 36-item survey (KDQOL-36™). Blood samples were analyzed for lipids, lipoprotein subfractions, and inflammatory markers. Food intake was measured using six non-consecutive 24-h dietary recalls over 15 months. Implausible energy intake reports were screened out by comparing reported energy intake (rEI) with predicted total energy expenditure (pTEE). Cluster analysis, using the k-means algorithm, identified two distinct dietary patterns in the study population: a high "sugar sweetened beverage" pattern (hiSSB) and a low "sugar sweetened beverage pattern" (loSSB). In the hiSSB group, consumption of SSB accounted for ~28% of energy intake, while SSB represented only 9% of energy intake in the loSSB group. The hiSSB group was characterized by a higher intake of total calories, sugar and percentage of kilocalories from carbohydrates, whereas the percentage of kilocalories from protein and fat was lower. While additional micronutrient intakes differed between groups (vitamin C, zinc, chromium), these were significantly lower than recommended values in the entire cohort. Patients in the hiSSB group presented with lower high-density lipoprotein cholesterol (HDL-C), lower large HDL particles and smaller low density lipoprotein (LDL) particle diameters. Antidepressant usage was significantly higher in the hiSSB group. Patients in the hiSSB group scored lower across all five KDQOL domains and scored significantly lower in the mental composite domain. MHD patients following a hiSSB dietary pattern had smaller dense LDL particles, lower HDL-C, and a lower QOL. Suboptimal intakes of fruits, vegetables, and grains as well as key micronutrients were evident in both patterns.
    Matched MeSH terms: Renal Dialysis*
  9. Sivathasan S, Mushahar L, Yusuf WS
    Perit Dial Int, 2014 2 15;34(1):143-6.
    PMID: 24525611 DOI: 10.3747/pdi.2012.00332
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory*
  10. Lim YN, Lim TO, Lee DG, Wong HS, Ong LM, Shaariah W, et al.
    Med J Malaysia, 2008 Sep;63 Suppl C:5-8.
    PMID: 19230240
    The Malaysian National Renal Registry was set up in 1992 to collect data for patients on renal replacement therapy (RRT). We present here the report of the Malaysian dialysis registry. The objectives of this papar are: (1) To examine the overall provision of dialysis treatment in Malaysia and its trend from 1980 to 2006. (2) To assess the treatment rate according to the states in the country. (3) To describe the method, location and funding of dialysis. (4) To characterise the patients accepted for dialysis treatment. (5) To analyze the outcomes of the dialysis treatment. Data on patients receiving dialysis treatment were collected at initiation of dialysis, at the time of any significant outcome, as well as yearly. The number of dialysis patients increased from 59 in 1980 to almost 15,000 in 2006. The dialysis acceptance rate increased from 3 per million population in 1980 to 116 per million population in 2006, and the prevalence rate from 4 to 550 per million population over the same period. The economically advantaged states of Malaysia had much higher dialysis treatment rates compared to the less economically advanced states. Eighty to 90% of new dialysis patients were accepted into centre haemodialysis (HD), and the rest into the chronic ambulatory peritoneal dialysis (CAPD) programme. The government provided about half of the funding for dialysis treatment. Patients older than 55 years accounted for the largest proportion of new patients on dialysis since the 1990s. Diabetes mellitus has been the main cause of ESRD and accounted for more than 50% of new ESRD since 2002. Annual death rate averaged about 10% on HD and 15% on CAPD. The unadjusted 5-year patient survival on both HD and CAPD was about 80%. Fifty percent of dialysis patients reported very good median QoL index score. About 70% of dialysis patients were about to work full or part time. There has been a very rapid growth of dialysis provision in Malaysia particularly in the older age groups. ESRD caused by diabetes mellitus, despite being a preventable and treatable cause of ESRD--has increased and accounted for more than 50% of incident dialysis patients. Death and survival rates on dialysis are comparable to those from other countries.
    Matched MeSH terms: Renal Dialysis/statistics & numerical data*; Peritoneal Dialysis, Continuous Ambulatory/statistics & numerical data
  11. Liu WJ, Chew TF, Chiu AS, Zaki M
    Med J Malaysia, 2006 Dec;61(5):540-6.
    PMID: 17623953 MyJurnal
    The aims of this retrospective analysis were (i) to examine the trends of quality of life (QoL) scores and (ii) to identify the risk factors for QoL scores among 6908 dialysis patients entering dialysis between 1997 and 2002. The Spitzer QoL Index was the instrument used by the National Renal Registry of Malaysia to assess the QoL amongst dialysis patients. Demographic and biochemical data were analysed to identify risk factors for poor QoL. The median QoL-index score ranged between 9 and 10. Significant risk factors for poor QoL were female gender, age > 40, diabetes, cohort starting dialysis 2001-2002, haemodialysis modality, body mass index < 18.5, albumin < 30g/dL, cholesterol < 3.2 mmol/L, haemoglobin < 10 g/dL, diastolic blood pressure of > 90 mHg, iPTH < 100 pg/ml. The overall QoL of dialysis patients is satisfactory. The negative impact of diabetes and haemodialysis on QoL warrants further evaluation as each factor involves 50% and 90% of our dialysis population.
    Matched MeSH terms: Renal Dialysis/psychology*; Peritoneal Dialysis, Continuous Ambulatory/psychology
  12. Hassan J, Cader RA, Kong NC, Mohd M, Rahman AR, Hod R
    EXCLI J, 2013;12:681-92.
    PMID: 26600735
    To compare the efficacy of Coupled Plasma Filtration and Adsorption (CPFA) plus Continuous Veno-Venous Haemofiltration (CVVH) versus CVVH alone as an adjunct treatment of sepsis in terms of haemodynamic stability, inotropic requirement and inflammatory mediators.
    Matched MeSH terms: Renal Dialysis
  13. Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH
    Ther Apher Dial, 2016 Oct;20(5):453-461.
    PMID: 27151394 DOI: 10.1111/1744-9987.12406
    Hypertension is prevalent in 75-80% of hemodialysis patients and remains the most controversial prognostic marker in end stage kidney disease patients. In contrast to the general population where systolic blood pressure of ≤120 mm Hg is considered normal, a debate remains regarding the ideal target blood pressure in hemodialysis patients. Using the PUBMED and EMBASE databases, the research studies that evaluated the relationship between blood pressure measurements and mortality in hemodialysis patients were searched. Thirteen studies were identified from different regions of the world. Five studies reported low predialysis systolic blood pressure as a prognostic marker of mortality. Other studies showed varying results and reported postdialysis systolic blood pressure as well as ambulatory blood pressure as better predictors of mortality and emphasized their optimized control. One study in this review concluded that there is no direct relationship between mortality and blood pressure if the patients are on anti-hypertensive medications. The observed all-cause mortality varied from 12% to 36%, whereas the cardiovascular mortality varied from 16% to 60%. On the basis of studies included in the current review, a low predialysis systolic blood pressure (<120 mm Hg) is shown to be a widely accepted prognostic marker of mortality while ambulatory blood pressure best predicts CV mortality. Therefore, we recommend that apart from routine BP (pre, post and intradialysis) monitoring in centers, assessment of ambulatory BP must be mandatory for all patients to reduce CV mortality in hemodialysis patients.
    Matched MeSH terms: Renal Dialysis/adverse effects; Renal Dialysis/methods*; Renal Dialysis/mortality
  14. Gendeh BS, Said H, Gibb AG, Aziz NS, Zahir ZM
    J Laryngol Otol, 1991 Dec;105(12):999-1001.
    PMID: 1787382
    In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity.
    Matched MeSH terms: Peritoneal Dialysis*; Dialysis Solutions*
  15. Low A, Bansal V
    Biomed Imaging Interv J, 2010 01 01;6(1):e9.
    PMID: 21611068 DOI: 10.2349/biij.6.1.e9
    Many papers have been written on the synthesis of gold nanoparticles but very few included pictures of the process, and none of them used video to show the whole process of synthesis. This paper records the process of synthesis of gold nanoparticles using video clips. Every process from cleaning of glassware, an important step in the synthesis of metallic nanoparticles, to the dialysis process is shown. It also includes the preparation of aqua regia and the actual synthesis of gold nanoparticles. In some papers, the dialysis process was omitted, but in this paper, it is included to complete the whole process as it is being used for purification.
    Matched MeSH terms: Dialysis
  16. Lim JH, Lim CK, Ibrahim I, Syahrul J, Mohamed Zabil MH, Zakaria NF, et al.
    JMIR Mhealth Uhealth, 2020 06 01;8(6):e13808.
    PMID: 32478665 DOI: 10.2196/13808
    BACKGROUND: With the unprecedented growth of mobile technology, a plethora of dialysis diet apps have been developed to promote patient dietary self-management. Nevertheless, the utility of such apps remains questionable.

    OBJECTIVE: This study aimed to evaluate the content, features, and quality of commercial dialysis diet apps for adult dialysis patients.

    METHODS: This study consisted of a quantitative content analysis of commercial dialysis diet apps downloaded from Google Play and the Apple App Store available in the Asian marketplace, searched for using the following keywords in English: dialysis diet and diet for kidney disease. Free and paid apps available in English that provide nutrition information for adult dialysis patients were included. Apps that were not relevant to the dialysis diet, not meant for patient self-management, or redundant were excluded. Apps were evaluated for language medium (subscore=1), credibility (subscore=1), food database (subscore=1), valuable features (subscore=12), health-behavior theory constructs (subscore=60), and technical quality (subscore=25). The relationships among the variables of interest were determined by Pearson correlation. Stepwise multiple linear regression analysis was performed to identify the features that contribute to greater technical quality of dialysis diet apps. Statistical significance was defined as P

    Matched MeSH terms: Renal Dialysis
  17. Nurhidayati T, Pambudi DA, Rahayu DA, Elengoe A, Ramuni K
    Enferm Clin, 2020 06;30 Suppl 5:69-72.
    PMID: 32713588 DOI: 10.1016/j.enfcli.2019.11.023
    INTRODUCTION: The effect of depression on human behavior have been widely recognized in chronic kidney failure patients who undergoing hemodialysis. There was some depression technique management which could be applied. It could be a pharmacological or non-pharmacological technique. One of the complementary non-pharmacological therapy are Javanese gamelan therapy.

    OBJECTIVE: This research reduced depression level with Javanese gamelan therapy in chronic kidney failure patients' who undergo hemodialysis at RSUD KRMT Wongsonegoro Semarang.

    METHOD: It was a quasi-experimental research with pretest-post-test without control group. The research was administered during March-May 2019 with 30 respondents taken as sample using the total sampling technique.

    RESULTS: The research on 30 respondents showed that p-value=0.00,

    Matched MeSH terms: Renal Dialysis
  18. Sathasivam, Hans Prakash, Lau, Shin Hin
    MyJurnal
    Haemodialysis associated amyloidosis (HAA) is a complication of long-term haemodialysis caused by deposition of β2-microglobulin in tissues that most often presents clinically at osteoarticular sites. However, in very rarecircumstances, patients do present initially with oral manifestations of HAA. In a normally functioning kidney, β2-microglobulin is cleared by glomerular filtration and is catabolized in the proximal tubules. This article describes a patient with oral manifestation of haemodialysis associated amyloidosis with an unusual presenting complaint of lingual dysaesthesia.
    Matched MeSH terms: Renal Dialysis
  19. Liew NC, Lee L, Gee T, Jabar MF
    J Vasc Surg Cases, 2015 Dec;1(4):229-231.
    PMID: 31724592 DOI: 10.1016/j.jvsc.2015.07.007
    Venous ulcer as a complication of ankle arteriovenous fistula for hemodialysis is rarely reported. It poses a challenge between ulcer healing and fistula preservation. We report our experience in the management of venous ulcers secondary to an ankle arteriovenous fistula in a hemodialysis patient.
    Matched MeSH terms: Renal Dialysis
  20. Li PK, Lu W, Mak SK, Boudville N, Yu X, Wu MJ, et al.
    Nephrology (Carlton), 2022 Oct;27(10):787-794.
    PMID: 35393750 DOI: 10.1111/nep.14042
    Peritoneal dialysis (PD) first policy has been established in Hong Kong since 1985. After 35 years of practice, the PD first policy in Hong Kong has influenced many countries around the world including governments, health ministries, nephrologists and renal nurses on the overall health policy structure and clinical practice in treating kidney failure patients using PD as an important dialysis modality. In 2021, the International Association of Chinese Nephrologists and the Hong Kong Society of Nephrology jointly held a symposium celebrating the 35 years of PD first policy in Hong Kong. In that symposium, experts and opinion leaders from around the world have shared their perspectives on how the PD first policy has grown and how it has affected PD and home dialysis practice globally. The advantages of PD during COVID-19 pandemic were highlighted and the use of telemedicine as an important adjunct was discussed in treating kidney failure patients to improve the overall quality of care. Barriers to PD and the need for sustainability of PD first policy were also emphasized. Overall, the knowledge awareness of PD as a home dialysis for patients, families, care providers and learners is a prerequisite for the success of PD first. A critical mass of PD regional hubs is needed for training and mentorship. Importantly, the alignment of policy and clinical goals are enablers of PD first program.
    Matched MeSH terms: Renal Dialysis
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