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Problem The coronavirus disease 2019 (COVID-19) pandemic could affect health service provision of less urgent interventions, such as peritoneal dialysis for chronic kidney disease patients. Approach To assess how peritoneal dialysis centres in Thailand adapted their provision of care, we invited medical directors and peritoneal dialysis managers to respond to an online survey on 1 July 2021. We asked whether they had modified or deferred their training, catheter insertion or removal, intravenous supplements, follow-up and home visits, and workload. Local setting Patients needing dialysis receive peritoneal dialysis free of charge in Thailand. As of 31 December 2020, 240 peritoneal dialysis centres in Thailand have provided care to 32 284 patients. Relevant changes At 24.6% (29/118) of centres, educational sessions for patients were modified. Catheter insertion continued at 71.9% (82/114) of centres. Few facilities (19.7%; 23/117) continued to perform peritoneal equilibration tests as usual. On-site intravenous injections were mostly transferred to health centres close to the patients' homes. Most centres reduced their outpatient follow-up visits (51.7%; 61/118) and stopped visiting patients at home (66.9%; 79/118). Peritoneal dialysis nurses reported an increased workload at 62.7% (74/118) of centres, and in many instances (66.1%; 78/118) were providing nursing care to COVID-19 patients and administering COVID-19 vaccines. Lessons learnt Health-care providers altered clinical care activities to protect their patients from COVID-19. However, further evidence is needed on the consequences of such alteration in care. To prepare for future pandemics, actors need to explore nonconventional peritoneal dialysis care as well as financial and nonfinancial incentive mechanisms for such care. Probleme La pandemie de maladie a coronavirus 2019 (COVID-19) est susceptible d'affecter la realisation, par les services de sante, d'interventions moins urgentes, telles que les dialyses peritoneales pour les patients atteints de maladies renales chroniques. Approche Afin d'evaluer comment les centres medicaux procedant a des dialyses peritoneales en Thailande ont adapte leur prestation de soins, nous avons invite des directeurs medicaux et des personnes effectuant des dialyses peritoneales a repondre a une enquete en ligne le 1er juillet 2021. Nous leur avons demande s'ils avaient modifie ou reporte leur formation, l'insertion ou le retrait de catheters, des supplements intraveineux, des visites de suivi ou a domicile et leur charge de travail. Environnement local En Thailande, les patients necessitant une dialyse beneficient gratuitement d'une dialyse peritoneale. Au 31 decembre 2020, 240 centres thailandais realisant des dialyses peritoneales ont fourni des prestations a 32 284 patients. Changements significatifs Dans 24,6% (29/118) des centres, les seances educatives destinees aux patients ont ete modifiees. L'insertion de catheters s'est poursuivie dans 71,9% (82/114) des centres. Peu de centres (19,7%; 23/117) ont continue a effectuer le test d'equilibrage peritoneal comme a leur accoutumee. Les injections intraveineuses sur place ont ete transferees pour la plupart dans des centres de sante proches du domicile des patients. La plupart des centres ont reduit leurs visites de suivi ambulatoire (51,7%; 61/118) et ont cesse de rendre visite aux patients a leur domicile (66,9%; 79/118). Le personnel infirmier charge de realiser des dialyses peritoneales a signale une augmentation de sa charge de travail dans 62,7% (74/118) des centres et, dans de nombreux cas (66,1%; 78/118), il fournissait des soins infirmiers aux patients atteints de la COVID-19 et vaccinait contre la COVID-19. Lecons tirees Les prestataires de soins de sante ont modifie leurs activites cliniques pour proteger leurs patients contre la COVID-19. Cependant, des preuves supplementaires sont necessaires sur les consequences d'une telle modification du schema de soins. Pour se preparer aux futures pandemies, les acteurs de la sante doivent envisager des interventions de dialyse peritoneale non conventionnelles ainsi que des mecanismes d'incitation financiere et non financiere pour ces soins. Situacion La pandemia de la coronavirosis de 2019 (COVID-19) podria afectar a la prestacion de los servicios sanitarios de intervenciones menos urgentes, como la dialisis peritoneal para pacientes con enfermedades renales cronicas. Enfoque Para evaluar como los centros de dialisis peritoneal de Tailandia adaptaron su prestacion de cuidados, se invito a los directores medicos y a los gestores de dialisis peritoneal a responder a una encuesta en linea el 1. de julio de 2021. Se les pregunto si habian modificado o aplazado su formacion, la insercion o retirada de cateteres, los suplementos por via intravenosa, las visitas de revision y a domicilio y la carga de trabajo. Marco regional Los pacientes que necesitan dialisis reciben dialisis peritoneal de forma gratuita en Tailandia. A 31 de diciembre de 2020, 240 centros de dialisis peritoneal en Tailandia atendieron a 32 284 pacientes. Cambios importantes Se modificaron las sesiones educativas para los pacientes en el 24,6 % (29/118) de los centros. La insercion de cateteres continuo en el 71,9 % (82/114) de los centros. En pocos centros (19,7 %; 23/117) se siguio realizando la prueba de equilibrio peritoneal de forma habitual. Las inyecciones por via intravenosa in situ se transfirieron en su mayoria a los centros sanitarios cercanos a los domicilios de los pacientes. La mayoria de los centros disminuyeron sus visitas de revision ambulatoria (51,7 %; 61/118) y dejaron de visitar a los pacientes en sus domicilios (66,9 %; 79/118). Las enfermeras dedicadas a la dialisis peritoneal informaron de un incremento de la carga de trabajo en el 62,7 % (74/118) de los centros, y en muchos casos (66,1 %; 78/118) estaban proporcionando cuidados de enfermeria a los pacientes de la COVID-19 y administrando las vacunas contra la COVID-19. Lecciones aprendidas Los proveedores de servicios sanitarios modificaron las actividades de atencion clinica para proteger a sus pacientes de la COVID-19. No obstante, se necesitan mas evidencias sobre las consecuencias de esta modificacion de la atencion. Para prepararse para futuras pandemias, los agentes sanitarios deben explorar los cuidados de dialisis peritoneal no convencionales, asi como los mecanismos de incentivos financieros y no financieros para estos cuidados., Introduction The coronavirus disease (COVID-19) pandemic has challenged health systems worldwide. In Thailand, the pandemic has gradually affected the health-care provision for other diseases than COVID-19, including peritoneal dialysis for [...]

Byline: E. Lagomarsimo (1), Anita Valenzuela (2), Felipe Cavagnaro (1), Eric Solar (2) Keywords: Key wordsaEnd-stage renal disease; Dialysis; Renal transplantation; Chronic renal failure; Epidemiology Abstract: aThe Nephrology Branch of the Chilean Pediatric Society has greatly influenced the development of government health plans regarding the management and care of patients under 18 years with chronic renal failure (CRF). In order to assess the status of children with CRF in Chile up to 1996, a questionnaire was sent to all pediatric nephrologists in charge of those children. The total sample was of 227 patients under 18 years, giving a national prevalence of 42.5 and an incidence of 5.7 per million inhabitants of these patients, 50.7% were male, 58.6% over 10 years and 15% younger than 5 years. The most frequent etiologies of CRF were: obstructive uropathy, 18.1% hypo/dysplasia, 16.7% reflux nephropathy, 16.7% and glomerulopathies, 16.3%. Although 48% of patients were on conservative medical treatment, 42.2% of these were in end-stage renal disease, 22.9% were on dialysis, and 29.1% had undergone renal transplantation. Of the dialysis group, 75% were on peritoneal dialysis. Of the transplanted children, 78.8% had normal renal function, but 16.7% returned to dialysis. Three-year graft survival and patient survival were 68% and 94%, respectively. Author Affiliation: (1) Department of Pediatrics, Catholic University School of Medicine, Lira 40, Santiago, Chile Fax: +56-2-633 1457, CL (2) Pediatric Service, Sotero del Rio Hospital, Santiago, Chile, CL Article note: Received: 19 January 1998 / Revised: 6 July 1998 / Accepted: 16 July 1998

Byline: K. El-Reshaid (1), Madan M. Kapoor (2), M. R. Naryanan Nampoory (3), W. El-Reshaid (1), Kaivilayil V. Johny (1) Keywords: Key wordsaArab; Dialysis; End-stage kidney disease; Glomerulonephritis; Kuwait; Survival; Transplantation Abstract: aData on end-stage renal disease (ESRD) patients and their renal replacement therapy (RRT) were collected retrospectively from the three dialysis centers, the pediatric urology unit, and the organ transplant center of Kuwait. The study period was from 1 January 1986 to 31 December 1996. A total of 61 children, 50 of whom were Kuwaiti nationals, required RRT for ESRD during those 11 years. This gave an average annual incidence rate of 18 per million Kuwaiti children. Glomerulonephritis was the most-frequent underlying disease and accounted for 44% of total cases, while pyelonephritis (including urinary tract anomalies and dysplastic kidneys) was responsible for 30%. Multisystem disease was responsible for ESRD in 7 patients (14%), 2 of whom had lupus nephritis, 2 vasculitis, 2 Henoch-Schonlein purpura, and 1 hemolytic uremic syndrome. Continuous ambulatory peritoneal dialysis and home intermittent peritoneal dialysis, using cycler machines, were not favored dialysis techniques by most parents, especially for those &lt 6 years old. The actuarial survival on dialysis was 75%+-7% at 12 months. Of the 8 patients who died, 7 were &lt 6 years old. Thirty-eight patients received 46 kidney transplants, 13 of which were performed on a pre-emptive basis. The actuarial patient survivals at 12 months for those receiving first live and cadaveric kidney transplants were 90%+-5% and 85%+-2%, respectively, while those for grafts were 76%+-8% and 66%+-2%, respectively. This is the first nationwide long-term study of the incidence and etiology of pediatric ESRD in our area and the RRT in a country with adequate treatment facilities. Author Affiliation: (1) Department of Medicine, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait Tel.: +965-5319596, Fax: +965-5338907, KW (2) Al-Amiri Renal Center, Ministry of Health, Kuwait, KW (3) Mubarak Al-Kabeer Renal Center, Ministry of Health, Kuwait, KW Article note: Received: 23 July 1997 / Revised: 9 July 1998 / Accepted: 11 July 1998