Peritoneal Dialysis in Shanghai

Abstract

Although China lacks a national dialysis registry, several local systems (such as the Shanghai Dialysis Registry, established in 1996) do exist. The present report provides information from the registry concerning the development of peritoneal dialysis (PD) in Shanghai. Data from the Shanghai Dialysis Registry collected between 1999 and 2006 were used in the analysis. All 58 dialysis centers in Shanghai, of which 30 have a PD program, entered data into the registry. Point prevalence of PD on 31 December 2006 was 1204 patients, as compared with 459 patients in 1999. In 2006, 705 patients commenced PD, giving a treatment rate of 51.5 per million population. The percentage utilization of PD among all dialysis modalities exceeded 20% in 2006, as compared with 16% in 1999. The main cause of end-stage renal failure (ESRF) was chronic glomerulonephritis, affecting 40% of all patients. However, the incidence of diabetic nephropathy increased to 30.5% from 15.3% between 1999 and 2006, and represented the second major cause of ESRF in 2006. All PD patients were dialyzed with standard glucose-based solutions only. The annual death rate among PD patients decreased to 10.3% in 2006 from 16.1% in 1999. Infection was the leading cause of death and drop-out, although the peritonitis rate decreased (to 1 episode in 48.8 patient-months in 2006 from 1 episode in 36.6 patient-months in 1999). Dialysis adequacy, hepatitis infection control, and anemia control improved over time. The PD population in Shanghai has continuously grown and improved in clinical outcome over the 8 years from 1999 to 2006.