Does Current Nephrology Fellowship Training Affect Uti-lization of Peritoneal Dialysis in the United States?

Nand K. Wadhwa, Catherine R. Messina, Nasser M. Hebah

Corporate Home Dialysis, Dialysis Clinic Inc., Nashville, USA..
Department of Preventive Medicine, Stony Brook School of Medicine, Stony Brook, New York, USA.
Division of Nephrology, Stony Brook School of Medicine, Stony Brook, New York, USA.

DOI: 10.4236/ojneph.2013.32019                

Abstract

Background: The 2010 US Renal Data System annual report revealed that peritoneal dialysis is used by only 7% of end-stage renal disease patients on chronic dialysis vs. hemodialysis which is used by 93% of such patients, despite documented benefits of peritoneal dialysis over hemodialysis in these cases. Purpose: We examined whether education of nephrology fellows contributed to underutilization of peritoneal dialysis in the US. Methods: Self-report questionnaires were administered electronically to nephrology fellowship training program directors, October 2010-March 2011 (55% response). Results: Median number of training faculty and patients/fellow were significantly lower for peritoneal-dialysis vs. hemodialysis training. Hours of didactic teaching for fellows over their 2-year training period were significantly lower for peritoneal dialysis vs. hemodialysis. Peritoneal dialysis training was 20% of total training vs. 80% for hemodialysis. Most program directors (87%) believed lack of trained faculty in peritoneal dialysis and insufficient peritoneal dialysis patient population contributed to inadequate fellows’ peritoneal dialysis training. Conclusions: Findings suggest that current nephrology fellowship training in peritoneal dialysis is inadequate and contributes to its underutilization.

Keywords

Peritoneal Dialysis; Hemodialysis; Utilization; Nephrology Fellowship Training

Conflicts of Interest

The authors declare no conflicts of interest.

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