TITLE:
Does Current Nephrology Fellowship Training Affect Uti-lization of Peritoneal Dialysis in the United States?
AUTHORS:
Nand K. Wadhwa, Catherine R. Messina, Nasser M. Hebah
KEYWORDS:
Peritoneal Dialysis; Hemodialysis; Utilization; Nephrology Fellowship Training
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.2,
June
19,
2013
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.