The outcomes of mentor and mentee program in peritoneal dialysis between tertiary
hospital and community hospitals under PD First Policy at Nakornratchasima, Thailand

Watanyu Parapiboon¹, Nintita Sripaiboonkij Thokanit², Siribha Changsirikulchai³

Renal Division, Department of Medicine, MaharatNakornratchasima Hospital, Ministry of Public Health, Thailand ¹, Ramathibodi Comprehensive Cancer Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ², Renal Division, Department of Medicine, Faculty of Medicine, Srinakharinwirot University,Thailand ³

Purpose: PD First in Thailand has expanded PD centers to community based hospitals for helping patients with end stage renal disease (ESRD) to access peritoneal dialysis (PD). PD centers at tertiary based hospitals (tertiary center) will be the mentors to community based hospitals (community centers). We evaluate patient survival between tertiary center and community centers.

Method: Cohort data registry in Database of Peritoneal dialysis in EXcel (DPEX) during 2016 to 2018 of one tertiary center and 10 community centers at Nakornratchasima were enrolled. ESRD patients were initiated PD by a nephrologist at tertiary center. After 6 to 12 weeks, stable PD patients were referred to community centers nearby patients ́home. General practitioners treated patients under advice from tertiary center. Patient survival between tertiary center and community centers were compared.

Result: 578 patients from tertiary center and 108 patients from 10 community centers were analysed. The age and gender were similar between two groups. Patients with diabetes and unplanned dialysis were higher in tertiary center than those in community centers (55% vs 44%, 62% vs 46%, respectively, p<0.05). The ratio of PD nurse to patients was 1:90 in the tertiary center and 1:43 in the community centers. One year patient survival of patients from community centers was higher than those from tertiary center (88.3% vs 71.3%, p<0.01).

Conclusion: PD patients at community centers has better survival than patients at tertiary center. The reasons may be from selecting stable PD patients and mentor system provided by nephrologists from tertiary center.