Availability of assisted peritoneal dialysis in Europe: call for increased and equal access

Edwina A Brown, Agneta Ekstrand, Maurizio Gallieni, Maite Rivera Gorrín, Helga Gudmundsdottir, Anabela Malho Guedes, Marco Heidempergher, Benno Kitsche, Thierry Lobbedez, Ulrika Hahn Lundström, Kate McCarthy, George J Mellotte, Olivier Moranne, Dimitrios Petras, Johan V Povlsen, Sally Punzalan, Martin Wiesholzer

Research output: Journal article (peer-reviewed)Journal article

8 Citations (Scopus)


INTRODUCTION: Availability of assisted PD (asPD) increases access to dialysis at home, particularly for the increasing numbers of older and frail people with advanced kidney disease. Although asPD has been widely used in some European countries for many years, it remains unavailable or poorly utilised in others. A group of leading European nephrologists have therefore formed a group to drive increased availability of asPD in Europe and in their own countries.

METHODS: Members of the group filled in a proforma with the following headings: personal experience, country experience, who are the assistants, funding of asPD, barriers to growth, what is needed to grow, and their top 3 priorities.

RESULTS: Only 5 of the 13 countries surveyed provided publicly funded reimbursement for asPD. The use of asPD depends on overall attitudes to PD with all respondents mentioning need for nephrology team education and/or patient education and involvement in dialysis modality decision making.

CONCLUSION AND CALL TO ACTION: Many people with advanced kidney disease would prefer to have their dialysis at home, yet if the frail patient chooses PD most healthcare systems cannot provide their choice. AsPD should be available in all countries in Europe and for all renal centres. The top priorities to make this happen are education of renal healthcare teams about the advantages of PD, education of and discussion with patients and their families as they approach the need for dialysis, and engagement with policy makers and healthcare providers to develop and support assistance for PD.

Original languageEnglish
Pages (from-to)2080-2089
Number of pages10
JournalNephrology Dialysis Transplantation
Issue number11
Early online date07 Jun 2022
Publication statusPublished - 01 Nov 2022


  • Europe
  • Humans
  • Kidney Diseases
  • Kidney Failure, Chronic/therapy
  • Peritoneal Dialysis
  • Renal Dialysis
  • frailty
  • community care
  • peritoneal dialysis
  • quality of life
  • equity

ASJC Scopus subject areas

  • Nephrology
  • Transplantation


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