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논문분류	춘계학술대회 초록집
제목	PD-first Policy in Hong Kong: Pros and Cons
저자	Philip Kam-Tao Li
출판정보	2024; 2024(1):
키워드
초록	Peritoneal dialysis (PD)-First Policy has been established in Hong Kong since 1985 and it has been successful given the collaborative effort from the government, health ministries, medical professionals, patients and caregivers. The PD-First Policy represented a significant advancement in the management of end stage kidney disease (ESKD), building upon historical achievements in PD and embracing the current evidence supporting its clinical, social and economic benefits. By adopting the PD-First Policy, the healthcare system can optimise patient outcomes, enhance resource allocation and improve overall care for ESKD patients. However, addressing the challenges associated with implementation is crucial for realising the full potential of the PD-First Policy in transforming kidney replacement therapy (KRT) practice. PD first policy has grown and has affected PD and home dialysis practice globally. The advantages of PD during COVID-19 pandemic were also observed and the use of telemedicine is an important adjunct in treating kidney failure patients to improve the overall quality of care. There are also barriers to PD which include patient identified barriers, provider identified barriers, health systems /organizational barriers. There is a need for sustainability of PD first policy. Addressing patients' PD problems is the key to sustainability of the PD-first policy. Three important groups of patients that may lead to PD technique failure: those with frequent peritonitis, ultrafiltration failure or inadequate dialysis. Overall, the knowledge awareness of PD as a home dialysis for patients, families, care providers and learners is a prerequisite for the success of PD first. A critical mass of PD regional hubs is needed for training and mentorship. Importantly, the alignment of policy and clinical goals are enablers of PD first program.
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