Rapport annuel RDPLF : profil des patients en dialyse péritonéale en France en 2022, résultats bruts et synthétiques

Résumé

Nous présentons sous forme de tableaux et graphiques uniquement les principales données descriptives des patients traités par dialyse péritonéale en France en 2022. Les patients des DROM-TOM et autres pays et régions francophones du RDPLF seront décrits dans un prochain numéro afin de regrouper des régions ayant des caractéristiques socio-economique et climatiques voisines.

Depuis l’épidemie de SARS-Cov2, en 2020 et les trois années qui ont suivi le nombre de patients traités par dialyse péritonéale en France a diminué de 6,7 % en France mais avec des variations régionales importante variant de +20% à -30%.

Les néphropathies vasculaires (23,5%) et diabétiques (20,5%) sont les plus nombreuses.

L’âge moyen en DPCA est de 70 ans et de 58 ans en DPA

36% des patients sont assistés par une infirmière et 5% par un membre de la famille.

Le délais d’attente des patients transplantés à été de 20 mois en moyenne.

On observe une grande différence dans les techniques de pose de cathéter avec une survie des cathéters 72% à 5 ans.

INTRODUCTION

The purpose of this document is to summarize with graphics ad tables the main descriptive elements obtained from the database of the Peritoneal Dialysis and Home Hemodialysis Registry (RDPLF) in metropolitan France in 2022. No discussion is intended in this report, which is primarily intended to provide background material for readers to illustrate their own work or presentations.

These tables and charts may be freely copied provided that this document is cited with its DOI.

The originals can also be obtained as PowerPoint files from the RDPLF secretariat.

COMPLETENESS

The Réseau Epidemiologie Information en Nephrologie (REIN) is comprehensive for France, it is possible to know the completeness of peritoneal dialysis (PD) patients included in the RDPLF by comparing the number of patients treated on December 31 in each database. According to the 2019 REIN report[1]97.8% of French patients were included in 2020. On January 1, 2022 the number of treated patients was identical in both registries (personal communication Cécile Couchoud and Mathilde Lassalle). The RDPLF database is structured in several modules described elsewhere [2,3]. Various tables and graphs included in this text were also obtained from the RDPLF open access statistical analysis web module[4].

DESCRIPTION OF THE POPULATION

Number of prevalent patients in 2022 (treated at least 1 day): 3955 patients

Figure 1:Percentage variations in the number of patients treated with PD in France, in its various regions, between January 2020 and the end of December 2022

Figure 2.Nephropathies of peritoneal dialysis patients in France in 2022

Figure 3.Age distribution of patients treated with PD in France in 2022, in metropolitan France, all methods combined.

TREATMENT BEFORE PD

- non-dialysed: 3113 (80.4%)

- hemodialysed: 626 (16.2%) (of which 11 in self-dialysis and 2 in home hemodialysis)

- transplantated: 135 (3.4%)

Peritoneal dialysis modalities

Figure 4.Age distribution of patients treated with APD and CAPD in metropolitan France in 2022

Table I.ialysis solutions used in addition to glucose-based solutions

Solutions other than glucose	Non-diabetic patients	diabetic patients
No other solution than glucose	24,2%	16,6%
Icodextrine	57,7%	52,0%
Amino-acids	2,1%	3,4%
Icodextrine+amino-acids	15,9%	28,0%

DIABETES

Figure 5.diabetic status and treatment of patients treated with PD in metropolitan France in 2022

AUTONOMY

Table II.Autonomy of peritoneal dialysis patients in metropolitan France in 2022

Autonomous	2316	59%
Nurse assisted	1409	36%
Family assisted	203	5%
Asisted (withou precision)	21	1%
Missing data	8	<1%

Figure 6.Autonomy by patient according to age

Figure 7.autonomy by PD modality

TRANSPLANTATION

Table III.Transplant status of patients in metropolitan France treated with PD in 2022

Transplantation status	number	Percentage
Pre-transplant assessment not done	86	3,4%
Pre-transplant assessment not finished	395	15,7%
Registered on waiting list	665	26,5%
Not transplantable	896	35,7%
Transplantation refused by patient	213	8,5%
Temporaly contra-indication	254	10,1%

Figure 8.. Waiting times since the start of PD for patients transplanted in 2022 in France

CATHETERS

Information on catheters in 2022 was provided for 2900 catheters and represents 73% of catheters used during this period in France.

Table IV.Shapes of the catheters used

Extraperitoneal section	Intraperitoneal section	Percentages
Straight	Straight	22,8%
Swan Neck	Straight	28,2%
Straight	Coil	24,7%
Swan Neck	Coil	21,7%
not registered	Non registered	2,6%

Note: 6% of catheters have a weighted tip

Anesthesia technique (indicated for 2332 catheters):

- General anesthesia: 87.2

- Local anesthesia: 7.5

- Spinal: 0.3

- TAP block: 5%.

Catheter placement technique (reported for 2900 catheters):

- Laparotomy : 57%.

- Laparoscopy: 41.27%.

- Percutaneous Trocard: 1.37

- Percutaneous peelable dilator: 0.34

Percentage of buried catheters using the Moncrief technique: 4.38%

Nasal staphylococcus aureus carriage

- not tested: n=2011 (69.3%)

- tested: n=889 (30.7%)

- positive: 15

- negative: 85

Actuarial survival (Kaplan-Meier) of peritoneal dialysis catheters (years 2013 to 2023)

(dates are censored at the date of transfer to another method, death or transplantation)

- 12 months: 97% ± 07

- 24 months: 84.8% ± 1%.

- 36 months: 80.7% ± 1.2

- 48 months: 76.7 ± 1.6%.

- 60 months : 72.1± 1.1%.

DATA FROM THE NURSING SECTION OF THE DATA BASE

45% of RDPLF centers participate to the optional data-base module on nursing, the results below represent some of the data available in 2022

Figure 9.96,7 % des patients ont été formés après la pose du cathéter et 3,3 % avant. Parmi ceux formés après la pose du cathéter , le délais entre pose et début de formations est très variable, avec une durée médiane de 19 jours

Figure 10.duration of training of autonomous patients treated by peritoneal dialysis, all methods included.

Figure 11.Nurses who train patients report some degree of visual or manual impairment in patients that requires adaptation of training in 21% of cases

Peer reviewing

The figures, tables, and figures in this document are raw data extracted from the database, without interpretation, available to readers as a starting point for encouraging future research projects. They have not been subjected to peer.

Acknowledgments

We warmly thank the medical and nursing teams who regularly register their data in the RDPLF and thanks to whom these data are possible. We are at their disposal to help them in any work they would like to undertake with the database.

Références

1. M. Lassale, C Couchoud.Publisher Full Text
2. Verger C., Fabre E., Veniez G., Padernoz M.C.. Données statistiques synthétiques du Registre de Dialyse Péritoneale de Langue Française et Hémodialyse à

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