Authors (including presenting author) :
Lam MK, Ma KMM
Affiliation :
K18 Renal Unit, Queen Mary Hospital
Introduction :
Patient with end-stage renal failure will receive renal replacement therapy. Hospital Authority adopts a Peritoneal Dialysis (PD) first policy in Hong Kong. Patients will be offered PD unless they are contraindicated. They need to undergo Intermittent Peritoneal Dialysis (IPD) in K18 renal ward twice a week after PD catheter insertion until they are ready to receive PD training to start home dialysis. Each IPD usually last for 24 hours depends on patient’s condition and treatment regime for 8 – 10 weeks duration.
Reduce the length of hospital stay with shorter IPD duration may improve patients’ quality of life, minimizing related clinical costs and labor intensive. Besides, unoccupied renal bed can alleviate access block and ward congestion in specialty emergency wards (SEW). In view of the above considerations, day IPD in HKWC (both in QMH and TWH) renal day centres were proposed.
Objectives :
1) To improve patients’ quality of life
2) To minimize clinical costs and labor intensive
3) To alleviate access block and ward congestion in SEW
Methodology :
After PD catheter insertion, renal patients with stable medical condition and renal function will be selected to receive day IPD either twice or thrice per week from 9am to 6pm in renal day centres in HKWC.
Result & Outcome :
The program was started in QMH since December 2023, followed by TWH in February 2024. 11 out of 41 patients (26.8%) were selected for day IPD in QMH and 7 out of 39 patients (17.9%) in TWH. With an average of 8 – 10 weeks IPD duration with a minimum of twice IPD sessions per week. A reduction of 16 - 20 admission per patient was encountered which contributes a total of 176 – 220 reductions of admission episodes to K18 renal ward and 112 – 140 reductions of admission in TWH renal ward.
Enhancement of day IPD service is effective in reducing the number of admissions to renal wards in HKWC which helps in the alleviation of access block and ward congestion in specialty emergency wards (SEW).
