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A. R. Nissenson, R. Agarwal, M. Allon, A. K. Cheung, W. Clark, T. Depner, et al., “Improving Outcomes in CKD and ESRD Patients: Carrying the Torch from Training to Practice,” Seminars in Dialysis, Vol. 17, No. 5, 2004, pp. 380-397. doi:10.1111/j.0894-0959.2004.17350.x

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• TITLE: Does Current Nephrology Fellowship Training Affect Uti-lization of Peritoneal Dialysis in the United States?

  AUTHORS: Nand K. Wadhwa, Catherine R. Messina, Nasser M. Hebah

  KEYWORDS: Peritoneal Dialysis; Hemodialysis; Utilization; Nephrology Fellowship Training

  JOURNAL NAME: Open Journal of Nephrology, Vol.3 No.2, June 19, 2013

  ABSTRACT: Background: The 2010 US Renal Data System annual report revealed that peritoneal dialysis is used by only 7% of end-stage renal disease patients on chronic dialysis vs. hemodialysis which is used by 93% of such patients, despite documented benefits of peritoneal dialysis over hemodialysis in these cases. Purpose: We examined whether education of nephrology fellows contributed to underutilization of peritoneal dialysis in the US. Methods: Self-report questionnaires were administered electronically to nephrology fellowship training program directors, October 2010-March 2011 (55% response). Results: Median number of training faculty and patients/fellow were significantly lower for peritoneal-dialysis vs. hemodialysis training. Hours of didactic teaching for fellows over their 2-year training period were significantly lower for peritoneal dialysis vs. hemodialysis. Peritoneal dialysis training was 20% of total training vs. 80% for hemodialysis. Most program directors (87%) believed lack of trained faculty in peritoneal dialysis and insufficient peritoneal dialysis patient population contributed to inadequate fellows’ peritoneal dialysis training. Conclusions: Findings suggest that current nephrology fellowship training in peritoneal dialysis is inadequate and contributes to its underutilization.