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RDPLF annual report: Profile of peritoneal dialysis patients in France in 2022, synthetic raw results

Christian Verger, Emmanuel Fabre

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Christian Verger, Emmanuel Fabre. RDPLF annual report: Profile of peritoneal dialysis patients in France in 2022, synthetic raw results. Bulletin de la Dialyse à Domicile, 2023, 6 (1), pp.41-49. 10.25796/bdd.v6i1.77293 . hal-04135372

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# Bulletin de la Dialyse à Domicile

## RDPLF annual report: Profile of peritoneal dialysis patients in France in 2022, synthetic raw results

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

Christian Verger et Emmanuel Fabre

Registre de dialyse péritonéale et hémodialyse à domicile de langue française (RDPLF, Pontoise (France)

**To cite :** Verger C, Fabre E. RDPLF annual report: Profile of peritoneal dialysis patients in France in 2022 synthetic raw results. Bull Dial Domic [Internet]. 6(1):41-49. Available from: https://doi.org/10.25796/bdd.v6i1.77293

Note : this publication is bi-lingual. English original text available same url : https://doi.org/10.25796/bdd.v6i1.77293

## Summary

We present the main descriptive data of patients treated by peritoneal dialysis in France in 2022 in the form of tables and graphs. Patients from DROM-TOM and other French-speaking countries and regions of the RDPLF will be described in a future issue in order to group together regions with similar socio-economic and climatic characteristics.

Since the SARS-Cov2 epidemic in 2020 and the three years that followed, the number of patients treated by peritoneal dialysis in France has decreased by 6.7%, but with significant regional variations ranging from +20% to -30%.

Vascular (23.5%) and diabetic (20.5%) nephropathies are the most numerous.

The average age for CAPD is 70 years and 58 years for APD

36% of patients are assisted by a nurse and 5% by a family member.

The average waiting time for transplant patients was 20 months.

There is a great difference in the technique of catheter placement with a catheter survival of 72% at 5 years.

## 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-economiques 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 importantes 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 délai d'attente des patients transplantés a 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.

**Mots clés** : Registre, RDPLF, Dialyse péritonéale, France, rapport annuel

**Keywords** : Registry, RDPLF, peritoneal dialysis, France, annual report
## 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><img src="image_3.png" /></figure>

<table><caption>▲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</caption><thead><tr><th rowspan="2">REGIONS</th><th colspan="2">Number of patients</th></tr><tr><th>01/01/2020</th><th>31/12/2022</th></tr></thead><tbody><tr><td>Alsace</td><td>212</td><td>171</td></tr><tr><td>Aquitaine</td><td>102</td><td>126</td></tr><tr><td>Auvergne</td><td>112</td><td>97</td></tr><tr><td>Basse-Normandie</td><td>120</td><td>106</td></tr><tr><td>Bourgogne</td><td>101</td><td>68</td></tr><tr><td>Bretagne</td><td>119</td><td>102</td></tr><tr><td>Centre</td><td>40</td><td>43</td></tr><tr><td>Champagne-Ardenne</td><td>92</td><td>99</td></tr><tr><td>Corse</td><td>12</td><td>4</td></tr><tr><td>Franche-Comté</td><td>93</td><td>81</td></tr><tr><td>Haute-Normandie</td><td>83</td><td>77</td></tr><tr><td>Ile-de-France</td><td>346</td><td>330</td></tr><tr><td>Languedoc-Roussillon</td><td>122</td><td>107</td></tr><tr><td>Limousin</td><td>54</td><td>71</td></tr><tr><td>Lorraine</td><td>94</td><td>68</td></tr><tr><td>Midi-Pyriv/©nv©es</td><td>77</td><td>98</td></tr><tr><td>Nord-Pas-de-Calais</td><td>199</td><td>202</td></tr><tr><td>Pays de la Loire</td><td>169</td><td>177</td></tr><tr><td>Picardie</td><td>30</td><td>19</td></tr><tr><td>Poitou-Charentes</td><td>64</td><td>56</td></tr><tr><td>Provence-Alpes-Cote d'Azur</td><td>207</td><td>196</td></tr><tr><td>Rhone-Alpes</td><td>288</td><td>253</td></tr></tbody><tfoot><tr><td>Total</td><td>2736</td><td>2551</td></tr></tfoot></table>
<figure><img src="image_4.png" /><figcaption>▲Figure 2. Nephropathies of peritoneal dialysis patients in France in 2022</figcaption></figure>

<figure><img src="image_5.png" /><figcaption>▲Figure 3. Age distribution of patients treated with PD in France in 2022, in metropolitan France, all methods combined.</figcaption></figure>

## TREATMENT BEFORE PD

- non-dialysed: 3113 (80.4%)

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

- transplanted: 135 (3.4%)
## MODALITES DE DIALYSE PERITONEALE

<figure><img src="image_6.png" /><figcaption>▲ Figure 4. Age distribution of patients treated with APD and CAPD in metropolitan France in 2022</figcaption></figure>

<table><caption>▼ Table I. Dialysis solutions used in addition to glucose-based solutions</caption><thead><tr><td>Solutions other than glucose</td><td>Non-diabetic patients</td><td>diabetic patients</td></tr></thead><tbody><tr><td>No other solution than glucose</td><td>24,2%</td><td>16,6%</td></tr><tr><td>Icodextrine</td><td>57,7%</td><td>52,0%</td></tr><tr><td>Amino-acids</td><td>2,1%</td><td>3,4%</td></tr><tr><td>Icodextrine+amino-acids</td><td>15,9%</td><td>28,0%</td></tr></tbody></table>

## DIABETES

<figure><img src="image_7.png" /><figcaption>▲ Figure 5. diabetic status and treatment of patients treated with PD in metropolitan France in 2022</figcaption></figure>

## AUTONOMY

<table><caption>▼ Table II. Autonomy of peritoneal dialysis patients in metropolitan France in 2022</caption><tr><td>Autonomous</td><td>2316</td><td>59%</td></tr><tr><td>Nurse assisted</td><td>1409</td><td>36%</td></tr><tr><td>Family assisted</td><td>203</td><td>5%</td></tr><tr><td>Asisted (withou precision)</td><td>21</td><td>1%</td></tr><tr><td>Missing data</td><td>8</td><td>&lt;1%</td></tr></table>
<figure><img src="image_8.png" /><figcaption>▲Figure 6. Autonomy by patient according to age</figcaption></figure>

<figure><img src="image_9.png" /><figcaption>▲Figure 7. autonomy by PD modality</figcaption></figure>

TRANSPLANTATION

<table><caption>▼ Tableau III. Transplant status of patients in metropolitan France treated with PD in 2022</caption><thead><tr><td>Transplantation status</td><td>number</td><td>Percentage</td></tr></thead><tbody><tr><td>Pre-transplant assessment not done</td><td>86</td><td>3,4%</td></tr><tr><td>Pre-transplant assessment not finished</td><td>395</td><td>15,7%</td></tr><tr><td>Registered on waiting list</td><td>665</td><td>26,5%</td></tr><tr><td>Not transplantable</td><td>896</td><td>35,7%</td></tr><tr><td>Transplantation refused by patient</td><td>213</td><td>8,5%</td></tr><tr><td>Temporally contra-indication</td><td>254</td><td>10,1%</td></tr></tbody></table>
<figure><img src="image_10.png" /><figcaption>▲Figure 8. Waiting times since the start of PD for patients transplanted in 2022 in France</figcaption></figure>

## CATHETERS

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

<table><caption>▼ Table IV : shapes of the catheters used</caption><thead><tr><td>Extraperitoneal section</td><td>Intraperitoneal section</td><td>Percentages</td></tr></thead><tbody><tr><td>Straight</td><td>Straight</td><td>22,8%</td></tr><tr><td>Swan Neck</td><td>Straight</td><td>28,2%</td></tr><tr><td>Straight</td><td>Coil</td><td>24,7%</td></tr><tr><td>Swan Neck</td><td>Coil</td><td>21,7%</td></tr><tr><td>not registered</td><td>Non registered</td><td>2,6%</td></tr></tbody></table>

**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><img src="image_11.png" /></figure>

▲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><img src="image_12.png" /><figcaption>▲Figure 10. duration of training of autonomous patients treated by peritoneal dialysis, all methods included.</figcaption></figure>

<figure><img src="image_13.png" /><figcaption>▲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</figcaption></figure>

**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.

**Authoship** : CV wrote the text and did the analysis. EF participated in the creation of the graphics and the output of the results.
**Funding** :The RDPLF operates independently with grants from non-profit home dialysis associations and laboratories. Funding sources are available on the RDPLF website at
https://www.rdplf.org/financement.html

References

1- Lassale M. and Couchoud C. REIN annual report 2019 [Internet]. Available at : https://www.agence-biomedecine.fr/IMG/pdf/rapport_rein_2019_2021-10-14.pdf.

2 - Verger C, Fabre E, Veniez G, Padernoz MC. Données statistiques synthétiques du Registre de Dialyse Péritoneale de Langue Française et Hémodialyse à Domicile (RDPLF) en 2018. Bull Dial Domic [Internet]. 10 avr. 2019 [cité 25 avr. 2023];2(1):1-10. Disponible sur: https://doi.org/10.25796/bdd.v2i1.19093

3 - Verger C, Ryckelynck JP, Duman M, Veniez G, Lobbedez T, Boulanger E, Moranne O. French peritoneal dialysis registry (RDPLF): outline and main results. Kidney Int Suppl. 2006 Nov;(103):S12-20. doi: 10.1038/sj.ki.5001911. Erratum in: Kidney Int Suppl. 2007 Jan;71(1):87. Fabre, E [added].

4 - Thieurmel B, Masson M. Development of an application for accessing and analyzing RDPLF data. Bull Dial Domic [Internet]. 2020 Aug. 21 [cited 2023 Apr. 26];3(3):155-68. Available from: https://doi.org/10.25796/bdd.v3i3.57943

Published 2023-04-25

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