Peritoneal Dialysis Guidelines 2019 Part 2: Main Text (Position paper of the Japanese Society for Dialysis Therapy)
Authors: Ryuzaki Munekazu , Ito Yasuhiko , Nakamoto Hidetomo , Ishikawa Yuichi , Itami Noritomo , Ito Minoru , Ueda Atsushi , Kanazawa Yoshie , Kawanishi Hideki , Kanno Yoshihiko , Sugiyama Hitoshi , Tsuruya Kazuhiko , Terawaki Hiroyuki , Tomo Tadashi , Fukasawa Mizuya , Yamashita Akihiro C. , Yokoi Hideki , Nakayama Masaaki , Yuasa Hidemichi , Tsujimoto Yasushi , Tsujimoto Hiraku , Saka Yosuke , Kuroki Yusuke , Yasuda Kaoru , Fujii Takayuki , Kanno Atsuhiro , Fujikura Emi , Watanabe Kimio , Obata Yoko , Murashima Miho , Toda Naohiro , Yamamoto Shuto , Tsujimoto Yoshihiro , Sakurada Tsutomu , Komukai Daisuke , Uchiyama Kiyotaka , Washida Naoki , Morimoto Kohkichi , Kasai Takahiro , Maruyama Yukio , Higuchi Chieko , Io Hiroaki , Wakabayashi Keiichi ,   on behalf of the Working Group on Revision of Peritoneal Dialysis Guidelines of the Japanese Society for Dialysis Therapy, Ito Yasuhiko , Ryuzaki Munekazu , Nakamoto Hidetomo , Ishikawa Yuichi , Itami Noritomo , Ito Minoru , Ueda Atsushi , Kanazawa Yoshie , Kawanishi Hideki , Kanno Yoshihiko , Sugiyama Hitoshi , Tsuruya Kazuhiko , Terawaki Hiroyuki , Tomo Tadashi , Fukasawa Mizuya , Yamashita Akihiro C. , Yokoi Hideki , Nakayama Masaaki , Yuasa Hidemichi , Tsujimoto Yasushi , Tsujimoto Hiraku , Minoru Ito , Saka Yosuke , Kuroki Yusuke , Yasuda Kaoru , Fujii Takayuki , Kanno Atsuhiro , Fujikura Emi , Watanabe Kimio , Obata Yoko , Murashima Miho , Toda Naohiro , Yamamoto Shuto , Tsujimoto Yoshihiro , Sakurada Tsutomu , Komukai Daisuke , Uchiyama Kiyotaka , Washida Naoki , Morimoto Kohkichi , Kasai Takahiro , Maruyama Yukio , Higuchi Chieko , Io Hiroaki , Wakabayashi Keiichi , Tamura Masahito , Furuzono Tsutomu , Masakane Ikuto , Masaki Hiroya , Matsumura Mamiko , Miyazaki Masanobu , Tokumoto Shinobu , Nogami Masayo , Mikami Yuko , Toyoshima Yoshihiro , Nangou Eishyu , Abe Shinichi , Ishihara Chihiro , Hoshi Keika , Mitani Mieko 
Published: September 2021

Background

This article is a duplicated publication from the Japanese version of “2019 JSDT Guidelines for Peritoneal Dialysis” with permission from the Japanese Society for Dialysis Therapy (JSDT). This clinical practice guideline (CPG) was developed primarily by the Working Group on Revision of Peritoneal Dialysis (PD) Guidelines of the Japanese Society for Dialysis Therapy. Recently, the definition and creation process for CPGs have become far more rigorous; traditional methods and formats no longer adhere to current standards. To improve the reliability of international transmission of our findings, CPGs are created in compliance with the methodologies developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Part 2 of this PD guideline is the first CPG developed by our society that conforms to the GRADE approach.

Methods

Detailed processes were created in accordance with the Cochrane handbook and the GRADE approach developed by the GRADE working group.

Results

Clinical question (CQ)1: Is the use of renin-angiotensin system inhibitors (RAS inhibitors), such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB), effective in PD patients?

Recommendation: We suggest the usage of RAS inhibitors (ACEI and ARB) in PD patients (GRADE 2C).

CQ2: Icodextrin or glucose solution: which is more useful as a dialysate among patients with PD?

Recommendation: We suggest using icodextrin when managing body fluids in PD patients (GRADE 2C).

CQ3: Is it better to apply or not apply mupirocin/gentamicin ointment to the exit site?

Recommendation: We suggest not applying mupirocin/gentamicin ointment to the exit sites of PD patients (GRADE 2C).

CQ4: Which surgical approach is more desirable when a PD catheter is placed, open surgery or laparoscopic surgery?

No recommendation.

CQ5: Which administration route of antibiotics is better in PD patients with peritonitis, intravenous or intraperitoneal?

Recommendation: We suggest intraperitoneal administration of antibiotics in PD patients with peritonitis (GRADE 2C).

Note: The National Insurance does not currently cover intraperitoneal administration.

CQ6: Is peritoneal dialysis or hemodialysis better as the first renal replacement therapy in diabetic patients?

No recommendation.

Conclusions

In the future, we suggest that society members construct their own evidence to answer CQs not brought up in this guideline, and thereby show the achievements of Japan worldwide.