Current status of assisted peritoneal dialysis in Japan: A nationwide questionnaire survey

Abstract

Background

The aim of this study was to clarify the current status of assisted peritoneal dialysis (PD) implementation in Japan.

Methods

A nationwide, cross-sectional, questionnaire survey was conducted by the Working Group of the Academic Committee of the Japanese Society for Peritoneal Dialysis. A paper-based questionnaire of 22 items was developed based on a literature review and clinical experience. The questionnaires were sent to all 310 facilities that were members of the Japanese Society for Peritoneal Dialysis (JSPD).

Results

Responses were received from 209 facilities (response rate 67.4%). It was found that assisted PD is already being implemented in approximately two-thirds of PD facilities, accounting for 15.9% of all PD patients. Cognitive decline and muscle weakness were the leading reasons for starting assisted PD. Family members, particularly spouses and adult children, were the main caregivers in this cohort, either alone or in collaboration with visiting nurses; cooperation with general practitioners was relatively limited. Facilities with a large number of PD patients made use of collaboration with visiting nurses and respite care facilities, remote monitoring, and medical care-specific social networking sites.

Conclusion

This nationwide survey demonstrates that assisted PD is widely practiced in Japan and plays a critical role in sustaining PD therapy for elderly and functionally impaired patients. However, substantial heterogeneity in implementation and insufficient integration with broader medical and social care systems remain major challenges. Addressing these issues through standardization, multidisciplinary collaboration, and policy reform will be essential to meet the needs of Japan's rapidly aging dialysis population.