{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T23:01:37Z","timestamp":1780700497966,"version":"3.54.1"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Macrotech Farmac\u00e9utica"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perit Dial Int"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) represents a growing public health challenge worldwide, particularly in countries with a medium sociodemographic index such as the Dominican Republic (DR), where both the incidence and prevalence of CKD have shown a sustained increase. In response, the DR government launched a national peritoneal dialysis (PD) program in 2013 to expand access to kidney replacement therapy (KRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on the development and implementation of the national continuous ambulatory peritoneal dialysis (CAPD) program over ten years. The model was structured around three pillars: (1) a multidisciplinary team comprising nephrology, nursing, nutrition, psychology, and social work; (2) dedicated infrastructure for PD delivery; and (3) a management system driven by standardized processes and protocols, aligned with ISO certification standards. Patient care involved comprehensive baseline assessments, structured training, monthly follow-up, routine retraining, and home evaluations. Program performance was monitored through predefined clinical indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Since the implementation of the program, the PD penetration in DR increased from 2.7% to 22.4%, reaching 1118 patients by the end of 2024. This growth reflects the program's ability to improve access to KRT through a centralized and standardized care model. This model not only facilitated consistency in care delivery across participating centers but also enhanced the growth of PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 10-year experience of the national PD program in the DR provides evidence for the feasibility and effectiveness of a standardized, patient-centered, and multidisciplinary PD program. The implementation of this program has significantly increased access to kidney replacement therapies and driven the sustained growth of KRT in the DR and provides a scalable model for the implementation of national PD initiatives in similar contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08968608261452388","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:52:16Z","timestamp":1780408336000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ten-year implementation of a National Peritoneal Dialysis Program in the Dominican Republic: A retrospective study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6352-4720","authenticated-orcid":false,"given":"Sergio \u00d3scar","family":"Hern\u00e1ndez Ord\u00f3\u00f1ez","sequence":"first","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7672-9787","authenticated-orcid":false,"given":"Erwin Iv\u00e1n","family":"Campos Echavarr\u00eda","sequence":"additional","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"},{"name":"Department of Nephrology, Salvador Bienvenido Gautier Teaching Hospital, Santo Domingo, Dominican Republicc"},{"name":"School of Medicine, Pontifical Catholic Mother and Teacher University, Santo Domingo Campus, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-0089","authenticated-orcid":false,"given":"Elianny","family":"Sarina Polanco Brazoban","sequence":"additional","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0091-5845","authenticated-orcid":false,"given":"Zulma Bolena","family":"Lara Mayorga","sequence":"additional","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3379-0147","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Cuevas Budhart","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-9408","authenticated-orcid":false,"given":"Jos\u00e9","family":"Carolino Divino-Filho","sequence":"additional","affiliation":[{"name":"Karolinska Institutet"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9293-7631","authenticated-orcid":false,"given":"Janny","family":"Katherine","sequence":"additional","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Encarnaci\u00f3n Ogando","sequence":"additional","affiliation":[{"name":"Dialysis Program, National Health Service, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yocasta","family":"Lara Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Directorate of Hospital Centres, National Health Service, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-3553","authenticated-orcid":false,"given":"Alfonso","family":"Ramos-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Renal Division, Macrotech Farmac\u00e9utica, Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00769-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32367-X"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030678"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_3_3_6_2","unstructured":"World Development Indicators | DataBank [Internet]. 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