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[What are the prerequisites for establishing a peritoneal dialysis treatment? (Training center, the place of private practice nurses, the administrative structure of management)].

In spite of the same quality of results in term of five year survival by peritoneal dialysis (PD) compared to hemodialysis (HD), this method of renal substitutive therapy is concerning no more than 7% ESRF patients in France. What structural inadaptations could account for such striking differences between the two modalities? We present here the results of a French multi-center survey and our proposal for improving the actual tendency. Nonante PD centers were included representing a total number of 1592 patients, among them 90% were on continuous ambulatory peritoneal dialysis. We could observe a predominant proportion of public district services and non-profit associations. Sixty per cent of PD units were part of hemodialysis centers and 20% were totally independent. Patient mean age was very old, with limited autonomy, necessitating frequent visits of liberal nurses for 57% patients. We suggest to reinforce the role of non-profit making associations and to reorganize the existing centers on two levels in term of facilities, personal services and on functional modalities according to the number of treated patients.