Abstract: Objective To promote peritoneal dialysis (PD) in primary health care institutions by using the two-way referral system in order to improve the survival rate and quality of life in patients with end-stage renal disease (ESRD). Methods We have established a mutual referral system with six community hospitals since 2012. We then set down our responsibilities, shared clinical data and therapeutic effects, organized a PD patient club, and collected feedbacks from patients and their family members with these community hospitals. Results ① A total of 276 new PD patients (141 males and 135 females) were treated from 2009 to 2014. The age at the beginning of PD was 52.75±13.31 years old, and the average PD age was 23.23±14.18 months. Chronic glomerulonephritis was the main cause of ESRD, followed by nephropathies due to diabetes mellitus and hypertension. After the implementation of mutual referral system, 226 new PD patients were treated in our center from Jan. 2012 to Dec. 2014. The treatment time, drop rate and mortality rate were 27.37 months, 29.41%, and 23.21% respectively during 2009 to 2011, and reduced to 19.95 months, 24.76%, and 19.08% respectively during 2012 to 2014. ②PD patients felt more convenient and less expense. Medical expenses were 8.5% lower for PD patients than for hemodialysis patients. ③Eighteen doctors/nurses from the six community hospitals were trained for PD knowledge and skills in our center to improved their PD professional abilities. Conclusions The two-way referral system to promote PD in primary health care institutions achieved favorable social and economic benefits and can therefore be used widely.

Key words: Peritoneal dialysis, two-way referral, primary health care institutions