From April 25th through April 28th 2010 we took part in the Peritoneal Dialysis (PD) Academy which took place in the Polish town Krakow. It is an annual educational course about topics mainly connected with peritoneal dialysis, which is organized especially for doctors from Central Europe. The specialization of the Academy is in the increase of interest and experience of nephrologists in PD mainly using interactive methods of learning, which were supplied by lectures of the lecturers with much experience in the area of PD. These lectures were regularly changed with practical exercises and learning of interesting casuistics, which took place in smaller, in advance divided groups, and they were in the form of dialogues with the lecturers. During the exercises we interchanged our own experience and opinions on some real cases of patients treated by PD with colleagues from other countries. We also suggested some ideas about the solutions of the problems at which we were also instructed and given some ideas by our lecturers.
The lecturers were respected medical specialists in the area of nephrology and PD; such as Dr.Jose Divino, MD, PhD, Prof.Dr.Max Dratwa, MD, PhD, Dr.Jacek Lange MD, PhD. The whole Academy was lead by Dr.Martin Wilkie, MD, PhD from Kidney Institute, Northern General Hospital Sheffield, England.
The main aims and topics of the course were to provide us with bigger confidence and experience in better-organized management and the initialization of the PD programme as well as to improve the quality of medical care of a PD patient. The programme was suggested for a good timing of the beginning of the PD treatment, as well as to show the advantages and disadvantages of the methods of PD and to point out the actual world suggestions for the implantation of peritoneal catheter, the after-implantation complications prevention, the prevention and treatment of non-infectious and infectious complications of PD, the strategy for improvement of the management of solutions prescriptions, the management of dietary treatment for PD patients and strategies leading to the improvement of electrolytical state and anemia.
The themes were divided into 4 days and the first day was given to registration, introduction and instructions about the later work. The second day was devoted to the history of PD preparation of patients to the PD programme and the initialization of PD as well as it was devoted to the character of peritoneal membrane, accessability of this healing method to patients and solutions of the basic non-infectious complications, whereas the lectures were changed with the above-mentioned 90-minute exercises.
The third day was devoted to the character of the solutions used at PD, whereas both their advantages and disadvantages were discussed. We also talked about the treatment of various types of patients using various solutions. This day was also devoted to the workshop specialized in the improvement of PD and ultrafiltration, while we again took part in two 90-minute exercises. The study day was finished by the excellent lecture by Dr.Jose Divina, MD, PhD on the usage of PD in emergency situations.
On the fourth day we learnt about the most frequent and most difficult complications of PD, which is infectious complications or infectious peritonitidis, while we mainly discussed the prevention; also in connection with the themes of the previous days, talking about the solutions using the biocompatibility of the materials used at PD. We also discussed new perspectives of healing methods and, of course, we discussed the management of antibiotical and antimycotical treatment. We again had 90-minute exercises where we talked about casuistics.
The course finished with the speech of the representatives of all countries which took part in the Academy. They talked about actual problems in the countries, considering not only PD, but also other aspects of nephrology. We tried to look for and suggest future solutions to the problems, however the specific circumstances of the countries were really quite different.
As for the social programme, I would like to mention the visit to the old and well-known salt mine in the town Wieliczka near Krakow, in which 7,5 million cubic meters of salt was mined since the 13th century. The visit started with 350 stairs down into the depth of 64 meters, which is by far not the deepest place in the mine, which was about 300 m deep. The route we took was "only" 2.5 km long; that is because the paths under the ground measure about 295 km. The temperature in the mine is 14 degrees whole year and the mine is visited by million of tourists every year. Nowadays the mine is only a big tourist attraction, which offers to see many statues, galleries and even chapels carved into salt by miners. Also the crystals of the chandeliers are made from the salt rock. The salt rock is of grey colour of various shades. At the end of the route there is a big hall and a chapel, which is used for various occasions and weddings. Except for that, there is also an underground lake and an exposition of the history of salt mining. The mine is also used as a rehabilitation and wellness centre, because the air in the mine is extraordinary healthy. Even our guide was 129 years old. In 1994 the mine was written on the First List of The World Cultural Heritage.
I consider the course very successful, that is we got many impulses for our work, which can be inspired by the motto of the well-known university in Krakow: plus ratio quam vis - reason will win over power.
(MUDr. Patrik Vrbjar, May 10, 2010)