Use of the face mask in peritoneal dialysis: Analysis of an online survey on global practices

Peritoneal dialysis (PD) is an established home-based therapy. Face masks have historically been used as an infection-prevention measure during PD exchanges, although their effectiveness remains uncertain. Current evidence emphasizes hand hygiene and aseptic technique, while the incremental benefit of routine face mask use has not been clearly established. We conducted a cross-sectional online survey of PD nurses and nephrologists to describe clinical practices regarding face mask use during PD exchanges. Participants were recruited through professional networks and international professional organizations. The survey included questions regarding patient and healthcare professional mask use, institutional guidance, patient training, and perceptions of effectiveness. A total of 733 healthcare professionals from 71 countries responded, including 617 nurses (84.2%). Face masks were reported to be always used by patients during bag exchanges or connection to the cycler by 72.3% (n = 530) of respondents. The most frequently reported reason for mask use was general infection prevention (40.9%, n = 299). Mask use was included in patient training by 80.2% (n = 588), and 77.6% (n = 567) believed that mask use helps prevent peritonitis. Significant regional differences were observed in reported mask-use practices (χ 2 = 44.65, df = 8, p < 0.001). Mask use also varied according to PD program size (χ 2 = 20.06, df = 6, p = 0.003). In addition, 39.6% (n = 290) reported that their facility followed specific guidance regarding mask use. Routine face mask use remains common in PD practice and is widely incorporated into patient training. Substantial regional and program-size variation was observed. Given the limited and uncertain evidence regarding the incremental benefit of routine mask use, these findings describe substantial variation in current practice and highlight the need for further evidence to clarify the role of face masks in PD infection prevention.