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Background: Life participation is an outcome of critical importance to patients receiving peritoneal dialysis (PD). However, there is no widely accepted or validated tool for measuring life participation in patients receiving PD. Methods: Online consensus workshop to identify the essential characteristics of life participation as a core outcome, with the goal of establishing a patient-reported outcome measure for use in all trials in patients receiving PD. Thematic analysis of transcripts was performed. Results: Fifty-five participants, including 17 patients and caregivers, from 15 countries convened via online videoconference. Four themes were identified: reconfiguring expectations of daily living (accepting day-to-day fluctuation as the norm, shifting thresholds of acceptability, preserving gains in flexibility and freedom), ensuring broad applicability and interpretability (establishing cross-cultural relevance, incorporating valued activities, distinguishing unmodifiable barriers to life participation), capturing transitions between modalities and how they affect life participation (responsive to trajectory towards stable, reflecting changes with dialysis transitions) and maximising feasibility of implementation (reducing completion burden, administrable with ease and flexibility). Conclusions: There is a need for a validated, generalisable outcome measure for life participation in patients receiving PD. Feasibility, including length of time to complete and flexible mode of delivery, are important to allow implementation in all trials that include patients receiving PD.

Background Peritoneal dialysis (PD) solutions containing low levels of glucose degradation products (GDPs) are associated with attenuation of peritoneal membrane injury and vascular complications. However, clinical benefits associated with neutral pH, low GDP (N-pH/L-GDP) solutions remain unclear. Methods Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the associations between N-pH/L-GDP solutions and all-cause mortality, cause-specific mortality, transfer to haemodialysis (TTH) for ≥ 30 days, and PD peritonitis in adult incident PD patients in Australia and New Zealand between January 1, 2005, and December 31, 2020, using adjusted Cox regression analyses. Results Of 12 814 incident PD patients, 2282 (18%) were on N-pH/L-GDP solutions. The proportion of patients on N-pH/L-GDP solutions each year increased from 11% in 2005 to 33% in 2017. During the study period, 5330 (42%) patients died, 4977 (39%) experienced TTH, and 5502 (43%) experienced PD peritonitis. Compared to use of conventional solutions only, use of any form of N-pH/L-GDP solution was associated with reduced risks of all-cause mortality (adjusted hazard ratio [aHR] 0.67, 95% confidence interval [CI] 0.61–0.74), cardiovascular mortality (aHR 0.65, 95%CI 0.56–0.77), infection-related mortality (aHR 0.62, 95%CI 0.47–0.83) and TTH (aHR 0.79, 95%CI 0.72–0.86), but an increased risk of PD peritonitis (aHR 1.16, 95%CI 1.07–1.26). Conclusions Patients who received N-pH/L-GDP solutions had decreased risks of all-cause and cause-specific mortality despite an increased risk of PD peritonitis. Studies assessing the causal relationships are warranted to determine the clinical benefits of N-pH/L-GDP solutions.