Factors Associated with the Choice of Peritoneal Dialysis in Patients with End-Stage Renal Disease

Chiang, Pei-Chun; Hou, Jia-Jeng; Jong, Ing-Ching; Hung, Peir-Haur; Hsiao, Chih‐Yen; Ma, Tsung-Liang; Hsu, Yuan-Yu

doi:10.1155/2016/5314719

Cited by 13 publications

(23 citation statements)

References 38 publications

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“…Many of these patients wish for a more extensive discussion of their dialysis modality choices before dialysis initiation (28,30). Unplanned start on PD is considered a safe and efficient alternative to unplanned HD, even in the elderly (29,(31)(32)(33), and decreases the need for temporary tunneled dialysis catheter for HD, without increasing hospital stays (13,34).…”

Section: Unplanned Dialysismentioning

confidence: 99%

Setting Up and Expanding a Home Dialysis Program: Is There a Recipe for Success?

2020

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Home dialysis modalities remain significantly underused in the United States despite similar overall survival in the modalities, and recent incentives to expand these modalities. Although the absolute number of patients using home modalities has grown, the proportion compared to in-center hemodialysis (ICHD) continues to remain quite low. Well known barriers to home dialysis utilization exist, and an organized and team-based approach is required to overcome these barriers. Herein, we describe our efforts at growing our home dialysis program at a large academic medical center, with the proportion of home dialysis patients growing from 12% to 21% over the past 9 years. We prioritized individualized education for patients and better training for physicians, with the help of existing resources, aimed at better utilization of home modalities; an example includes dedicated dialysis education classes taught twice monthly by an experienced nurse practitioner, as well as the utilization of the dialysis educator from a dialysis provider for inpatient education of patients with CKD. The nephrology fellowship curriculum was restructured with emphasis on home modalities, and participation in annual home dialysis conferences has been encouraged. For timely placement and troubleshooting of access for dialysis, we followed a complementary team approach using surgeons and interventional radiologists and nephrologists, driven by a standardized protocol developed at UAB, and comanaged by our access coordinators. A team-based approach, with emphasis on staff engagement and leadership opportunities for dialysis nurses as well as collaborative efforts from a team of clinical nephrologists and the dialysis provider helped maintain efficiency, kindle growth, and provide consistently high-quality clinical care in the home program. Lastly, efforts at reducing burden of disease such as decreased number of monthly visits as well as using innovative strategies, such as telenephrology and assisted PD and HHD, were instrumental in reducing attrition.

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Section: Unplanned Dialysismentioning

confidence: 99%

Setting Up and Expanding a Home Dialysis Program: Is There a Recipe for Success?

2020

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“…Looking at patient-related characteristics, the international literature shows, that due to only a few absolute contraindications against PD, most ESRD patients are eligible for both modalities [ 10 , 11 ]. Nevertheless, several studies have identified differences in educational level and gender between HD and PD patients [ 5 , 12 – 15 ], and the majority of prior research indicates PD patients to be younger [ 2 , 3 , 12 – 17 ]. Other patient-related factors, like personality traits or attitudes, and their role in the context of dialysis modality choice have hardly been investigated.…”

Section: Introductionmentioning

confidence: 99%

The role of personal attitudes of control and responsibility for the uptake of peritoneal dialysis- a national survey among dialysis patients

Schellartz

Ohnhaeuser

Mettang³

et al. 2021

BMC Nephrol

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Background Although most patients are suitable for both hemodialysis (HD) and peritoneal dialysis (PD), there seem to be differences in the outlook of patients who choose one modality over the other. There is currently limited literature about the impact of patients’ personal attitudes on the decision for PD or HD. In this study, we tried to find out whether there were differences between patients who were on HD and PD in their desire for control and responsibility for their treatment. Methods The data were drawn from a nationwide postal survey of 630 HD and PD patients. Patients’ desire for control was measured by scores on the internal locus of control (ILOC) scale. Patients were also asked how important taking responsibility for their dialysis had been for their treatment decision (ITR). Two multivariate logistic regression models, both adjusted for age, were applied to investigate whether there were differences between HD and PD patients in ILOC and ITR. Having one generic measure (ILOC) and one tailored to the dialysis context (ITR) gave the opportunity to investigate if it is a generic personality trait or rather a specific attitude that affects choice of dialysis modality. Results PD patients were younger and showed higher ILOC and ITR values. Multivariate logistic regression models adjusted for age confirmed the significant influence of ILOC and ITR on the uptake of PD. The odds ratios for being in the PD group were 1.53 for ILOC (p = 0.030; 95% CI 1.04–2.25), 1.49 for ITR (p = 0.019; 95% CI 1.07–2.07), and 0.95 (p = 0.000; 95% CI 0.94–0.97) for age in both models. Conclusions Our analysis shows the impact of personal attitudes on the uptake of PD. Participants who generally want to keep control of their lives and take responsibility for their dialysis treatment tended to choose PD. As PD is a home dialysis treatment that requires patients to participate and contribute, it is beneficial if patients’ personalities support the treatment procedure. Having two completely different treatment options that suit to different personalities gives us the opportunity to consider the relationship between personal attitudes and choice of dialysis modality. Trial registration The MAU-PD study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00012555. Date of Registration in DRKS: 2018/01/04.

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“…Previous studies have identi ied several factors associated with RRT selection, including the timing of referral, physician bias, predialysis education, resource availability, social and cultural status [4][5][6]. In contrast, a recently published registry study show that patients with early awareness of the method [7] were more likely to select self care dialysis and avoid unnecessary invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

Impact of a multidisciplinary pre-dialysis program on renal treatment modalities choice

Oliveira¹,

Castro²,

Morgado³

2021

J Clini Nephrol

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Factors Associated with the Choice of Peritoneal Dialysis in Patients with End-Stage Renal Disease

Cited by 13 publications

References 38 publications

Setting Up and Expanding a Home Dialysis Program: Is There a Recipe for Success?

Setting Up and Expanding a Home Dialysis Program: Is There a Recipe for Success?

The role of personal attitudes of control and responsibility for the uptake of peritoneal dialysis- a national survey among dialysis patients

Impact of a multidisciplinary pre-dialysis program on renal treatment modalities choice

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