Importance of non-medical reasons for dropout in patients on peritoneal dialysis

Zhang, Lin; Lee, Wen‐Chin; Wu, Chien-Hsing; Kuo, Li-Chueh; Yang, Hongtao; Moi, Sin-Hua; Yang, Chih‐Jen; Chen, Jin‐Bor

doi:10.1007/s10157-020-01948-y

Cited by 5 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presence of diabetic retinopathy and peripheral neuropathy, anxiety about poorer glycemic control, and increased risk for peritonitis may be the underlying reasons (29). Transfer to HD may be more common in diabetic PD patients (25). However, our study revealed that a significant amount of PD patients in Northern Cyprus had DM, and number of diabetic patients who chose PD as the initial RRT modality were not different than non-diabetic patients.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Overview of peritoneal dialysis outcomes in Northern Cyprus: a nation based study

Bardak¹,

BEHLÜL²,

Oygar³

2022

Anatolian Current Medical Journal

View full text Add to dashboard Cite

Aim: Peritoneal dialysis (PD) is the more preferred renal replacement therapy (RRT) option for most patients with end-stage renal disease (ESRD) who can not achieve a kidney transplantation. By an enhanced national PD program, more patients may have a chance to take the advantage of this treatment option. In this study, we aim to investigate whether PD is preferred as the first dialysis treatment modality in Northern Cyprus and reveal the outcomes in order to improve the further PD program. Material and Method: Peritoneal dialysis patients aged above 18 years who were followed between 2003-2021 in Northern Cyprus were investigated retrospectively. Demographic data, primary kidney diseases, comorbidities and previous RRT modalities were analysed. Episode(s) of peritonitis, total duration on PD therapy, switch to kidney transplantation or HD, and mortality rate were evaluated. Outcomes of elderly (≥ 65 years) and diabetic patients who were dropped out from PD were found out. Results: A total of 123 patients aged 18-83 years were included in the study. Forty percent of 123 PD patients initiated RRT with PD. The median time was found 1 month in the rest of the patients to transfer PD from other modalities. Renal transplantation was performed in 16.8% of patients during follow-up whereas 34.7% were transferred to HD after 41 months. Inadequate dialysis (40.7%), PD-related infections (29.6%), ultrafiltration insufficiency (18.5%), mechanical complications (11.1%) were the most common causes of switching from PD to HD. The duration of being under PD therapy was 36.5 months for 46 patients who died under PD therapy. Cardiovascular events (50%) and various infections (%35) were the leading causes of mortality. A total of 48 (43.2%) PD patients had at least one episode of peritonitis. Total duration on PD treatment, PD rate as initial RRT modality, the prevalence of hypertension and diabetes mellitus (DM), peritonitis rate, and use of automated PD were not significantly different between elderly (n=34) and adult individuals (18-65 years). The duration of being under PD therapy was longer for males than females (p=0.044) and the duration of PD therapy was similar in the dropped out patients with or without DM (p=0.205). Conclusion: A significant amount of patients received HD before initiation of PD (60%). Age is not be considered as a challenging barrier for PD initiation in Northern Cyprus. Precautions to prevent the development of peritonitis may contribute to extend the total duration of PD treatment.

show abstract

Section: Discussionmentioning

confidence: 58%

“…Different characteristics of the PD population like age, the need for sufficient numbers of caregivers might affect the results. Male and female patients may also have different coping skills (25). We found the duration of being under PD therapy was longer in males than females.…”

Section: Discussionmentioning

confidence: 62%

Overview of peritoneal dialysis outcomes in Northern Cyprus: a nation based study

Bardak¹,

BEHLÜL²,

Oygar³

2022

Anatolian Current Medical Journal

View full text Add to dashboard Cite

show abstract

“…https://doi.org/10.1177/08968608221077461 [ 26 ] Transfer to in-center HD for ≥ 30 days, or death Importance of non-medical reasons for dropout in patients on peritoneal dialysis (2020) Clinical and Experimental Nephrology. 24:1050–1057 [ 27 ] Transfer to HD or death …”

Section: Early Vs Late Pd Discontinuation Definitionmentioning

confidence: 99%

“…3(3):335–342 https://doi.org/10.1016/j.xkme.2020.12.010 [ 10 ] Diabetes History of major abdominal surgery Catheter implant technique Obesity Peritonitis Catheter-related problems (27.3%) Peritonitis (25.4%) Psychosocial factors (20.6%) 6.9% transfer to HD c 13.5% transfer to HD e 19.6% transfer to HD f Overall 22.6% (1462/6452) Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors (2022) Perit Dial Int https://doi.org/10.1177/08968608221077461 [ 26 ] Older age Higher comorbidity scores Ischemic heart disease CAPD Leakage and catheter problems (15% b –5% later) Death PD-related infections (20%) Clearance problems (11–12%) 318/695 (of which 99 early discontinuation and 219 late discontinuation) Importance of non-medical reasons for dropout in patients on peritoneal dialysis (2020) Clinical and Experimental Nephrology. 24:1050–1057 [ 27 ] Age Diabetes PD performance by caregivers Lack of caregivers Losing confidence in PD PD-related peritonitis – a After 3 months from PD start; b after 6 months from PD start; c after 12 months from PD start; e after 24 months from PD start; f after 36 months from PD start …”

Section: Early Vs Late Pd Discontinuation Definitionmentioning

confidence: 99%

“…The impact of non-medical reasons (i.e., lack of a caregiver and/or losing confidence in PD) on PD discontinuation (defined as switch to HD or death) was tested in a registry study conducted in Taiwan between 2014 and 2018 [ 27 ]. A total of 224 patients receiving PD at the Kaohsiung Chang Gung Memorial Hospital in Taiwan were identified.…”

Section: Early Vs Late Pd Discontinuation Definitionmentioning

confidence: 99%

See 1 more Smart Citation

Peritoneal dialysis discontinuation: to the root of the problem

Piarulli,

Vizzardi,

Alberici

et al. 2023

J Nephrol

View full text Add to dashboard Cite

As the global burden of chronic kidney disease continues to increase, the use of peritoneal dialysis is often advocated as the preferred initial dialysis modality. Observational studies suggest a survival advantage for peritoneal dialysis over hemodialysis for the initial 2–3 years of dialysis. Peritoneal dialysis has been associated with better graft survival after kidney transplantation and has a reduced cost burden compared to hemodialysis. However, several medical and non-medical reasons may limit access to peritoneal dialysis, and less than 20% of patients with end-stage kidney disease are treated with peritoneal dialysis worldwide. In this narrative review, we sought to summarize the recent medical literature on risk factors for peritoneal dialysis discontinuation, distinguishing the early and the late phase after peritoneal dialysis initiation. Although the definition of clinically relevant outcomes varies among studies, we observed that center size, older age, and the presence of many comorbidities are risk factors associated with peritoneal dialysis discontinuation, regardless of the phase after peritoneal dialysis initiation. On the contrary, poor technique training and late referral to nephrology care, as opposed to the need for a caregiver, patient burnout and frequent hospitalizations, are related to early and late peritoneal dialysis drop-out, respectively. The aim of the review is to provide an overview of the most relevant parameters to be considered when advising patients in the selection of the most appropriate dialysis modality and in the clinical management of peritoneal dialysis patients. In addition, we wish to provide the readers with a critical appraisal of current literature and a call for a consensus on the definition of clinically relevant outcomes in peritoneal dialysis to better address patients' needs. Graphical abstract

show abstract

Risk factors and outcomes in patients who switched from peritoneal dialysis to physician-oriented or patient-oriented kidney replacement therapy

Zhang,

Guan,

Liu

et al. 2024

Renal Failure

View full text Add to dashboard Cite

Importance of non-medical reasons for dropout in patients on peritoneal dialysis

Cited by 5 publications

References 25 publications

Overview of peritoneal dialysis outcomes in Northern Cyprus: a nation based study

Overview of peritoneal dialysis outcomes in Northern Cyprus: a nation based study

Peritoneal dialysis discontinuation: to the root of the problem

Risk factors and outcomes in patients who switched from peritoneal dialysis to physician-oriented or patient-oriented kidney replacement therapy

Contact Info

Product

Resources

About