Lack of Motivation: A New Modifiable Risk Factor for Peritonitis in Patients Undergoing Peritoneal Dialysis?

Paudel, Klara; Namagondlu, Girish; Samad, Nasreen; McKitty, Khadija; Fan, Stanley

doi:10.1111/jorc.12101

Cited by 15 publications

(17 citation statements)

References 32 publications

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“…Patients with CKD were aware of the consequences associated with non‐adherence to integrated management, and these findings are supported by Ghimire et al () Physiological consequences of non‐adherence to integrated management include pulmonary and peripheral edema, septicemia, dosage adjustment, peritonitis (patients undergoing CAPD), readmissions, elevated urea and electrolytes, weakness of bones, and changes in treatment plans, which ultimately increases the cost of medical care, thus exacerbating the economic burden (Paudel et al, ; Tannor et al, ). Furthermore, poor adherence has been cited as causing reduced lifespan of patients with CKD, and consequently increased mortality, as well as faster progression to late stages of CKD for those in the early stages.…”

Section: Discussionmentioning

confidence: 82%

“…Other motivators of adherence in patients with CKD include being aware of the consequences and severity of symptoms, such as deterioration in health, fear of death, positive interaction with the health-care team (Ghimire et al, 2017), and the use of evidence-based practice to encourage fluid restriction (Jia, Huang, Chu, Lu, & McArthur, 2016). Lack of motivation has been found to be a risk factor for complications, such as peritonitis, in patients with CKD undergoing peritoneal dialysis (Paudel, Namagondlu, Samad, McKitty, & Fan, 2015). Poor adherence in CKD population creates severe complications, coupled with increased mortality and morbidity rates (Ahlawat, Tiwari, & D'Cruz, 2016).…”

Section: Background and Literature Reviewmentioning

confidence: 99%

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Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Chironda

Bhengu

2018

Nursing & Health Sciences

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The integrated management of chronic kidney disease (CKD) demands significant changes, as patients need to adhere to dialysis, medication, and dietary and fluid restrictions. Therefore, there is a need to identify the motivators of adherence to improve the quality of life of these patients. The aim of the present study was to explore the motivators of adherence to integrated management among patients with CKD in South Africa. A phenomenological design was used. A sample size of 12 participants was selected according to data saturation. The purposive sampling method was used to select the participants. Data were collected with the help of a semistructured interview schedule developed from the literature. A thematic framework analysis was conducted to identify the motivators of adherence to integrated management; these were found to be family support, anxiety about eligibility for kidney transplant, support of other patients, awareness of complications associated with non-adherence to integrated management, and fear of being removed from the CKD program. Identified motivators could be used to develop specific interventions that address or foster adherence behavior as a requirement for integrated management.

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Section: Discussionmentioning

confidence: 82%

Section: Background and Literature Reviewmentioning

confidence: 99%

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Chironda

Bhengu

2018

Nursing & Health Sciences

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“…To reduce peritonitis risk, we traditionally focus on patient training, although there is diminishing return to intensification of a training scheme; potential improvement of patient technique needs to be counterbalanced against increasing risk of patient burnout. In fact, in a retrospective study, we were unable to find an association between peritonitis risk and ‘exchange technique’ . There are theoretical reasons to believe that fluid overload may be a modifiable risk factor for peritonitis; patients with severe fluid overload may develop bowel wall oedema and ischaemia .…”

Section: Introductionmentioning

confidence: 79%

“…In fact, in a retrospective study, we were unable to find an association between peritonitis risk and 'exchange technique'. 6 There are theoretical reasons to believe that fluid overload may be a modifiable risk factor for peritonitis; patients with severe fluid overload may develop bowel wall oedema and ischaemia. 7 This may lead to an increased gut permeability causing high circulating endotoxaemia.…”

Section: Introductionmentioning

confidence: 99%

Hydration status measured by BCM: A potential modifiable risk factor for peritonitis in patients on peritoneal dialysis

2016

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We found an association between overhydration and increased rates of peritonitis. While this may partly be due to the high co-morbidity of patients (advanced age and diabetes), on multivariate analysis, only inclusion of nutritional parameters reduced this association. It remains to be determined if overhydration will prove to be a modifiable risk factor for peritonitis or whether malnutrition will prove to be more important.

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“…In our study, patients on APD lived in institutional households, and the caregiver was not a relative; all of these patients had at least one peritonitis episode, suggesting that there may be a relationship between peritonitis and emotional, social, and psychological factors in this setting. This may affect patient situation as is shown in one study where lack of motivation was reported as a modifiable predictor factor of peritonitis [23].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Peritonitis in a Pediatric Dialysis Program in Guatemala, 2011–2014

Chinchilla¹,

Sebastián²,

Meléndez

et al. 2016

Advances in Nephrology

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Background. Peritonitis is the most common complication of peritoneal dialysis but there is limited data regarding peritonitis related risk factors in developing countries. Objective. Describe the PD program at Foundation for Children with Kidney Disease (FUNDANIER), in Guatemala, and identify peritonitis related risk factors in these patients. Methods. This retrospective open cohort study included medical records from FUNDANIER during 2011 to 2014. Baseline demographics, treatment modalities, caregivers' characteristics, and socioeconomic status were recorded. Results. Eighty-nine medical records were included with a treatment time of 1855 months. Median age of patients was 11.3 years (range 6-17). Median duration of PD therapy was 20.8 months (range 1-28). Sixty-eight peritonitis episodes were registered; forty-eight patients (54%) remained peritonitis-free. Median time to first peritonitis episode was 5 months (range 2-16). Peritonitis rate was one episode every 27 months or 0.44 episodes per patient-year. Peritonitis rate in patients with fair housing was 2.5 times higher than in those with good housing (CI = 1.0-5.2, = 0.01). Conclusion. Housing conditions are a relevant risk factor related to peritonitis. Strategies toward preventing peritonitis must consider housing status, establishing adequate follow-up in high-risk patients. Close monitoring of technique serves to overcome understaffing issues in this setting.

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Lack of Motivation: A New Modifiable Risk Factor for Peritonitis in Patients Undergoing Peritoneal Dialysis?

Abstract: Lack of motivation predicted peritonitis particularly if associated with depression. Further studies are required focusing on specific motivation scoring schemes and the psychosocial support that might lead to better outcomes.

Cited by 15 publications

References 32 publications

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

Hydration status measured by BCM: A potential modifiable risk factor for peritonitis in patients on peritoneal dialysis

Risk Factors for Peritonitis in a Pediatric Dialysis Program in Guatemala, 2011–2014

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