#2603 Focus on a crucial moment in decision making: evaluate peritoneal dialysis as incident renal replacement therapy

Abstract

Abstract Background and Aims Chronic kidney disease affects 10% of the world population (15.1% in Spain, ENRICA 2019 study), being a health problem with important physical, emotional, and socio-occupational repercussions. Deciding on the most appropriate renal replacement therapy (RRT) for each patient, according to their lifestyle and family environment, represents a considerable challenge. Peritoneal dialysis (PD) offers several benefits, including greater independence, preserved kidney function, less restrictive diet, and better adaptation to the patient's lifestyle. It also improves the capacity for self-training and learning. Although kidney transplantation is the best RRT option, PD has demonstrated better quality of life, patient autonomy, and higher survival rates. Despite these advantages, PD as a technique for starting RRT represents 16.4% among incident patients in Spain, reaching 25% in our community, similar data to that of other northern European countries (ERA EDTA Report 2021). Method We carried out a retrospective descriptive study of patients followed in Advanced Chronic Kidney Disease (ACKD) over a period of five years (2017-2021). The inclusion criteria considered the acceptance of the technique in optimal candidates, with integrity of the peritoneal membrane and/or functional abdominal cavity, as well as the ability to learn the technique and family support. The study aimed to assess the percentage of patients who, meeting optimal criteria for PD candidacy, successfully initiated the technique. Results The analyzed population consisted of 113 patients, 73.4% males, with a mean age of 77 years. 59% of ACKD patients were considered candidates, and of these, 73% (n 38) chose PD as the modality, successfully initiating the technique. The main causes of abandonment or failure of the technique were: Out of the 38 patients successfully initiating PD as RRT, 34% continued with this modality. Conclusion PD provides quality of life and autonomy to patients who choose this technique. Individualized and ongoing training through updated information is essential during this process, as it helps reduce most complications and reinforces patient autonomy.