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

Pei-Chun Chiang,Yueh-Han Hsu,Tsung-Liang Ma,Chih-Yen Hsiao,Ing-Ching Jong,Jia-Jeng Hou,Peir-Haur Hung

doi:10.1155/2016/5314719

Abstract

Background. The purpose of this study was to analyze the factors associated with receiving peritoneal dialysis (PD) in patients with incident end-stage renal disease (ESRD) in a hospital in Southern Taiwan. Methods. The study included all consecutive patients with incident ESRD who participated in a multidisciplinary predialysis education (MPE) program and started their first dialysis therapy between January 1, 2008, and June 30, 2013, in the study hospital. We provided small group teaching sessions to advanced CKD patients and their family to enhance understanding of various dialysis modalities. Multivariate logistic regression models were used to analyze the association of patient characteristics with the chosen dialysis modality. Results. Of the 656 patients, 524 (80%) chose hemodialysis and 132 chose PD. Our data showed that young age, high education level, and high scores of activities of daily living (ADLs) were positively associated with PD treatment. Patients who received small group teaching sessions had higher percentages of PD treatment (30.5% versus 19.5%; P = 0.108) and preparedness for dialysis (61.1% versus 46.6%; P = 0.090). Conclusion. Young age, high education level, and high ADL score were positively associated with choosing PD. Early creation of vascular access may be a barrier for PD.

Highlights

The prevalence of end-stage renal disease (ESRD) is increasing steadily globally, with the highest one in Taiwan [1]
In the National Health Insurance (NHI) program in Taiwan, the costs of dialysis (both hemodialysis (HD) and peritoneal dialysis (PD)) are reimbursed by the government; the health care costs for ESRD patients are a heavy burden on society
ESRD patients who had better family/caregiver support, higher cognition of dialysis, and stronger receptivity to dialysis were associated to the high percentage of PD treatment [10]

Summary

Introduction

The prevalence of end-stage renal disease (ESRD) is increasing steadily globally, with the highest one in Taiwan [1]. Previous studies have identified several crucial factors associated with renal replacement modality (RRM) selection, including the timing of referral, physician bias, predialysis education, resource availability, social and cultural habits, access to hospital dialysis beds, and lack of teamwork experience with certain dialysis modalities [5,6,7]. The purpose of this study was to analyze the factors associated with receiving peritoneal dialysis (PD) in patients with incident end-stage renal disease (ESRD) in a hospital in Southern Taiwan. Our data showed that young age, high education level, and high scores of activities of daily living (ADLs) were positively associated with PD treatment. High education level, and high ADL score were positively associated with choosing PD. Creation of vascular access may be a barrier for PD

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