Influence of holidays on peritoneal dialysis patients: an observational study

Abstract

Objective To observe the clinical parameters, self-management, and compliance in peritoneal dialysis (PD) patients before and during Spring Festival, and to describe holiday syndrome in PD patients. Methods We prospectively observed PD patients with regular follow-up in our center before Chinese Spring Festival (January 8-February 7, 2016) and during Chinese Spring Festival (February 8- March 8, 2016). Demographic and clinical characteristics, self-management, and compliance with its influencing factors were collected by face-to-face method in outpatient care. Results Totally 130 PD patients were enrolled. The average age was (58.5±15.4) years, and women accounted for 53.1%. The primary diagnosis was diabetic kidney disease (32.3%), followed by primary glomerulonephritis (26.2%). Fourteen patients (10.8%) received automated peritoneal dialysis (APD), and most of the remaining patients chose continuous ambulatory peritoneal dialysis (CAPD, 73.8%), with a median dialysis age of 34 months. During the 4-week followed-up, the appetite was stable, while the serum phosphate and pre-albumin increased [(1.5±0.4)mmol/L vs. (1.6±0.4)mmol/L, P=0.025; 325.3 (272.2, 355.1)mmol/L vs. 326.0(284.2, 376.5)mmol/L, P<0.01, respectively]. No difference was observed in edema, dyspnea, and nighttime lying flat. However, the weight elevated significantly [(61.3±13.9)kg vs. (63.4±13.0)kg, P=0.002], with the median peritoneal ultrafiltration volume increased from 783.3 ml to 900.0 ml (P=0.005). During the holiday, the incidences of dialysis-related infections were unchanged, while the incidences of digestive system comorbidities increased significantly (5.4% vs. 13.8%, P=0.021). As for the compliance, 8 patients reduced their PD cycles during the holiday, which was more frequent than before holiday (P=0.018). One patient changed his PD pattern, and 6 patients did not follow the medication orders. Demographic characteristics such as gender, age, and marriage conditions were not associated with the compliance. Conclusions Holiday syndrome remarkably affects PD patient's volume load, metabolism, and compliance. Poor self-management of PD patients during holidays needs further concern. Key words: Peritoneal dialysis; Patient compliance; Self-management