P1197ASSISTED APD IN ITALY: TRENTO EXPERIENCE

Abstract

Abstract Background and Aims End-stage renal disease (ESRD) is common in elderly and fragile patients with several comorbidities. Dialysis (Hemodialysis-HD or Peritoneal Dialysis-PD) is often required. The choice between HD or PD is sometimes not easy. PD prevalence is significantly lower than HD prevalence in old and fragile patients because they are less likely to complete PD assessment, and due to stress over performing self-therapy. In the last years, in order to overcome these problems, assisted PD programs have spread out in several countries. Method Since 2008 in Trento Province (area of 541.399 people in the North East of Italy) we developed a program for elderly non-self sufficient patients requiring dialysis in nursing home. Admission criteria in nursing home were: age>65 years, living in the province, PD therapy, non-self patient, no acute complications, no home caregivers. This patient had a priority access to nursing home. We selected HomeChoice Baxter APD as PD technique. Our nurses gave specific training of 6 hours to nursing home nurses. The patients were on APD during the night. Every 45 days patients had a clinical visit by nephrologists and hospital PD nurses, with a particular emphasis on clinical data and dialysis performances. Results From 1.1.2008 to 12.31.2018 we enrolled 36 patients (16 male and 20 female) in a population of 226 PD incident patient, age (M±DS) at PD start was 78 ± 7.3 years (range 65-91); break-in was 27 ± 20.4 days and time in PD was 374 ± 347 days (range 15-1257). The cumulative incidence of peritonitis was 1/75-patient/month. During these eleven-year period we trained 19 nursing home nurses. Conclusion Assisted APD in nursing home could be an appropriate therapy choice for non-self sufficient elderly patients requiring renal replacement therapy. These option is safe for patients and could increase PD incidence.