Abstract

BackgroundSelf-care and peritoneal dialysis (PD) benefits have been underutilized in patients with end-stage renal disease (ESRD). The pre-dialysis education program (PDEP) has been generally introduced as an acceptable tool in increasing the rates of PD and has been reportedly recommended for ESRD patients as part of the introduced care. We aim to study the effect of PDEP on ESRD and whether they would prefer PD of center-based hemodialysis (HD).MethodsThis is a retrospective cohort study that was done at King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, in the dialysis center. Data were collected on patients and included demographics, preference of renal replacement therapy modality, and other possible factors that may affect patient choices such as educational level, economic status, and age.ResultsA total of 213 ESRD patients that met our criteria were included, with a total of 75 patients receiving PDEP. Out of those who received the PDEP, 57.3% and 42.7% of patients decided to perform HD and PD, respectively. There was a significant impact of PDEP on reducing HD choice [OR (95% CI) = 0.11 (0.05-0.24); P-value < 0.001]. Infections did not occur in 50.5% of the included patients while 45.8%, 3.3%, and 0.5% had central line-associated bloodstream infection (CLABSI), other infections, and peritonitis, respectively. Most of the PD patients (81.8%) did not have an infection as compared to 42.3% of the HD patients. HD was also associated with increased admission days [OR (95% CI) = 1.27 (1.07-1.51); P-value = 0.007].ConclusionWe found that PDEP positively impacted the rate of PD while PD was associated with favorable outcomes and lower infection rates, emphasizing the importance of an educational program.

Highlights

  • Incidence rates are growing and have reached up to 6%-8% in end-stage renal disease (ESRD) globally [1]

  • There was a significant impact of pre-dialysis education program (PDEP) on reducing HD choice [odds ratios (ORs) = 0.11 (0.05-0.24); P-value < 0.001]

  • We found that PDEP positively impacted the rate of peritoneal dialysis (PD) while PD was associated with favorable outcomes and lower infection rates, emphasizing the importance of an educational program

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Summary

Introduction

Incidence rates are growing and have reached up to 6%-8% in end-stage renal disease (ESRD) globally [1]. In the Kingdom of Saudi Arabia (KSA), the rate has been reportedly increasing, as the Saudi Center for Organ Transplantation (SCOT) previously estimated that 19,659 patients underwent either hemodialysis (HD) or peritoneal dialysis (PD), with the largest proportion favoring HD (18,270 patients) in 2017 [2,3]. Favoring either of the renal replacement therapy (RRT) modalities is hugely variable among the different healthcare systems managing ESRD patients worldwide. Self-care and peritoneal dialysis (PD) benefits have been underutilized in patients with end-stage renal disease (ESRD). The pre-dialysis education program (PDEP) has been generally introduced as an acceptable tool in increasing the rates of PD and has been reportedly recommended for ESRD patients as part of the introduced care. We aim to study the effect of PDEP on ESRD and whether they would prefer PD of centerbased hemodialysis (HD)

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