Expansion of Peritoneal Dialysis Feasible

Expansion of the use of peritoneal dialysis (PD) is feasible, according to a study published online in JAMA Internal Medicine.

Leonid V. Pravoverov, M.D., from The Permanente Medical Group in Oakland, California, and colleagues conducted a retrospective cohort study involving adults who initiated chronic dialysis therapy from Jan. 1, 2008, through Dec. 31, 2018. During that time, a multidisciplinary, systemwide approach, including patient and caregiver education, education and support tools for health care professionals, streamlined system-level processes, monitoring, and continuous quality improvement, was implemented to increase use of PD.

The researchers found that initiation of PD increased from 15.2 percent of 1,089 new dialysis patients in 2008 to 33.8 percent of 1,438 new dialysis patients in 2018, which was considerably higher than national trends (6.1 percent in 2008 and 9.7 percent in 2016). Overall, 80.3 percent of the 2,974 patients who initiated PD from 2008 to 2017 continued PD at one year after initiation; a significant increase in age-, sex-, and race-standardized rates was seen from 2008 to 2017 (69.1 to 84.2 percent). For patients receiving PD and hemodialysis, age-, sex-, and race-standardized one-year mortality did not change significantly during this 10-year period.

"Our findings support the feasibility of coordinated expansion of the ability to provide PD within an integrated care delivery model to improve outcomes for patients with chronic kidney disease," the authors write.

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