Self-performed peritoneal dialysis in prisoners

Area of Science:

• Nephrology
• Public Health
• Correctional Medicine

Background:

• End-stage renal disease (ESRD) necessitates renal replacement therapy (RRT).
• Peritoneal dialysis (PD), specifically self-administered continuous ambulatory PD (CAPD), is a viable RRT option.
• Limited data exists on CAPD efficacy and safety in correctional institutions.

Purpose of the Study:

• To compare the demographic characteristics, efficacy, and outcomes of CAPD in Department of Corrections (DOC) patients versus the free-living population (FLP).
• To assess the safety and effectiveness of self-administered CAPD within a correctional setting.

Main Methods:

• Retrospective chart review of 10 DOC patients undergoing CAPD over 7 years.
• Comparison of baseline and follow-up data (serum chemistries, anemia, bone profiles, Kt/V) with U.S. Renal Data System FLP data.
• Analysis of major adverse events including hemodialysis (HD) switch, hospitalizations, and mortality.

Main Results:

• DOC patients were younger (median age 45) with higher rates of HIV-associated nephropathy and elevated BUN/creatinine levels at presentation.
• Anemia profiles and hemoglobin levels were comparable to the FLP.
• Hospitalization rates for peritonitis were similar between DOC and FLP patients; cardiac disease was prevalent in both groups.

Conclusions:

• Self-administered CAPD can be safely and effectively implemented in patients within correctional institutions.
• DOC patients present with distinct demographic and clinical profiles requiring tailored RRT considerations.
• CAPD offers a feasible RRT option for ESRD patients in correctional settings, mirroring outcomes seen in the general population.