Nonclinical factors associated with treatment with peritoneal dialysis in ESRD patients in Taiwan

Less than 10% of end-stage renal disease (ESRD) patients in Taiwan receive peritoneal dialysis (PD), which reveals the situation of underutilization of PD. We thus aimed to investigate factors associated with treatment with PD in ESRD patients in Taiwan. ♢

Patients that were 18 years of age or older and had been on dialysis for at least 3 months since 2001 were recruited and interviewed with a structured questionnaire. ♢

98 hemodialysis (HD) and 102 PD patients were recruited. In univariate analysis, age, sex, level of education, employment status, marital status, traffic time, family support, patient cognition, and receptivity were correlated with treatment with PD. Multivariate analysis showed that patients that were not married (p = 0.006), that spent more time traveling to the dialysis clinic (p = 0.006), that were not emergent at the start of dialysis (p = 0.003), and that had better family support (p = 0.045), a higher cognition of dialysis (p = 0.034), and stronger receptivity to dialysis (p < 0.001) were more likely to receive PD. ♢

We recommend patients follow the standard process to obtain more exhaustive information, consultation, and early referral. In addition, we suggest healthcare providers remind patients to take into account such nonclinical factors as family support and patient receptivity when they choose their dialysis modality.