Peritoneal dialysis in rural Australia

Area of Science:

• Nephrology
• Public Health
• Epidemiology

Background:

• Rural Australians face higher rates of renal replacement therapy and poorer dialysis survival than urban dwellers.
• This study investigates disparities in peritoneal dialysis (PD) patient characteristics and outcomes between rural and urban settings in Australia.

Purpose of the Study:

• To compare patient characteristics and outcomes for peritoneal dialysis (PD) in rural versus urban Australia.
• To assess the suitability of PD as a dialysis modality for rural populations.

Main Methods:

• Analysis of non-indigenous Australian adults commencing chronic dialysis between 2000-2010 using ANZDATA.
• Patients classified by remoteness (Major City, Inner Regional, Outer Regional, Remote/Very Remote) based on Australian Bureau of Statistics index.

Main Results:

• PD uptake increased with remoteness; 1.8% of patients in remote/very remote areas used PD compared to 69.0% in major cities.
• Early PD technique failure (first 6 months) was less common in rural areas (SHR 0.47).
• No significant differences observed in technique failure after 6 months, peritonitis rates, or patient survival by region.

Conclusions:

• Peritoneal dialysis (PD) uptake is significantly higher in more remote Australian regions.
• PD demonstrates lower early technique failure rates and comparable peritonitis rates in rural settings.
• PD is a viable and effective dialysis modality for rural Australian patients, with comparable survival rates to urban patients.