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Where we fail; First Nations starting dialysis with inadequate nephrology referral time: an IKHealth (improving responsiveness across the continuum of kidney health care in rural and remote Manitoba First Nation communities) substudy.

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Is Assisted Peritoneal Dialysis a Solution for Northern Manitoba?

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Few First Nations patients in Manitoba use home peritoneal dialysis (PD) due to barriers like distrust and housing issues. An assisted PD model may help overcome these challenges for end-stage kidney disease patients.

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Area of Science:

  • Nephrology
  • Indigenous Health
  • Public Health

Background:

  • End-stage kidney disease (ESKD) significantly affects First Nations (FN) populations.
  • Home peritoneal dialysis (PD) offers mobility but has low uptake among Manitoba FN patients.

Purpose of the Study:

  • To explore the experiences of Manitoba FN patients with PD.
  • To identify barriers and enablers for expanding PD in rural and remote FN communities.

Main Methods:

  • Qualitative analysis of interviews.
  • Participants included 14 individuals with ESKD, 14 family caregivers, and 27 healthcare providers/administrators.

Main Results:

  • Key barriers to PD include medical suitability, patient distrust of home treatments, and fear of self-management.
  • Limited family support and inadequate housing also hinder PD adoption.

Conclusions:

  • Assisted peritoneal dialysis (APD), featuring centralized supplies and peer support, is a promising model.
  • APD could potentially mitigate current barriers and improve PD accessibility for FN patients.