Assisted peritoneal dialysis (asPD): age is not the key

Area of Science:

• Nephrology
• Geriatrics
• Home Healthcare

Background:

• Peritoneal dialysis (PD) offers home-based advantages, promoting patient autonomy and lifestyle.
• Traditionally, patient dependency was a contraindication for PD, limiting its use.
• Assisted PD (asPD) can be provided irrespective of patient age or dependency duration.

Purpose of the Study:

• To report on the utilization and outcomes of assisted PD (asPD) in a Spanish center.
• To analyze the characteristics and needs of patients requiring assistance for PD.
• To evaluate asPD as a safe and potentially cost-effective dialysis modality.

Main Methods:

• Retrospective review of electronic medical records for PD patients from May 1997 to December 2020.
• Categorization of patients into four groups based on dependency status: initial total dependency, developed dependency, short-term assistance, and self-care (control).
• Definition of assisted PD as treatment requiring help from another person.

Main Results:

• 73% of patients requiring asPD developed dependency during follow-up, highlighting the need for support.
• 44% of initially autonomous PD patients became dependent over time, underscoring the importance of asPD availability.
• Spouses were primary caregivers; caregiver loss was a key reason for switching to hemodialysis.
• 14% of patients received asPD for palliative care, achieving adequate results in symptom management and well-being.

Conclusions:

• Assisted PD is a safe and effective option for dependent patients, including the elderly.
• asPD can potentially reduce healthcare system costs, even with caregiver incentives.
• The study provides the first report on asPD from Spain, contributing valuable data to the field.