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Retraining programme for older patients undergoing peritoneal dialysis: A randomised controlled trial
Wai Yin Leung1, Marques S N Ng2, Anthony K C Hau3
1The Mount Sinai Hospital, New York City, New York, USA.
Journal of Renal Care
|December 4, 2022
Summary
Periodic retraining for older adults on peritoneal dialysis did not significantly reduce peritonitis or exit site infections. Further large-scale trials are needed to confirm the effectiveness of this intervention.
Area of Science:
- Nephrology
- Geriatrics
- Public Health
Background:
- Peritonitis is a major complication for patients on peritoneal dialysis.
- Older adults on peritoneal dialysis may benefit from periodic retraining to prevent infections.
Purpose of the Study:
- To assess the effectiveness of a retraining program in reducing peritonitis and exit site infection rates in older adults undergoing peritoneal dialysis.
- To calculate the cost-benefit ratio of the retraining program.
Main Methods:
- A prospective randomized controlled trial involving 130 patients aged 55 years and older.
- The intervention group received retraining 90 days post-initiation of continuous ambulatory peritoneal dialysis (CAPD), while the control group received usual care.
- Outcomes measured included peritonitis rate, exit site infection rate, and direct medical costs over 360 days.
Main Results:
- No statistically significant differences in peritonitis rates (0.11 vs. 0.13 episodes/patient-year) or exit site infection incidence (20.0% vs. 12.3%) between groups.
- The cost-benefit ratio of retraining was 1:9.6.
- Baseline characteristics were similar between the intervention and control groups.
Conclusions:
- The study's premature termination may have impacted statistical significance.
- Larger, multi-center trials are recommended to evaluate retraining effectiveness, timing, and long-term effects.
- The current study did not demonstrate a significant benefit of retraining on infection rates in this population.
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