Peritoneal Dialysis Prehabilitation: Background and Protocol for the CORE-PD Pilot Trial

Physical function impairment and decline is common for people living with kidney failure and receiving peritoneal dialysis. Consequently, this population experience unfavourable health outcomes including loss of independence, reduced life participation and overall poor quality of life. Physical function is a patient identified research priority with strategies to mitigate decline critical, however, yet to be rigorously explored and moreover, implemented as part of routine care. Prehabilitation refers to a process of improving physical function prior to a surgery or medical treatment and, may represent a novel strategy to prepare people who are due to commence peritoneal dialysis treatment. These interventions typically involve exercise and aim to enhance cardiorespiratory fitness, muscle strength and, foster positive behaviour change. This paper discusses the impact and challenges associated with peritoneal dialysis and physical function decline and, introduces a protocol for how prehabilitation could be implemented for people preparing to commence peritoneal dialysis. The primary aim of this proposed protocol is to explore the feasibility and acceptability of such an intervention, with secondary outcomes focusing on the impact of the intervention on patient identified, high-priority outcomes including life participation, infection and technique survival.