In Case You Missed It! June 2024

This month’s newsletter highlights a selection of recently published peer-reviewed articles that piqued our interest related to:

Peritoneal Dialysis (PD)
Conservative Care

We hope you find these recent findings useful and of value in your day-to-day practice.

PD Recent Findings

Factors influencing renal replacement therapy modality choice from the nephrologist’s perspective

In this qualitative study, semi-structured interviews with 29 nephrologists were conducted. Using Charmaz’ constructive approach to grounded theory, four themes were identified:

  • Trust and belief in PD as a technique; own expertise, knowledge and team; in behavior of patient, family practitioner
  • Feeling of control paternalism; insecurity; prejudice
  • Vision of care and approach shared decision making; troubleshooting attitude; flexibility and creativity; complacency
  • Organizational issues pre-dialysis; access; financial; and assisted PD

Quotes from respondents have been included in the study to illustrate how these themes were identified and prioritized, which showed there are more intrinsic factors impacting the uptake of home dialysis, compared to the usually reported factors of late referrals, pre-nephrology care, etc.

Evaluation and outcomes of a 5-year assisted peritoneal dialysis program

In a study involving 322 patients who received “Peritoneal Dialysis Assist” (PDA) services from 2016 to 2021, several outcomes were examined: death, transfer to hemodialysis, transplantation, and withdrawal from the PDA program while remaining on PD. Investigators assessed whether PDA program extended patients’ time on PD therapy, thereby preserving their preferred kidney replacement modality at home, avoiding in-center hemodialysis, and for how long this was achieved.

Patient adherence to Continuous Ambulatory Peritoneal Dialysis treatment in a low-resource setting: An interventional study

Guided questionnaires and assessments were conducted in 29 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients to design and evaluate an intervention aimed at improving patient adherence. Identified gaps were addressed by offering three one-day workshops for patients and their care partners. The new system was implemented over five months, after which patients were reassessed using the same questionnaire. Investigators found significant improvements in patients’ personal hygiene practices, overall feeling about their current health condition, and record keeping, in addition to fewer hospitalizations.

Conservative Care Recent Findings

A national survey of conservative kidney management practices for patients who forgo RRT

A cross-sectional, national survey, in which 81 (39.9%) Nurse Practitioners, 21 (10.3%) Physician Assistants, and 101 Physicians (49.8%) were asked about their experiences with patients who do not wish to pursue kidney replacement therapy and their capacity to provide conservative kidney care. Working with primary, palliative, and hospice care were commonly cited as resources, however several other specialties/supportive services were also offered to patients.

APM5073 Rev.A

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