Kidney Week

Abstract: TH-PO372

Differing Attitudes Towards Peritoneal Dialysis (PD) Among PD and Hemodialysis (HD) Medical Directors

Session Information

• Dialysis: Peritoneal Dialysis - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Shen, Jenny I., LaBiomed at Harbor-UCLA, Torrance, California, United States

Jenny I. Shen,

• Schreiber, Martin J., DaVita HealthCare Partners Inc., Cleveland, Ohio, United States

Martin J. Schreiber,

• Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Junhui Zhao,

• Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Bruce M. Robinson,

• Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Ronald L. Pisoni,

• Mehrotra, Rajnish, University of Washington, Seattle, Washington, United States

Rajnish Mehrotra,

• Oliver, Matthew J., Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

Matthew J. Oliver,

• Tomo, Tadashi, Oita University Hospital, Yufu, Japan

Tadashi Tomo,

• Tungsanga, Kriang, Chulalongkorn University, Bangkok, Thailand

Kriang Tungsanga,

• Teitelbaum, Isaac, University of Colorado School of Medicine , Aurora, Colorado, United States

Isaac Teitelbaum,

• Ghaffari, Arshia, University of Southern California, Los Angeles, California, United States

Arshia Ghaffari,

• Lambie, Mark, Keele University, Crewe, United Kingdom

Mark Lambie,

• Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada

Jeffrey Perl,

Background

Negative perceptions towards PD may be limiting its use. We compared differences in attitudes towards PD among medical directors in PD vs. HD units.

Methods

PDOPPS and DOPPS are international prospective cohort studies based on national samples of PD and HD patients. From 2014-18 we asked medical directors of dialysis units in Canada, Japan, US, and UK: 1) to rate the level of training and support for PD in their units, 2) whether certain patient factors would influence recommendations to use PD, and 3) to cite potential reasons PD was not more widely used in their program.

Results

178 (74%) HD and 134 (67%) PD directors responded. PD directors agreed more than HD directors that their nephrologists and nursing staff were well trained in and were enthusiastic about PD (72-96% vs. 59-72%, by country). HD directors were less likely to recommend PD among certain patients (Figure). Among PD medical directors (78%), a leading reason for the lack of PD utilization was due to the myth that “in-center HD would result in the highest quality of care compared to PD” compared to 29% of HD medical directors. Among HD medical directors, leading reasons included patient fears about PD (68%), and comfort with facility HD (75%) as major barriers to PD growth.

Conclusion

Compared to HD medical directors, PD medical directors feel their units have higher levels of trained, enthusiastic staff towards PD, are more likely to recommend PD, and have different opinions regarding drivers of low PD use. Given the majority of patients receive HD, educating HD physicians and staff about PD may lead to consideration of more patients for PD, and greater PD utilization.

Funding

• Other U.S. Government Support