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Abstract: PO1324

Longitudinal Changes in the Use of Peritoneal Dialysis Assistance for Patients Maintained on Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Fonseca-Correa, Jorge Ignacio, University of Toronto, Toronto, Ontario, Canada
  • Farragher, Janine F., University of Calgary, Calgary, Alberta, Canada
  • Oliver, Matthew J., Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Jain, Arsh, London Health Sciences Centre, London, Ontario, Canada
  • Jassal, Sarbjit Vanita, University Health Network, Toronto, Ontario, Canada
Background

Home dialysis therapies such as peritoneal dialysis (PD) offer flexibility and improved wellbeing for older individuals. However, a substantial proportion require assistance with personal care and health self-management. The study objective was to assess whether the nature of, and need for, assistance with PD management tasks changes over time. We hypothesized that patients and families would require less assistance as they became more familiar with PD management.

Methods

Using a multicentred, prospective observational study design, we recruited patients aged ≥50 years initiating PD. Patients underwent formal evaluation at baseline using validated components of a Comprehensive Geriatric Assessment. They then completed a monthly questionnaire for 6 months about their need for assistance with PD management tasks.

Results

111 patients (age 69 ± 10 years, 68% male, 56% diabetic) were followed for a total of 609 patient-months. Assistance for PD management tasks remained generally stable throughout follow-up, and did not vary according to age, frailty, functional dependence or cognitive impairment. The proportion of patients needing assistance varied widely across the 13 different PD management tasks, but the proportion of patients needing help for each task remained relatively stable across time (Figure 1). Of those who needed assistance, 40% had help from a family member and 33% were helped by nurses. The family/nurse caregiver ratio for the different tasks did not change over time.

Conclusion

Older patients initiating PD, in the outpatient setting, have a high need for assistance with PD-related tasks which appears to persist over the initial 6-month period. It emphasizes the importance of starting discussions early, and addressing advance care plans, goals and most importantly expectations, as patients approach dialysis initiation.