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Abstract: PO1256

Trends in Automated Peritoneal Dialysis (APD) Prescriptions in Adult Chronic Dialysis Patients at a Large Dialysis Organization from 2015 to 2019

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Parameswaran, Vidhya, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Comerford, Allison, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Anger, Michael S., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Giles, Harold E., Nephrology Associates PC, Birmingham, Alabama, United States
Background

Benefits of patients dialyzing at home have been well-reported. Peritoneal dialysis (PD) has grown in recent years and is expected to grow further due to the recent executive order encouraging home dialysis. Trends in APD prescriptions have not been well-described in the literature. This current retrospective analysis aims to describe trends in APD prescriptions from 2015-2019

Methods

All demographic, lab, and prescription data were retrospectively extracted and de-identified from a LDO’s (Fresenius Kidney Care) electronic data warehouse. Patients included in the analysis were adults with chronic kidney disease on dialysis, incident to APD from Jan 1, 2015 to Dec 31, 2019, completed APD training, had at least one APD treatment recorded, and no data quality issues with their records. Patients were stratified by the year they started PD (2015, 2016, 2017, 2018, 2019) and patients’ first APD prescription information was summarized.

Results

16,047 patients were eligible for inclusion. The number of APD new starts eligible increased from 2,005 patients in 2015 to 4,751 patients in 2019, as did mean patient age (56.0 years in 2015 to 58.3 years in 2019, p<0.05). Few patients were prescribed daytime exchanges (7.6% in 2015 to 4.8% in 2019, p<0.05) and of those with daytime exchanges, the majority (>93% in all years) had 1 exchange. Table describes other prescription parameters by year.

Conclusion

Comparing 2019 to 2015 initial PD prescription patterns, there have been reductions in cycler volume, total number of exchanges, and prescriptions for daytime exchanges. These findings may support future studies on the current use of lower volumes with newer catheters (e.g. urgent starts) and accommodations made for patient lifestyle and choice

Funding

  • Commercial Support