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Abstract: PO0822

The Association Between Prevalence of Peritoneal Dialysis vs. Hemodialysis and Patients' Home Distance to Dialysis-Providing Facilities

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Pattharanitima, Pattharawin, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • El Shamy, Osama, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chauhan, Kinsuk, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Saha, Aparna, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Wen, Huei Hsun, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Sharma, Shuchita, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Uribarri, Jaime, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

Accessibility to dialysis facilities should play a role when deciding on a patient’s long-term dialysis modality. Studies investigating the effect of distance to nearest dialysis-providing unit on modality choice, however, have yielded conflicting results. We investigated the association between patients’ dialysis modality and the distances (driving and straight) to the closest HD and PD-providing units.

Methods

All ESKD patients (USRDS) who initiated in-center HD and PD in 2017, were 18-90 years old, and on dialysis for ≥30 days were included. Patients who resided in non-conterminous US or lived >90 miles from the nearest HD-providing unit were excluded.

Results

Among 102,247 included patients, median driving distance to the closest HD unit was greater for PD patients (3.9 vs 2.9 miles; p <0.001). Compared to HD patients, PD patients had longer driving distances to their nearest PD unit (4.4 vs 3.4 miles; p <0.001). PD utilization increased with increasing distance from patients’ homes to the nearest HD unit (OR 1.11, 95% CI 1.08-1.14 per 10-mile increase). This association did not change whether the PD unit was farther/closer than the nearest HD unit (Figure 1). This association was not seen when analysis was performed using straight line distance.

Conclusion

PD utilization increases with increasing driving distances from the nearest dialysis providing units (HD or PD). Using driving distance, but not straight line distance affects data analysis and outcomes. Increasing the number of PD units may have a limited impact on increasing PD utilization.

Adjusted OR for PD utilization categorized by the driving distance (miles) from patient’s residence to the closest HD-providing unit and distance to closest PD-providing unit (equal/closer or farther than the distance to HD-providing unit)