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Kidney Week

Abstract: PO0969

Length of Peritoneal Dialysis Training and Risk of Early Treatment Attrition

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Giles, Harold E., Nephrology Associates PC, Nashville, Tennessee, United States
  • Parameswaran, Vidhya, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Chatoth, Dinesh K., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Kraus, Michael A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Anger, Michael S., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
Background

Patient training is a critical component of the peritoneal dialysis (PD) program to ensure safe dialysis outcomes. However, there is a lack of clarity on how long patients should be trained before initiating PD at home. In this analysis, we evaluate the associations between the length of PD training and patient outcomes (early treatment attrition, peritonitis, and hospitalizations) among patients prescribed automated PD (APD).

Methods

Adult patients who initiated APD between 2017-2019 and received PD training at Fresenius Kidney Care facilities within 30 days of home treatments were included. Crude and case-mix adjusted risk of early PD attrition (discontinuation from PD within 3 months of enrollment due to switch to HD, death, or loss to follow-up) were compared between patients with a shorter (≤ 5 days), medium (6 to 10 days), and longer (>10 days) lengths of training. Early rates of peritonitis and hospitalizations were compared between patients with ≤ 10 days vs >10 days of training.

Results

11,039 patients who received training ≤ 30 days prior to APD initiation were included. Compared to patients with a shorter PD training (n=3,333), patients with a medium length of training (n=6,310) had no significant difference in the risk of early attrition (Figure 1). Patients with longer PD training (n=1,396) had a lower risk of early attrition when compared to shorter PD training patients in the crude analysis, and no significant difference when controlled for case-mix variables (significant confounders: vintage, residual kidney function, and body surface area). There were no differences in the early rates of peritonitis and all-cause and peritonitis-related hospitalizations between patients receiving training for >10 days vs ≤10 days.

Conclusion

There were no significant associations between length of PD training and risk of early treatment attrition, hospitalizations, or peritonitis among automated PD patients.

Figure 1

Funding

  • Commercial Support