Abstract: FR-PO522
Exploring Preconceptions in Peritoneal Dialysis Eligibility: The PD Myths Survey
Session Information
- Home Dialysis, Policy, Novel Approaches
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Shah, Nikhil A., University of Alberta, Edmonton, Alberta, Canada
- Bennett, Paul N., University of South Australia, Adelaide, South Australia, Australia
- Abra, Graham E., Stanford University, Stanford, California, United States
- Kanjanabuch, Talerngsak, Chulalongkorn University, Bangkok, Bangkok, Thailand
- Cho, Yeoung Jee, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Leibowitz, Saskia, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Baharani, Jyoti B., University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
Group or Team Name
- PDMyths
Background
Peritoneal dialysis (PD) is underutilized globally. A contributory factor may be myths around its use, some of which are mistaken as evidence after being shared routinely, gaining credence with repetition.
Methods
An online global survey (in English and Thai) was administered for completion by nephrologists and trainees, to ascertain decisions on choosing PD as a treatment modality in various clinical settings. Ethical approval was granted by the University of Alberta, Canada. Informed consent was obtained prior to survey completion from each participant. The obtained outcomes were further evaluated according to status (nephrologist vs. trainee), experience, region and income group of the country.
Results
In total, 645 participants (522 nephrologists; 123 trainees; 56% male) from 54 countries completed the survey. Participants were mostly 36-45 years old (36%) with 0-5 years experience in nephrology (39%) and from high-income countries (HIC; 66%). In general, PD was recommended for most scenarios, including repeated exposures to heavy lifting, swimming (especially in a private pool and ocean), among patients with cirrhosis or cognitive impairment with available support, and those living with a pet if a physical separation can be achieved during PD. Divergent responses were observed in other scenarios, including patients with BMI>40 whereby PD was discouraged by clinicians from low-income countries (75%) but not from HIC (21%). Certain abdominal surgeries were more acceptable to proceed with PD (hysterectomy 90%) compared to others (hemicolectomy 45%). Similar variation was noted for different types of stomas (nephrostomies 74%; suprapubic catheters 53%; ileostomies 27%). The probability of recommending PD in various scenarios was greater among clinicians from HIC, larger units and consultants with longer years of clinical experience.
Conclusion
There is a huge disparity in approach to recommending PD across various clinical scenarios driven by experience, unit-level characteristics and region of practice. Globally, evidence-informed education is warranted to rectify misconceptions to enable greater PD uptake.