Abstract: FR-PO0525
Early and Established Peritoneal Dialysis Prescriptions in the US Peritoneal Dialysis Outcomes and Practice Patterns Study
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Abra, Graham E., Stanford University School of Medicine, Stanford, California, United States
- Bansal, Shweta, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
- Bermudez, Maria, Geisinger Medical Center, Danville, Pennsylvania, United States
- El Shamy, Osama, George Washington University Medical Faculty Associates, Washington, District of Columbia, United States
- Rivara, Matthew B., University of Washington School of Medicine, Seattle, Washington, United States
- Srivatana, Vesh, Weill Cornell Medicine, New York, New York, United States
- Perl, Jeffrey, St Michael's Hospital, Toronto, Ontario, Canada
- Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Group or Team Name
- US PDOPPs Advisory Group.
Background
PD prescriptions evolve within and between patients due to residual kidney function loss, peritoneal membrane changes, & accrual of comorbidities/complications. Limited contemporary data exist on these changes. We explored PD prescription differences between early (<4 months on PD [PD-early]) & established (≥4 months on PD [PD-late]) patients in the US-PDOPPS cohort.
Methods
At study entry, we identified 8139 PD early & 5941 PD late adult PDOPPS participants from U.S. facilities (2014-2022). Automated peritoneal dialysis (APD) & continuous ambulatory peritoneal dialysis (CAPD) prescriptions were analyzed separately.
Results
CAPD was used in 14% of PD-early & 11% of PD-late patients. Among CAPD patients, mean daily volume was 7.58L (SD = 2.04) in PD-Early vs. 8.24L (SD = 2.64) in PD-Late with similar exchange distribution (≥4 exchanges: 70% PD-early, 68% PD-late). Median urine volume was lower in PD-late patients (0.95L vs 1.05L PD-early) with greater anuria (20% vs 9%).
In APD patients, prescriptions with ≥5 cycles were more common in PD-late vs. PD early patients (41% vs 27%). Cycler volume > 8 L was slightly higher in PD-late vs. PD-early patients (63% vs. 57%). 24-hour urine volume was lower in PD-late vs. PD-early patients (0.80L vs 0.90L), & anuria higher (21% vs 13%).
Conclusion
PD prescription intensification differs by modality, with the major changes being to: (1) increase dwell volumes vs number of exchanges in CAPD, in contrast to (2) increase number of cycles in APD and to a lesser extent total volume. Further research should explore drivers of these changes (i.e. increasing solute clearances) and their impact on clinical outcomes including burden of therapy.
Funding
- Other NIH Support – Vantive