Abstract: FR-PO1072
Completion of Peritoneal Dialysis Treatments After Discharge Is Associated with Reduced Rates of Cumulative Hospitalizations
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Weinhandl, Eric D., DaVita Inc, Denver, Colorado, United States
- Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States
- del Rosario, Maria B., DaVita Inc, Denver, Colorado, United States
- Cassin, Michelle, DaVita Inc, Denver, Colorado, United States
- Tentori, Francesca, DaVita Inc, Denver, Colorado, United States
- Brunelli, Steven M., DaVita Inc, Denver, Colorado, United States
Background
Resumption of dialysis after hospital discharge is important for all end-stage kidney disease (ESKD) patients. There is little evidence of clinical outcomes following resumption of peritoneal dialysis (PD) treatments following discharge. In this study, we wanted to test whether treatment adherence, as measured from electronic treatment records (ETRs), is associated with rates of transfer to hemodialysis and cumulative hospitalizations in automated PD (APD) patients.
Methods
Electronic health records were used to identify adult (20-100 years) ESKD patients who started PD training (N=18,892) between April 2022 and March 2025 at a large kidney care organization and were then hospitalized and discharged to home. We followed them for up to a year to the earliest of transfer to hemodialysis, death, kidney transplant, recovery of kidney function, transfer out, or end of study (November 30, 2025). Outcomes included transfer to hemodialysis and cumulative hospitalizations. Adherence to prescribed treatment was defined by percentage of prescribed treatments that were completed within 5 days of discharge. Outcome window started on day 6 post discharge and continued for up to 12 months. Transfer to hemodialysis associations were derived from Cox proportional hazard regression models adjusted for demographic factors. Cumulative hospitalization comparisons (incidence rate ratios) were estimated using a generalized linear mixed model with a Poisson distribution and adjusted for covariates.
Results
Adherent patients were slightly older (61.7 yrs vs. 58.7 yrs) and had been on PD longer (18.3 months vs. 17.6 months). At three months of follow up, completion of all prescribed treatments during the first 5 days after discharge is associated with lower rates of transfer to hemodialysis [0.74 (0.68, 0.81)] and cumulative hospitalizations [0.89 (0.85, 0.93)]. In a sensitivity analysis of patients with ≥2 confirmed treatments after discharge, those with 100% adherence to scheduled treatments experienced lower rates of transfer to hemodialysis [0.89 (0.82, 0.96)] and cumulative hospitalizations [0.90 (0.85, 0.94)] at 6 months follow up.
Conclusion
Treatment adherence following hospitalization is associated with lower rates of hospitalization and transfer to hemodialysis in PD patients.