A Brazilian Experience in Assisted Automated Peritoneal Dialysis: A Reliable and Effective Home Care Approach

Franco, Marcia Regina Gianotti; Fernandes, Natália; Ribeiro, Claúdia Azevedo; Qureshi, Abdul Rashid; Divino-Filho, José Carolino; Lima, Maria da Glória

doi:10.3747/pdi.2012.00031

Cited by 38 publications

(34 citation statements)

References 33 publications

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“…This finding highlights the potential for more growth in PD use in the coming years. The use of home-assisted PD, for instance, may further increase PD use among patients who face barriers to selfcare (34)(35)(36). Altogether, our results suggest that as the PPS era moves forward, PD use could continue to increase not only at dialysis initiation, but also months or years afterward, as patient awareness of and education on treatment modalities improve and as providers become more experienced in managing patients on PD.…”

Section: Discussionmentioning

confidence: 77%

Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform

Sloan

Coffman

Sanders³

et al. 2019

CJASN

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Background and objectives Peritoneal dialysis (PD) for ESKD is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis (HD), but has historically been underused. We assessed the effect of the 2011 Medicare prospective payment system (PPS) for dialysis on PD initiation, modality switches, and stable PD use.Design, setting, participants, & measurements Using US Renal Data System and Medicare data, we identified all United States patients with ESKD initiating dialysis before (2006)(2007)(2008)(2009)(2010) and after (2011-2013) PPS implementation, and observed their modality for up to 2 years after dialysis initiation. Using logistic regression models, we examined the associations between PPS and early PD experience (any PD 1-90 days after initiation), late PD use (any PD 91-730 days after initiation), and modality switches (PD-to-HD or HD-to-PD 91-730 days after initiation). We adjusted for patient, dialysis facility, and regional characteristics.Results Overall, 619,126 patients with incident ESKD received dialysis at Medicare-certified facilities, 2006-2013. Observed early PD experience increased from 9.4% before PPS to 12.6% after PPS. Observed late PD use increased from 12.1% to 16.1%. In adjusted analyses, PPS was associated with increased early PD experience (odds ratio [OR], 1.51; 95% confidence interval [95% CI], 1.47 to 1.55; P,0.001) and late PD use (OR, 1.47; 95% CI, 1.45 to 1.50; P,0.001). In subgroup analyses, late PD use increased in part due to an increase in HD-to-PD switches among those without early PD experience (OR, 1.59; 95% CI, 1.52 to 1.66; P,0.001) and a decrease in PD-to-HD switches among those with early PD experience (OR, 0.92; 95% CI, 0.87 to 0.98; P=0.004).Conclusions More patients started, stayed on, and switched to PD after dialysis payment reform. This occurred without a substantial increase in transfers to HD.

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Section: Discussionmentioning

confidence: 77%

Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform

Sloan

Coffman

Sanders³

et al. 2019

CJASN

View full text Add to dashboard Cite

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“…A Brazilian observational study included elderly patients with motor and cognitive issues and lack of a supportive environment as well as HD patients with hemodynamic instability or vascular access loss. The study showed that assisted APD is a reliable and effective home HD modality for patients without any other renal replacement therapy alternatives [99].…”

Section: Apd In Children and The Elderly-assisted Pdmentioning

confidence: 90%

APD or CAPD: one glove does not fit all

Roumeliotis

Leivaditis

et al. 2020

Int Urol Nephrol

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The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality. Improved patients' compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis have been also associated with APD. However, concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep are APD's setbacks. Besides APD superiority over CAPD in fast transporters, the other medical advantages of APD still remain controversial. In any case, APD should be readily available for all patients starting PD and the most important indication for its implementation remains patient's choice.

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“…, Franco et al . ) are in use in other countries specifically to enable older adults to receive dialysis in the home. Providing home support for PD which is consistent and persistent should increase home‐dialysis uptake.…”

Section: Discussionmentioning

confidence: 99%