Person-centered peritoneal dialysis prescription and the role of shared decision-making

Blake, Peter G.; Brown, Edwina A.

doi:10.1177/0896860819893803

Cited by 22 publications

(46 citation statements)

References 41 publications

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“…The approach by its nature promotes individualization of PD prescription and a move away from a “one size fits all” approach. This topic is reviewed elsewhere in these “Guidelines.” 18…”

Section: Other Pd Prescription Strategiesmentioning

confidence: 99%

Incremental peritoneal dialysis

2020

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Incremental peritoneal dialysis (PD) has been variably defined. It involves taking advantage of the residual renal function that is usually present at initiation of dialysis to initially prescribe less onerous lower doses of PD while still achieving individualized clearance goals. We propose that incremental PD be defined as a strategy, rather than a particular regime, in which: (1) less than standard “full-dose” PD is initially prescribed in recognition of the value of residual renal function; (2) peritoneal clearance is initially less than the individualized clearance goal but the combination of peritoneal plus renal clearance achieves or exceeds that goal clearance; and (3) there is a clear intention to increase dose of PD as renal clearance declines and/or symptoms appear. Incremental PD by its nature lessens the workload of dialysis for those doing PD, reduces cost and exposure of the peritoneal membrane to glucose, and may lessen mechanical symptoms. Evidence that incremental PD improves clinical outcomes compared to the use of full-dose PD is lacking but one randomized controlled trial, multiple observational studies, and a systematic review all suggest that outcomes are at least as good. Given that incremental PD costs less and is inherently less onerous, it is reasonable, pending larger randomized trials, to adopt this strategy.

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Section: Other Pd Prescription Strategiesmentioning

confidence: 99%

Incremental peritoneal dialysis

2020

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“…Intuitively, this process holds particularly relevant to the care pathway of chronic debilitating diseases such as dialysis-requiring ESKD. 40,41 The reason why a person in need of dialysis chooses home PD as the modality is usually its less intrusive impact on lifestyle and the possibility to self-manage therapy. Individuals choosing PD show high desire for control and are confident in taking responsibility for their therapy.…”

Section: Patient's Values and Perceived Outcomesmentioning

confidence: 99%

Automated Peritoneal Dialysis: Patient Perspectives and Outcomes

Domenici¹,

Giuliani²

2021

IJNRD

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A steadily increasing number of end stage kidney disease (ESKD) patients are maintained on automated peritoneal dialysis (APD) worldwide, in long-standing as well as in more recently established peritoneal dialysis (PD) programs. A better understanding of the technique, paralleled by progress in involved technology, sustained this growth to the point that APD has become the prevalent mode of PD delivery in most high-income countries. While APD is now regarded to be at least as efficient as continuous ambulatory peritoneal dialysis (CAPD) with regard to major biomedical outcomes, its impact on patient-reported outcomes has been less investigated. This paper reviews the main outcomes of APD from a clinical point of view and from the person on dialysis perspective.

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“…In the present study, the authors proposed PD+HD as a part of an integrated dialysis care and mentioned that dialysis staff should be familiar with this combined modality. A patient-centered dialysis prescription by the shared decision-making is desired [8], however, many patients are feeling that they had not been sufficiently explained about dialysis modalities at the start of dialysis [9]. An increased awareness of PD+HD would provide patients more treatment choices in the precision medicine era.…”

Section: Pd+hd Compared To Hdmentioning

confidence: 99%

Need for evidence on long-term prognosis of PD+HD: a commentary

Tanaka

Mise

2021

BMC Nephrol

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Combination therapy with peritoneal dialysis and hemodialysis (PD+HD) is an alternative dialysis method for patients with end-stage kidney disease (ESKD). The complementary use of once-weekly HD expedites to achieve adequate dialysis and enables to prolong PD duration. Although PD+HD has been widely employed among Japanese PD patients, it is much less common outside Japan. Clinical evidences are still not enough, especially in long-term prognosis and appropriate treatment duration, suitable patients, and generalizability. A retrospective cohort study by Chung et al. (BMC Nephrol 21:348, 2020) compared the risk of mortality and hospitalization between PD patients who were transferred to PD+HD and those who were transferred to HD in Taiwan. Because the mortality and hospitalization rates did not differ between the groups, the authors concluded that, PD+HD may be a rational and cost-effective treatment option. It should be noted that the effects of PD+HD on long-term prognosis are still unknown due to too-short PD+HD duration. However, the study identified the high-risk patient population and showed the generalizability of PD+HD. PD+HD is a treatment of choice in patients with ESKD who prefer PD lifestyles even after decline in residual kidney function.

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Person-centered peritoneal dialysis prescription and the role of shared decision-making

Cited by 22 publications

References 41 publications

Incremental peritoneal dialysis

Incremental peritoneal dialysis

Automated Peritoneal Dialysis: Patient Perspectives and Outcomes

Need for evidence on long-term prognosis of PD+HD: a commentary

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