Assisted Peritoneal Dialysis: results in a Peritoneal Dialysis unit

Macarena Méndez, Unidad Académica de Nefrología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Sofía San Román, Unidad Académica de Nefrología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Cecilia Baccino, Unidad Académica de Nefrología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Ricardo Silvariño, Unidad Académica de Nefrología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay

Objective: To evaluate the outcomes of an assisted PD peritoneal dialysis program. Worldwide, 10% of patients with End-Stage Renal Disease (ESRD) advanced Chronic Kidney Disease opt for peritoneal dialysis as renal replacement. Assisted peritoneal dialysis is a treatment performed with the help of a family member or health care technician. It enables home dialysis for patients who are ineligible due to social, cognitive, or physical barriers. Materials and methods: We included patients on PD peritoneal dialysis (2022- 2024) who required partial or total assistance to maintain the technique and compared them with a matched similar control group (sex, age, comorbidities). Results: 36 patients were included (18 PD-As assisted/18 control), with 55.5% female sex. No differences were found in sex (p = 0.354), age (p = 0.106), previous treatments (p = 0.153), duration on PD (p = 0.145), PD modality of peritoneal dialysis (p = 0.204) between the groups. Assistance was total in 12(66.6%) and partial in 3(33.3%). The prevalence of complications was similar between the groups: peritonitis (p = 0.104), exit site infection (p = 0.228), catheter dysfunction (p = 0.105), and death (p = 0.243). The cumulative survival in PD peritoneal dialysis was similar between the groups (p = 0.678). Conclusions: PD-As assisted modality is a strategy to maintain PD peritoneal dialysis in patients with limitations. It is not associated with a higher complication rate and ensures a similar duration of PD in the technique compared to those who do not receive assistance.

Keywords: Chronic kidney disease. Peritoneal dialysis. Assisted peritoneal dialysis. Home dialysis.