Few ESRD Patients Choose PD Despite Awareness

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Few ESRD Patients Choose PD Despite Awareness
3 days ago]
Posted in News, Peritoneal Dialysis, U.S. Renal Data System (USRDS), Archives Of Internal Medicine, Home Dialysis, Clinical & Pharma, Practice Management

WASHINGTON—Despite early awareness of peritoneal dialysis as a treatment option, very few kidney failure patients choose the PD option, according to a study published online Sept. 27 in the Archives of Internal Medicine.

“Few US patients with kidney failure start treatment on peritoneal dialysis (PD) despite its potential survival, quality of life, and cost-saving benefits,” the researchers wrote. “We investigated patient awareness of PD and variables associated with PD selection, including dialysis unit ownership and geographic area.”

The researchers performed a cohort study, with incident dialysis patients identified by the Centers for Medicare & Medicaid Services (CMS) and included in the United States Renal Data System (USRDS). The patients were surveyed from 2005 to 2007 for the USRDS Comprehensive Dialysis Study. Participants reported whether PD had been discussed with them before they started regular treatment for kidney failure, and initial dialysis modality was verified in the USRDS patient registry.

They found that 61 percent of patients in the study cohort reported that PD had been discussed with them. This was higher than in previous surveys, according to the authors. However, only 10.9 percent of informed patients initiated PD.

With patient demographic and clinical characteristics controlled for, the proportion of informed patients who started PD differed substantially across large dialysis organizations, according to the study. Substantial variation in selection of PD was also evident among patients starting dialysis in the 18 end-stage renal disease Network areas.

“Despite patients' early awareness of PD as a treatment option, PD selection was low in this national cohort,” the authors concluded. “Factors associated with PD selection merit continued study as CMS seeks to improve quality and cost-effectiveness of kidney patient care.”

http://www.renalbusiness.com/news/2010/09/few-esrd-patients-choose-pd-despite-awareness.aspx