Many Patients Initially Choose PD, but Start on HD

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Many patients start dialysis treatment with hemodialysis (HD) even though they initially had opted for peritoneal dialysis (PD), according to researchers.

Scott E. Liebman, MD, and colleagues at the University of Rochester in New York studied 217 patients who received dialysis modality education at their institution and subsequently started dialysis. The study's outcome measure was HD use at dialysis initiation and day 91 of dialysis therapy in patients initially selecting PD.

At the time of education, 124 patients chose PD, 41 chose HD, and 52 were undecided. Of the 124 patients who chose PD at the time of education, 59 started dialysis therapy with PD and 65 started on HD, the researchers reported online ahead of print in the American Journal of Kidney Diseases. On day 91, 60 patients were on PD and 55 were on HD. Nine patients either died, had a renal transplant, or not yet reached 91 days of dialysis therapy.

Nonglomerular cause of end-stage renal disease, age older than 75 years, and being unemployed predicted starting on HD therapy; age older than 75 years, nonwhite race, and nonglomerular causes of ESRD predicted HD use at day 91.

“These findings help define a group that should be monitored carefully to ensure that they start PD therapy if this remains their modality choice,” the authors concluded.

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