Key result
Assisted peritoneal dialysis allows ~50% of patients to achieve independence, while others transition to hemodialysis.
Why the study?
Although peritoneal dialysis at home often offers better quality of life than in-center hemodialysis, it can be challenging for many patients.
Assisted peritoneal dialysis is feasible and can help patients transition to PD independence, though staffing remains a significant logistical challenge.
May support assisted PD feasibility in select patients; hypothesis-generating and should not yet change practice.
Despite often offering a better quality of life than in-center hemodialysis, peritoneal dialysis (PD) at home can be challenging for many. From May 2021 to October 2024, we offered PD assistance at 2 home dialysis clinics in Dialysis Clinic, Inc, a mid-size national dialysis provider. Eligible patients could be incident to or established on PD, with anticipated need for either permanent or temporary assistance. Over 3 years, 6 patients received assisted PD. Three established PD patients needed assistance when their care partners were unavailable. Three other patients required assistance to initiate PD. Assistance duration ranged from 1 day to 5 months. Three patients ultimately transitioned to PD independence, and 3 transferred to in-center hemodialysis. Our greatest challenge was hiring assistants for unpredictable work with odd hours, and we eventually hired 2 postbaccalaureate students preparing for medical careers. Our successes, minimal missed treatments, and a high rate of PD continuation are a testament to their dedication. Assisted PD programs would benefit from economies of scale by being embedded in the health care system. As interest in assisted PD grows, we advocate for sharing of programs' successes and challenges so that we may together learn how to enable assisted PD in the US.
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Kim et al. (2025) studied Peritoneal dialysis (n=6). Assisted peritoneal dialysis was evaluated on Transition to PD independence or in-center hemodialysis. Assisted peritoneal dialysis was provided to 6 patients over 3 years, with 3 patients transitioning to PD independence and 3 transferring to in-center hemodialysis.
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