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Modality related infections peritonitis tunnel infection, exit-site infections inadequate dialysis unable to meet clearance targets (Kt/V or creatinine clearance) ultrafiltration failure inability to achieve dry weight persistent volume overload mechanical problems catheter problems infections mechanical complications System related lack of infrastructure lack of patient modality education/training transfer to a facility where PD is unavailable center effect provider expertise physician reimbursement ownership of dialysis facility Patient related patient burnout social reasons, family, age, occupation, etc. geography: distance to travel loss of RRF malnutrition/excess protein loss diabetic complications: severe neuropathy, blindness abdominal surgeries or development of hernia respiratory problems, chronic cough stroke or severe illness limiting manual dexterity Modality related peritonitis prophylaxis membrane preservation: use of glucose polymers/ACE inhibitors adjust dialysis prescription according to RRF correction of catheter malfunction System related better infrastructure to support PD patient education/training physician education incentives to physicians, dialysis centers redirecting resources Patient related social support psychological counseling (as needed) assisted PD ACE, angiotensin converting enzyme.
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Peritoneal Dialysis First: Rationale
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- Feasibility of Urgent-Start Peritoneal Dialysis in Older Patients with End-Stage Renal Disease: A Single-Center Experience
- Racial Differences in Home Dialysis Utilization and Outcomes in Canada
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- Home Dialysis Utilization Among Racial and Ethnic Minorities in the United States at the National, Regional, and State Level
- Predictors of Transfer to Home Hemodialysis after Peritoneal Dialysis Completion
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- Patient-Centered Care: An Opportunity to Accomplish the "Three Aims" of the National Quality Strategy in the Medicare ESRD Program
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- Patient Education and Care for Peritoneal Dialysis Catheter Placement: A Quality Improvement Study
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- Determinants of Peritoneal Dialysis Technique Failure in Incident US Patients
- Is Assisted Peritoneal Dialysis Associated with Technique Survival When Competing Events Are Considered?