Self-care or assisted PD: development of a new approach to evaluate manual peritoneal dialysis practice ability
Jiaying Huang,
Aiping Gu,
Na Li,
Yanna He,
Weizhen Xie,
Wei Fang,
Jiangzi Yuan,
Na Jiang
Affiliations
Jiaying Huang
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Aiping Gu
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Na Li
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Yanna He
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Weizhen Xie
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Wei Fang
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Jiangzi Yuan
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Na Jiang
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China
Background Peritoneal dialysis (PD) is a home-based therapy which requires the patients or their caregivers to perform the practice. We aimed to develop a practical approach to evaluate PD practice ability of the patients and to identify berries to self-care PD.Methods A structural form was designed comprising measures of physical, cognitive, and operational abilities which were required to perform manual PD independently. The evaluation was jointly conducted by a PD nurse, a nephrologist and a close family member of the patient. Patients who met all the requirements were deemed as capable of performing PD independently (self-care PD) and others were deemed as needing an assistant (assisted PD).Results The evaluation form was applied in 280 prevalent PD patients and 33.9% of them were assessed as needing assisted PD, mainly due to physical (62.1%) or operational (66.3%) disabilities. The evaluation result was consistent with current dialysis status in 79.3% patients and it matched better in patients who performed PD with the help of an assistant (93.0 vs. 76.8%, p = 0.014). Patients who were evaluated as having barriers to self-care PD but still performed PD without an assistant were older and demonstrated higher prevalence of diabetic nephropathy and PD-related infection, lower education level, and lower serum albumin (p < 0.05).Conclusions The PD practice ability assessment form is useful to identify patients with barriers to self-care PD. It provides objective information to the patients and their family to choose feasible PD practice modality, self-care, or assisted PD.