Assessment for Assisted Peritoneal Dialysis by Peritoneal Dialysis Nurses: Results of a Cohort Study

2019 ◽  
Vol 50 (6) ◽  
pp. 489-498 ◽  
Author(s):  
Sonia Guillouët ◽  
Annabel Boyer ◽  
Antoine Lanot ◽  
Maxence Ficheux ◽  
Thierry Lobbedez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
National Level ◽  
Self Care ◽  
Subjective Assessment ◽  
French Language ◽  
Relative Risks ◽  
Dialysis Nurses ◽  
Selection Of Patients ◽  
Assisted Peritoneal Dialysis ◽  
Selection Of

Background: Selection of patients for assisted peritoneal dialysis (PD) is based on the nurse’s assessment of the patient. There is no data available about the nurse’s assessment of the PD patient at the initiation of PD to estimate the need for assisted PD at the national level. This study was carried out to evaluate the association between the nurse’s subjective assessment of the patient’s inability to be treated by self-care PD, the nurse evaluation of the patient disabilities and the utilization of nurse or family assisted PD. Methods: This was a retrospective study of patients starting PD between July 1, 2010 and 2015 and registered in the nurse section of the French Language PD Registry (RDPLF). Poisson regression and a linear regression model with a robust variance estimator were used for the statistical analysis to determine relative risks (RRs) and risk differences (RDs). Results: Of 4,101 PD patients, 403 were treated by family assisted PD, and 1,695 were treated by nurse-assisted PD. In the multivariate analysis, the nurse’s subjective assessment of the patient’s inability to be treated by self-care PD was associated with nurse-assisted PD (5.40 [4.58–6.35], 67% [64–70%]) and family assisted PD (11.11 [8.49–14.56], RD 62% [57–67%]). Nurse-assisted PD and family assisted PD were associated with functional impairment (RR 1.25 [95% CI 1.16–1.36], RD 14% [95% CI 10–19%] and RR 2.02 [95% CI 1.69–2.41], RD 27% [95% CI 20–34%] respectively), cognitive dysfunction (RR 1.23 [95% CI 1.15–1.32], RD 15% [95% CI 11–18%] and RR 1.73 [95% CI 1.39–2.16], RD 12% [95% CI 7–18%] respectively) and deafness (RR 1.10 [95% CI 1.04–1.16], RD 8% [95% CI 5–11%] and RR 1.46 [95% CI 1.22–1.74], RD 10% [95% CI 6–14%] respectively). Conclusion: Our results showed that the nurse’s subjective assessment of the patient’s inability to be treated by self-care PD and the patient’s disabilities were strongly associated with the utilization of nurse- and family assisted PD.

Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

2018 ◽  
Vol 48 (6) ◽  
pp. 425-433 ◽  
Author(s):  
Solène Guilloteau ◽  
Thierry Lobbedez ◽  
Sonia Guillouët ◽  
Christian Verger ◽  
Maxence Ficheux ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lower Risk ◽  
Regression Models ◽  
Cox Regression ◽  
French Language ◽  
Dialysis Modality ◽  
Technique Survival ◽  
Hazard Ratios ◽  
Effect Of Pd ◽  
Assisted Peritoneal Dialysis

Background: Patients on peritoneal dialysis (PD) can be assisted by a nurse or a family member and treated either by automated PD (APD) or continuous ambulatory PD (CAPD). The aim of this study was to evaluate the effect of PD modality and type of assistance on the risk of transfer to haemodialysis (HD) and on the peritonitis risk in assisted PD patients. Method: This was a retrospective study based on data from the French Language PD Registry. All adults starting assisted PD in France between 2006 and 2015 were included. Events of interest were transfer to HD, peritonitis and death. Cox regression models were used for statistical analysis. Results: Among the 12,144 incident patients who started PD in France during the study period, 6,167 were assisted. There were 5,060 nurse-assisted and 1,095 family-assisted PD patients. Overall, 5,171 were treated by CAPD and 996 by APD. In multivariate analysis, CAPD, compared to APD, was not associated with the risk of transfer to HD (cause specific hazard ratios [cs-HR] 0.96 [95% CI 0.84–1.09]). Patients on nurse-assisted PD had a lower risk of transfer to HD than family assisted PD patients (cs-HR 0.85 [95% CI 0.75–0.97]). Neither PD modality nor type of assistance were associated with peritonitis risk. Conclusions: In assisted PD, technique survival was not associated with PD modality. Nurse-assisted patients had a lower risk of transfer to HD than family assisted patients. Peritonitis risk was not influenced either by PD modality, or by type of assistance. Both APD and CAPD should be offered to assisted-PD patients.

Continuous Ambulatory Peritoneal Dialysis: An Option in the Developing World?

1994 ◽  
Vol 14 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Roy Lent ◽  
Jonathan E. Myers ◽  
Deidre Donald ◽  
Brian L. Rayner
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Tertiary Care ◽  
Therapeutic Success ◽  
Explanatory Variables ◽  
Large Tertiary Care ◽  
Selection For ◽  
The Relationship ◽  
Selection Of Patients ◽  
Selection Of

Objective To evaluate specified biomedical, socio-economic, and psychosocial criteria as predictors of therapeutic success to optimize patient selection for continuous ambulatory peritoneal dialysis (CAPD) in a developing country. Design A restrospective cohort study investigating the relationship between episodes of peritonitis and exitsite infection, and predetermined biomedical, socioeconomic, and psychosocial data. Setting A CAPD unit in a large tertiary care teaching hospital. Patients AI1132 patients entering the CAPD program between 1987 and 1991. Results Overall mean survival time on CAPD was 17.3 months. Peritonitis rates were high, especially among blacks. Multivariate analysis demonstrated that increased peritonitis rates were associated with age, black race, diabetes, and strongly so with several psychosocial factors. Because being black was strongly linked to poor socioeconomic conditions, repeat analysis excluding blacks showed the same associations with the above variables, but, additionally, several socioeconomic factors were associated with high peritonitis rates. No significant explanatory variables were shown for exit-site infections. Conclusions The association of biomedical, socio-economic, and psychosocial variables with high peritonitis rates has important implications for the selection of patients for CAPD in this setting.

Assisted Peritoneal Dialysis. Experience in a French Renal Department

2006 ◽  
Vol 26 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Thierry Lobbedez ◽  
Raluca Moldovan ◽  
Marie Lecame ◽  
Bruno Hurault de Ligny ◽  
Wael El Haggan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Survival ◽  
Self Care ◽  
Dialysis Patients ◽  
Actuarial Survival ◽  
Technique Survival ◽  
Comorbidity Index ◽  
The Impact ◽  
Home Nurse ◽  
Assisted Peritoneal Dialysis

Background The French healthcare system offers the possibility of increasing the use of peritoneal dialysis (PD) by involving in patient care nurses who work in the private system. Objective This study was conducted to evaluate the impact of a private home-nurse network on one dialysis program. Methods This was a retrospective study of 239 dialysis patients who started dialysis in our center between 1 January 1998 and 31 December 2003. Results Of these 239 patients, 142 were treated with hemodialysis and 97 with PD during the study period. Among the PD patients, 36 of 97 were treated with assisted PD and 61 of 97 with self-care PD. Assisted-PD patients were older (74 ± 10 vs 52 ± 18 years, p < 0.001) and presented more comorbidity (Charlson Comorbidity Index 7 ± 2.5 vs 4.3 ± 2.4, p < 0.05) compared with self-care patients. Continuous ambulatory PD was the modality of choice in the assisted group (32/36). Assisted patients were frequently hospitalized (31/36); actuarial survival free of hospitalization at 6 months was 46%. Patients with nurse assistance had a high risk of peritonitis (actuarial survival free of peritonitis: 52% at 1 year). Technique survival was 85% at 6 months and 58% at 1 year. Actuarial patient survival was 90% at 6 months and 83% at 1 year. Conclusion Assisted PD enables increased use of PD in incident dialysis patients. However, in view of the comorbidities of the assisted-PD patients, the need for frequent hospitalization has to be taken into account in such a program.

Training of Peritoneal Dialysis Nurses

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 206-209 ◽  
Author(s):  
Poh-choo Tan ◽  
Zaki Morad
Keyword(s):  
Peritoneal Dialysis ◽  
Nursing Staff ◽  
Resource Manager ◽  
Total Patient ◽  
Principal Source ◽  
Dialysis Nurses ◽  
General Experience ◽  
The Right ◽  
Selection Of

Clinical disciplines in which the nurse plays as preeminent a role in total patient care as in peritoneal dialysis (PD) are few. The PD nurse is readily identified by the patient as the principal source of advice on day-to-day aspects of treatment, as a resource manager for supplies of PD disposables and fluids, and as a general counselor for all kinds of advice, including diet, rehabilitation, and medication, among others. The PD nurse is thus the key individual in the PD unit, and most activities involve and revolve around the nursing staff. It is therefore not surprising that most nephrologists pay considerable attention to the selection of PD nurses, particularly in long-term PD programs such as continuous ambulatory peritoneal dialysis (CAPD). The appointment of a PD nurse depends on finding an individual with the right attributes, broad general experience, and appropriate training.

The Importance of Patient Selection for Continuous Ambulatory Peritoneal Dialysis

1981 ◽  
Vol 2 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Robert A. Coward ◽  
Linda Uttley Yvonne ◽  
Murray Elaine ◽  
Greenwood ◽  
Neter P. Mallick
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Hospital Admissions ◽  
Biochemical Control ◽  
Group I ◽  
Selection For ◽  
Group Ii ◽  
Medical Wards ◽  
Selection Of Patients ◽  
Selection Of

Continuous ambulatory peritoneal dialysis (CAPD) was used between May 1980 and May 1981 to treat 21 patients for a total of 8.2 “patient years”. On commencing CAPD, patients were also assessed according to our established criteria, as being suitable for home hemodialysis -Group I (independent) 13 patients, 62 patient months; or hospital hemodialysis Group II (dependent) eight patients, 36 patient months. Biochemical control was good in both groups. In Group II, peritonitis was more frequent and rehabilitation was poorer with more frequent and longer hospital admissions than in Group I. Selection of patients can therefore reduce the incidence of complications. Fourteen of the 27 episodes of peritonitis occurred in the ward during training or while the patients were hospitalized for other reasons indicating the risk of such training in busy general medical wards.

scholarly journals A Nurse mailing list serving the Dialysis at Home community

2019 ◽  
Vol 2 (3) ◽  
pp. 159-162
Author(s):  
Marie PADERNOZ
Keyword(s):  
Peritoneal Dialysis ◽  
Home Treatment ◽  
Mailing List ◽  
French Language ◽  
Outpatient Management ◽  
Dialysis Patients ◽  
Home Dialysis ◽  
Material Supply ◽  
Email Address ◽  
Dialysis Nurses

Aware of the difficulties encountered by the centers in the outpatient management of peritoneal dialysis patients, on March 21, 2016, the French Language Peritoneal Dialysis Registry (RDPLF) launched an «alloDP» nursing list for the benefit of Home Dialysis units active in the Registry. Difficulties in relation to the isolation of the teams, the size of the centers, the number of participants, the lack of knowledge in the technique are undeniably a hindrance to the development of home treatment. This mailing list is exclusively reserved for home dialysis nurses after registration by the RDPLF. They need an email address, if possible, personal. Nephrologists and nurses at the material supply commercial providers may have access to alloDP, upon request, but only as «readers». To break her isolation, or sense of isolation, the nurse simply sends her question, request, or need to the nursing community to the address [email protected]. The wealth of sharing does the rest. To illustrate the content of the exchanges, we have chosen to summarize six of them in this article.

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