March 31, 2025
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Important takeouts:
- Of the young adults using peritoneal dialysis, 71% and 37% continued the type at 1 and 5 years, respectively.
- Common reasons for switching to hemodialysis were infection, missed sessions and mechanical issues.
Young adults with kidney disease, Peritoneal dialysis Data show that infections, non-adherence to treatment schedules, and hemodialysis due to mechanical issues.
“Young adulthood is a high-risk period for the transition from the peritoneum to hemodialysis.” Alexander Hamilton, MBBS, BSC, PhD, FRCP, A nephromedicine consultant at the University of Bristol, UK, told Helio. “There may have been a traditional view Peritoneal dialysis It was a “fit” suitable for young adults due to its increased independence, including flexibility and preservation of renal function, but the results were: [of this study] Challenge this view. ”
The researchers conducted a serial explanatory trial of 470 patients on dialysis to understand under 30 years of age (mean age, 16 years, 85% white people, 50% males) to understand the influencing factors that could lead to changes in dialysis methods. Investigators collected quantitative data from patients who were on dialysis between 1987 and 2015.
Additionally, qualitative data were collected from 13 patients aged 14 to 29, dialysis was conducted between 2013 and 2015, and retrospective interviews were conducted in 2020.
Data showed that 25% of patients had multiple episodes of PD, with 71% and 37% of patients continuing their dialysis type at 1 and 5 years, respectively. Hamilton and colleagues found a greater risk to the transition from PD to hemodialysis in a particular group, proven by hazard ratios, where patients between 15 and 19 years (HR = 2.41), 20 to 24 years (HR = 3.39), and 25 to 30 years (HR = 3.14) had a higher risk of transition.
Researchers said the main causes of dialysis type switching were infectious diseases (50%), violations (21%) and mechanical problems (18%). Other factors include systemic diseases compared to primary kidney disease, particularly tubular interstitial disease.
Qualitative analysis highlighted important themes regarding the communication of treatment options, the effects of dialysis on daily life, and the importance of support structures, the researchers wrote. Resilience has also emerged as a common thread for patients who remained in PD.
“This study suggests ways to enhance preparation for peritoneal dialysis in young adults,” Hamilton said. “Long-sectional cohort studies will enhance patient understanding of the journey. Research is needed to evaluate interventions to improve outcomes in young people.”
For more information:
Alexander Hamilton, MBBS, BSC, PhD, FRCP, It can be accessed at Alexander.hamilton@nhs.net.
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Disclosure: The study was funded through the MRES program in Health Sciences at the University of Bristol. Hamilton and other authors have not reported any related financial disclosures.
