4.6 Article

Delivering Person-Centered Peritoneal Dialysis

Publisher

AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.0000000000000281

Keywords

ESKD; peritoneal dialysis; quality of life

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Peritoneal dialysis allows for home-based therapy and greater autonomy, leading to improved satisfaction compared to in-center care. However, the treatment burden remains significant, highlighting the importance of person-centered care. Shared decision making is central to prescribing PD and balancing the benefits and burdens of treatment.
Peritoneal dialysis (PD) enables people to have a home-based therapy, permitting greater autonomy for individuals along with enhanced treatment satisfaction compared with in-center dialysis care. The burden of treatment on PD, however, remains considerable and underpins the need for person-centered care. This reflects the need to address the patient as a person with needs and preferences beyond just the medical perspective. Shared decision making is central to the recent International Society for Peritoneal Dialysis recommendations for prescribing PD, balancing the potential benefits of PD on patient well-being with the burden associated with treatment. This review considers the role of high-quality goal-directed prescribing, incremental dialysis, and remote patient monitoring in reducing the burden of dialysis, including an approach to implementing incremental PD. Although patient-related outcomes are important in assessing the response to treatment and, particularly life participation, the corollary of dialysis burden, there are no clear routes to the clinical implementation of patient-related outcome measures. Delivering person-centered care is dependent on treating people both as individuals and as equal partners in their care.

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