Peritoneal dialysis (PD) technique training: what features influence learning time?
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ORIGINAL ARTICLE
Peritoneal dialysis (PD) technique training: what features influence learning time? R. Haridian Sosa Barrios1,2,3 · V. Burguera Vion1,2,3 · C. Campillo Trapero1 · S. Ortego Pérez1 · E. López Melero1 · M. Álvarez Nadal1 · D. Villa Hurtado1 · M. Fernández Lucas1,2,3,4,5 · Maite E. Rivera Gorrín1,2,3,4,5 Received: 18 June 2020 / Accepted: 28 October 2020 © Japanese Society of Nephrology 2020
Abstract Background Within peritoneal dialysis (PD) complications, peritonitis remains a primary challenge for the long-term success of the technique. Proper technique training is essential, since it reduces peritonitis rates, but the adequacy of training has not been standardized. Furthermore, factors influencing training duration have not been well identified. Methods We retrospectively analyzed all consecutive training sessions of incident PD patients in our Unit from January 2001 to December 2018. Results Our analysis included 135 patients, 25.9% were diabetic and median Charlson index (CCI) was 4 (IQR 2–6). Above 13 sessions was chosen as the cut off between usual and prolonged training, as it was our cohort’s 75th percentile: 23% (31) had an extended training duration as per our study definition and 77% (104) had a usual training duration. The number of training sessions required increased with age (Spearman Rho 0.404; p = 0.000001), diabetic status (p = 0.001), unemployment status (p = 0.046) and CCI (Spearman Rho 0.369; p = 0.00001). Neither gender, cohabitation status, scheduled PD start, education level nor referral origin, were significant factors impacting training duration. Requiring longer training (> 13 sessions) was a significant risk factor for higher peritonitis risk, but extended training was not related to a shorter technique survival. Conclusion Number of PD training sessions depends on the patient’s age and comorbidities, but is not related to social, educational or employment status. Prolonged training duration was a statistically significant predictor of higher peritonitis risk, but it was not related to shorter permanence in PD in our series. Identifying these patients since the training period would be useful to adapt training schedule as an early prevention strategy to minimize the risk of peritonitis and plan a preemptive retraining. Keywords Training · Peritoneal dialysis · First peritonitis · Peritoneal dialysis outcome · Peritoneal dialysis learning
Introduction
* R. Haridian Sosa Barrios [email protected] 1
Servicio de Nefrología, Nephrology Department, Hospital Universitario Ramón y Cajal, Ctra Colmenar Viejo Km 9,1, 28034 Madrid, Spain
2
Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Madrid, Spain
3
Grupo de Nefrología Diagnóstica e Intervencionista de la Sociedad Española de Nefrología (S.E.N.), Madrid, Spain
4
Universidad de Alcalá de Henares, UAH, Madrid, Spain
5
Red de Investigación Renal (RedinREn), Madrid, Spain
Chronic Kidney Disease burden is growing worldwide, with more patients reaching end stage renal disease and choosing PD
