Abstract
［Background］In Japan, most patients who require renal replacement therapy (RRT) choose hemodialysis (HD) rather than peritoneal dialysis (PD). We investigated the factors associated with the selection of PD in patients who received pre‒dialysis education. ［Methods］This study included 356 patients who received pre‒dialysis education between April 2011 and August 2018 and were subsequently started on dialysis. We retrospectively investigated the factors associated with the selection of PD using logistic regression analysis. The candidate factors included age, sex, the estimated glomerular filtration rate (eGFR), the glycated hemoglobin level, diabetes mellitus (DM), the cardiothoracic ratio, the subjects’ ability to perform activities of daily living, and family support. A subgroup analysis was also performed by age (cut‒off：65 years). ［Results］The percentage of patients that select PD‒based RRT has recently decreased. Of the study subjects, 262 (74％) chose HD, and 94 (26％) chose PD. The factors associated with the selection of PD were age (adjusted odds ratio［OR］per 10 years, 0.74；95％ confidence interval［CI］, 0.60‒0.82), the eGFR (adjusted OR per 1 mL/min/1.73m2, 0.89；95％ CI, 0.82‒0.96), and DM (adjusted OR, 0.41；95％ CI, 0.22‒0.76). In the subgroup analysis, family support was associated with the selection of PD in patients aged ≥65 years (adjusted OR, 8.19；95％ CI, 1.07‒62.9). ［Conclusion］The percentage of elderly patients that selected PD‒based RRT was very low, but family support was associated with the selection of PD in patients aged ≥65 years. Family support may help elderly patients choose PD‒based RRT.
