Admitted noncompliance [NC] with CAPD exchanges is more common in US than Canadian patients.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:278A 1997
The CANUSA study reported a higher mortality rate in US than in Canadian patients, which could not be explained by investigated variables. This study tests the hypothesis of a different compliance to CAPD treatment between patients of different nations. Non-compliance (NC) was evaluated with a questionnaire in 170 US (5 Centers) and 339 Canadian (4 Centers) patients. NC was defined as more than one exchange missed per week or more than two exchanges missed per month. Canadian patients showed 7.1% NC rate against 23.5% NC rate in US patients. NC was more common in young, Afro-American and non-diabetic patients. NC was also more common in patients doing more than 4 exchanges and with fill volumes greater than 2 liters. These findings can explain the mortality differences found in the CANUSA study. Studies to investigate further NC are required.
Comment: Compliance with peritoneal dialysis is a major issue because this technique is self-managed. All efforts to increase dialysis dose can be nullified by a high non-compliance rate. It is important to apply all available strategies to quantify and reduce it. Control of solution use, questionnaires, interviews and kinetic measurements are possible quantification methods. Reduction of the non-compliance rate is the problem: more training is possible but humanization and personalization of treatment considering the patient's problems and life-style may be also important. (Gianpaolo Amici, M.D., Treviso, Italy).
To go back use the BACK button on your browser. Otherwise click on the desired link to this article below:
ASN 30th Annual Meeting, San Antonio
Basic peritoneal dialysis : Chronic PD regimens, adequacy, modeling
CRF: Problem Areas : Outcomes (Morbidity, Mortality)