Bernardini J, Piraino B
Measuring compliance with prescribed exchanges in PD patients
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S12 1997
In this important abstract, also presented at ASN in 1996, the authors
investigate the relatively neglected issue of noncompliance with
exchanges in PD patients. They use what might be considered a gold
standard methodology to assess this. This involves two visits to the
patient's home, separated by 4-8 weeks. On each occasion an inventory
of dialysate is made. Patients who have used less than 90% of
prescribed dialysate during the study interval are defined as
noncompliant. 20 patients were studied, of whom 15 were on CAPD and 5
on CCPD. 40% were noncompliant, performing a mean of 75% of their
exchanges. Sex, race, age and diabetes were not predictors of
noncompliance.
Comment: This is an important study, suggesting that
noncompliance is even more common than may have been imagined. An
obvious strength is the methodology used, which is clearly superior to
creatinine excretion ratios or questionnaires. A weakness is the
relatively small number of patients tested. This would not make it
possible to identify risk factors for noncompliance and larger studies
need to be done. Nevertheless, this study emphasizes how frequent and
potentially important this problem is. (Peter G. Blake, M.D.,
Victoria Hospital, London, Ontario)
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17th Annual CAPD Conference
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling