The Other Side of The Coin in Assisted Peritoneal Dialysis

Assisted Peritoneal Dialysis

Abstract views: 86 / PDF downloads: 48




Assisted peritoneal dialysis, SF-36 quality of life scale, peritonitis, Peritoneal dialysis, caregiver


Background: Assisted peritoneal dialysis (aPD) has long been used worldwide to treat elderly and frail patients with end-stage renal disease.  In developed countries, aPD is provided by health professionals, while in developing countries it is provided by family members or caregivers. The main aim of this study was to examine the quality of life (QoL) of caregivers and to investigate its impact on PD.
Methods: We included 31 patients on self-administered peritoneal dialysis and 40 patients on aPD. Patients were compared in terms of peritonitis, hospitalization, and catheter exit site infection. SF-36 questionnaire was administered to family members and caregivers assisting peritoneal dialysis and compared with the control group.
Results: When the SF-36 life scale sections of the assistants were evaluated separately, the median physical function score, median physical role difficulty score, median emotional role difficulty score, median social functioning score, median pain score, mean general health perception and total SF36 score were found to be statistically significantly lower compared to the control group ( 90 vs 57.5, 100 vs 0, 100 vs 16.7, 100 vs 50, 90 vs 55, 77.4 vs 47, 3020 vs 1575, p<0.001, p<0.001, p<0.001, p<0.001, p=0.001, p <0.001, p<0.001). There was no statistically significant difference between the groups in terms of clinical outcomes such as peritonitis, catheter exit site infection, and the need for hospitalization.
Conclusion: In developing countries, peritoneal dialysis supported by family members can be a convenient, safe, and cost-effective dialysis method. Nevertheless, it can be reasonable to establish measures and policies to enhance the quality of life of caregivers.


Choong HL. Eighth report of the Singapore Renal Registry. Singapore: Health Promotion Board. (2012).

Perico N, Remuzzi G. Chronic kidney disease: a research and public health priority. Nephrol Dial Transplant. 2012;27 Suppl 3:iii19-iii26. doi:10.1093/ndt/gfs284

European Renal Association. ERA-EDTA Registry Annual Report 2007. Accessed 26 September 2023

Dimkovic N, Aggarwal V, Khan S, Chu M, Bargman J, Oreopoulos DG. Assisted peritoneal dialysis: what is it and who does it involve?. Adv Perit Dial. 2009;25:165-170.

Boyer A, Solis-Trapala I, Tabinor M, Davies SJ, Lambie M. Impact of the implementation of an assisted peritoneal dialysis service on peritoneal dialysis initiation. Nephrol Dial Transplant. 2020;35(9):1595-1601. doi:10.1093/ndt/gfz287

Oliver MJ, Quinn RR, Richardson EP, Kiss AJ, Lamping DL, Manns BJ. Home care assistance and the utilization of peritoneal dialysis. Kidney Int. 2007;71(7):673-678. doi:10.1038/

Giuliani A, Karopadi AN, Prieto-Velasco M, Manani SM, Crepaldi C, Ronco C. Worldwide Experiences with Assisted Peritoneal Dialysis. Perit Dial Int. 2017;37(5):503-508. doi:10.3747/pdi.2016.00214

Hofmeister M, Klarenbach S, Soril L, Scott-Douglas N, Clement F. A Systematic Review and Jurisdictional Scan of the Evidence Characterizing and Evaluating Assisted Peritoneal Dialysis Models. Clin J Am Soc Nephrol. 2020;15(4):511-520. doi:10.2215/CJN.11951019

Li J, Zhong D, Ye J, et al. Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis. BMJ Open. 2019;9(7):e026844. Published 2019 Jul 19. doi:10.1136/bmjopen-2018-026844

Lobbedez T, Moldovan R, Lecame M, Hurault de Ligny B, El Haggan W, Ryckelynck JP. Assisted peritoneal dialysis. Experience in a French renal department. Perit Dial Int. 2006;26(6):671-676..

Xu R, Zhuo M, Yang Z, Dong J. Experiences with assisted peritoneal dialysis in China. Perit Dial Int. 2012;32(1):94-101. doi:10.3747/pdi.2010.00213

Smyth A, McCann E, Redahan L, Lambert B, Mellotte GJ, Wall CA. Peritoneal dialysis in an ageing population: a 10-year experience. Int Urol Nephrol. 2012;44(1):283-293. doi:10.1007/s11255-011-9973-2

Benabed A, Bechade C, Ficheux M, Verger C, Lobbedez T. Effect of assistance on peritonitis risk in diabetic patients treated by peritoneal dialysis: report from the French Language Peritoneal Dialysis Registry. Nephrol Dial Transplant. 2016;31(4):656-662. doi:10.1093/ndt/gfw011

Verger C, Duman M, Durand PY, Veniez G, Fabre E, Ryckelynck JP. Influence of autonomy and type of home assistance on the prevention of peritonitis in assisted automated peritoneal dialysis patients. An analysis of data from the French Language Peritoneal Dialysis Registry. Nephrol Dial Transplant. 2007;22(4):1218-1223.

Lobbedez T, Verger C, Ryckelynck JP, Fabre E, Evans D. Is assisted peritoneal dialysis associated with technique survival when competing events are considered?. Clin J Am Soc Nephrol. 2012;7(4):612-618. doi:10.2215/CJN.10161011

Querido S, Branco PQ, Costa E, Pereira S, Gaspar MA, Barata JD. Results in Assisted Peritoneal Dialysis: A Ten-Year Experience. Int J Nephrol. 2015;2015:712539. doi:10.1155/2015/712539

MJ Olive, RR Quinn. Assisted Peritoneal Dialysis in Elderly Persons. ASN. Geriatric Nephrology Curriculum. 2009. page:1-5

Fan SL, Sathick I, McKitty K, Punzalan S. Quality of life of caregivers and patients on peritoneal dialysis. Nephrol Dial Transplant. 2008;23(5):1713-1719. doi:10.1093/ndt/gfm830

Mehta KK. A critical review of Singapore's policies aimed at supporting families caring for older members. J Aging Soc Policy. 2006;18(3-4):43-57. doi:10.1300/J031v18n03_04

Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012;9(9):e1001307. doi:10.1371/journal.pmed.1001307

Derrett S, Samaranayaka A, Schollum JBW, et al. Predictors of Health Deterioration Among Older Adults After 12 Months of Dialysis Therapy: A Longitudinal Cohort Study From New Zealand. Am J Kidney Dis. 2017;70(6):798-806. doi:10.1053/j.ajkd.2017.06.023

Cloutier M, Manceur AM, Guerin A, Aigbogun MS, Oberdhan D, Gauthier-Loiselle M. The societal economic burden of autosomal dominant polycystic kidney disease in the United States. BMC Health Serv Res. 2020;20(1):126. Published 2020 Feb 18. doi:10.1186/s12913-020-4974-4

Kang A, Yu Z, Foo M, Chan CM, Griva K. Evaluating Burden and Quality of Life among Caregivers of Patients Receiving Peritoneal Dialysis. Perit Dial Int. 2019;39(2):176-180. doi:10.3747/pdi.2018.00049

Gilbertson EL, Krishnasamy R, Foote C, Kennard AL, Jardine MJ, Gray NA. Burden of Care and Quality of Life Among Caregivers for Adults Receiving Maintenance Dialysis: A Systematic Review. Am J Kidney Dis. 2019;73(3):332-343. doi:10.1053/j.ajkd.2018.09.006

Jafari-Koulaee A, Goudarzian AH, Beik S. Care burden in informal caregivers of hemodialysis patients: a systematic review and meta-analysis study. Asia Pacific Journal of Health Management. 2020; 15(4):78–85.

Chi NC, Demiris G. A systematic review of telehealth tools and interventions to support family caregivers. J Telemed Telecare. 2015;21(1):37-44. doi:10.1177/1357633X14562734

e‑Connected Family Caregiver: Bringing Caregiving into the 21st century. Accessed September 27, 2023.

Giuliani A, Sgarabotto L, Manani SM, Tantillo I, Ronco C, Zanella M. Assisted peritoneal dialysis: strategies and outcomes. Ren Replace Ther. 2022;8(1):2. doi:10.1186/s41100-021-00390-4

Chow KM, Szeto CC, Leung CB, Kwan BC, Law MC, Li PK. A risk analysis of continuous ambulatory peritoneal dialysis-related peritonitis. Perit Dial Int. 2005;25(4):374-379.

Povlsen JV, Ivarsen P. Assisted automated peritoneal dialysis (AAPD) for the functionally dependent and elderly patient. Perit Dial Int. 2005;25 Suppl 3:S60-S63.

Griva K, Li ZH, Lai AY, Choong MC, Foo MW. Perspectives of patients, families, and health care professionals on decision-making about dialysis modality--the good, the bad, and the misunderstandings!. Perit Dial Int. 2013;33(3):280-289. doi:10.3747/pdi.2011.00308

Li PK, Lui SL, Leung CB, et al. Increased utilization of peritoneal dialysis to cope with mounting demand for renal replacement therapy--perspectives from Asian countries. Perit Dial Int. 2007;27 Suppl 2:S59-S61.




How to Cite

Ercan, Z., & Ayar, Y. (2023). The Other Side of The Coin in Assisted Peritoneal Dialysis: Assisted Peritoneal Dialysis. Journal of European Internal Medicine Professionals, 1(4), 150–155.



Original Article