MCDONALD S1, LINCOLN G1, KANDAMBY M1, DAVIES C1, DUDDINGTON M2, HURST K1
1ANZDATA Registry, Adelaide, Australia, 2Baxter Healthcare, Toongabbie, Australia
Aim: Examine characteristics and treatment parameters of people receiving APD in 2019
Methods: We linked Sharesource data to ANZDATA, negotiating international regulatory and legal hurdles. Treatments delivered during 2019 were analysed, using hierarchical (mixed) models to account for data structure. Standard deviations given are “between-person”.
Results: The analysis include 1641 people (583 in NZ, 1058 in Australia) who received 314461 APD treatments (median 304 per person) in 2019. Median age was 62 and 38 % female. Median duration of PD at first recorded treatment in 2019 was 379 days. APD frequency varied over the week – 8% fewer treatments occurred on Saturday vs Tuesday. Overall, 0.5% of treatments were user-terminated – more commonly among children; less on the weekend; less with greater PD duration. Mean nightly fill was 9.47 (SD 2.61) litres. Mean nightly total UF was 668 (SD 402) ml: higher with longer time since PD start, and among younger and older adults (compared with 55-74 years), and among diabetics. In 13% of treatments, at least one treatment cycle was bypassed; in 4% a manual drain recorded.
Conclusions: Real-world data about actual events during APD was examined. Patient practices differ on weekends, presumably driven by social factors. Ultrafiltration varied with age, diabetes and time on dialysis among other factors. Understanding these factors and linking them to outcomes will help provide accurate advice to patients and improve PD experience.
The ANZDATA Registry collects a broad range of data about people receiving peritoneal dialysis. The Baxter “Claria” automated peritoneal dialysis (APD) device is used by most on this therapy. Introduced from late 2018, it collects characteristics for each treatment session into a database – “Sharesource”.
Prof Stephen McDonald;’s substantive role is as senior staff nephrologist at the Central Northern Adelaide Renal and Transplantation Service (CNARTS). He is Director of Dialysis for CNARTS, and Clinical Director of Renal Services for Country Health SA. He is Executive Officer of the Australia and New Zealand Dialysis and Transplant Registry, and chairs the National Indigenous Kidney Transplant Taskforce.