The Association between Prevalence of Peritoneal Dialysis versus Hemodialysis and Patients’ Distance to Dialysis-Providing Facilities.

Link: https://doi.org/10.34067/KID.0004762021
Authors: Pattharanitima, Pattharawin; El Shamy, Osama; Chauhan, Kinsuk; Saha, Aparna; Wen, Huei Hsun; Sharma, Shuchita; Uribarri, Jaime; Chan, Lili

Abstract: Accessibility to dialysis facilities plays a central role when deciding on a patient’s long-term dialysis modality. Studies investigating the effect of distance to nearest dialysis-providing unit on modality choice have yielded conflicting results. We set out to investigate the association between patients’ dialysis modality and both the driving and straight-line distances to the closest HD- and PD-providing units. All patients with ESKD who initiated in-center HD and PD in 2017, were 18-90 years old, and were on dialysis for ≥30 days were included. Patients in residence zip codes in nonconterminous United States or lived >90 miles from the nearest HD-providing unit were excluded. With increasing distances from the nearest dialysis-providing units (HD or PD), PD utilization increased. Using driving distance rather than straight-line distance affects data analysis and outcomes. Increasing the number of PD units may have a limited effect on increasing PD utilization.