Abstract
This study seeks to explore potential patient and care provider barriers that may explain why older patients with end-stage renal disease (ESRD) are less likely to choose peritoneal dialysis (PD). A mixed methods approach was used: survival analysis was performed on administrative data of patients deemed eligible for both PD and hemodialysis (HD); semi-structured interviews were also conducted with older patients. We found PD and HD are associated with similar survival in incident dialysis patients regardless of patient’s age, and the effect of modality on survival did not vary with follow-up time. Selection of a particular dialysis modality is highly personal and is driven by patient preference for the convenience and maintenance of a normal life provided by PD versus the heightened sense of security afforded by in-centre HD. Addressing these issues when counselling about dialysis choice may help increase PD uptake among older ESRD patients.
