Medical and Socioeconomic Barriers to Peritoneal Dialysis Utilization in the Central Province of Iran

Abstract

The objectives of this study were to determine the impact that medical and socioeconomic status have on incident peritoneal dialysis (PD) use. In a prospective cohort study, 77 consecutive end-stage renal disease patients (53% women, mean age, 57.5 ± 16.5 years) who were planned to start dialysis were assessed for PD eligibility. The physicians' referral rate for PD consultation was 71%. One-half of the patients had important medical and socioeconomic barriers to PD, such as lack of family support, learning and performance disability, and less-than-ideal home situation. Patients with barriers were older, low educated, and more likely to be diabetic. In conclusion, consultation with a multidisciplinary team and the availability of health care systems financial supports are important drivers of PD. In addition, there is a likely need for further educational activities focused on PD, in order to change physicians' preference towards hemodialysis.