title: Experiences with assisted peritoneal dialysis in China.
abstract: OBJECTIVE
  About half the patients on peritoneal dialysis (PD) in China need to be assisted by family members or home assistants. We explored whether these patients have a higher risk for peritonitis and death compared with self-care PD patients.
  
  
  METHODS
  We prospectively followed 313 incident PD patients until death or censoring. This cohort was divided into assisted and self-care PD groups according to the independence of bag exchange. Data on baseline demographics, Charlson comorbidity index, biochemistry, and residual renal function were recorded during the first 3 - 6 months. The outcome variables were first episode of peritonitis and all-cause mortality.
  
  
  RESULTS
  Of the 313 patients in this cohort study, 122 needed assistance in performing bag exchanges (86 from a family member, 36 from a home assistant); the remaining 191 patients did not need assistance. During a follow-up period averaging 44.5 months, 122 patients developed a first episode of peritonitis, and 135 patients died. Compared with patients having a family assistant, those with a home assistant had similar peritonitis-free and survival times, but a higher risk of mortality after adjustments for variables such as age, sex, Charlson comorbidity score, hemoglobin, serum albumin, and residual renal function. Furthermore, compared with self-care patients, assisted patients overall had a similar peritonitis-free time, but a higher risk of mortality, even after adjusting for covariates.
  
  
  CONCLUSIONS
  Based on our single-center experience in China, we conclude that assisted PD is a good option for patients with poor self-care ability. This result provides evidence for recruiting patients who need assistance to PD programs in China.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.forename: Min
authors.initials: M
authors.lastname: Zhuo
authors.forename: Zhikai
authors.initials: Z
authors.lastname: Yang
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006437:Hemodialysis, Home / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods*; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors