title: 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.
authors.affiliation: Division of Nephrology, Department of Medicine, Arak University of Medical Sciences, Arak, Iran. mahedalat@arakmu.ac.ir
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Edalat-Nejad
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Abdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult