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Causes et déterminants du transfert en hémodialyse chez les patients traités par dialyse péritonéale : la survie technique

Abstract : Dialysis is associated with a significant burden of care for patients, and home modalities, which offer a better quality of life, are underused in favor of in-center hemodialysis. The prevalence of peritoneal dialysis is low due to an insufficient incidence, but also often to a limited technique survival.Our objective was to determine the factors associated with the risk of transfer to in-center hemodialysis in patients treated by peritoneal dialysis in France from registry data.We showed that peritoneal dialysis care practices related to the catheter were heterogeneous between centers. However, clusters of centers with homogeneous practices were identified, and these clusters were associated with different risk of transfer to hemodialysis. The analysis of the practices used for autonomous peritoneal dialysis learning showed us that no single pedagogical support was associated with a decrease in the risk of peritoneal infection. Finally, we highlighted that the use of nurse assistance at home for peritoneal dialysis was associated with a better technique survival and especially with a lower risk of transfer to hemodialysis because of under-dialysis. Understanding this mechanism of peritoneal dialysis technique survival is important for patients. The freedom to choose a treatment at home and the possibility to maintain it over time are levers for improving the quality of lifeand empowerment of patients.
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https://tel.archives-ouvertes.fr/tel-03522518
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Submitted on : Wednesday, January 12, 2022 - 10:38:08 AM
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  • HAL Id : tel-03522518, version 1

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Antoine Lanot. Causes et déterminants du transfert en hémodialyse chez les patients traités par dialyse péritonéale : la survie technique. Médecine humaine et pathologie. Normandie Université, 2021. Français. ⟨NNT : 2021NORMC421⟩. ⟨tel-03522518⟩

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