Multicentre study of treatment outcomes in Australian adolescents and young adults commencing dialysis

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Excerpt

Adolescents and young adults (AYA) represent a small proportion of prevalent dialysis patients, but the physical, neurocognitive and social aspects of this stage of life provide unique challenges to individual patients, their families and the clinical teams caring for them.1 Very little has been published about the epidemiology, complications and outcomes of dialysis in this population group.7 Consequently, there is a paucity of evidence upon which to base decisions about dialysis modality.
Whether a patient receives peritoneal dialysis (PD) or haemodialysis (HD) when commencing dialysis will be determined partly by patient and family preference, according to how well the treatment best fits with their lifestyle, by clinical contraindications and by the availability of options within their local clinical service.8 Factors influencing patient/carer preference include their ability to carry out dialysis themselves; how dialysis will impact on schooling or employment, hobbies and family activities; changes to body image and changes to physical activities due to dialysis access; distance and time travelling to hospital; flexibility of treatment; and impact on social relationships.8 These considerations will differ for parents of young children, for adolescent patients and for adults. Improved understanding of the outcomes and complications of dialysis in AYA should inform decision‐making about the choice of modality best suited to an individual patient.
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