ArticleCanadian journal of kidney health and disease2018
Barriers to Peritoneal Dialysis in Aboriginal Patients.
Article in Canadian journal of kidney health and disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Examining Inequities in Clinical Outcomes for Indigenous Patients Treated With Dialysis in Canada: A Scoping Review.Kidney medicine · 2025Review
- The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD).International journal of environmental research and public health · 2021Review
- Community-Based Dialysis in Saskatchewan First Nations: A Grassroots Approach to Gaining Insight and Perspective From First Nations Patients With Chronic Kidney Disease.Canadian journal of kidney health and disease · 2020Article
- A Retrospective Study of Chronic Kidney Disease Burden in Saskatchewan's First Nations People.Canadian journal of kidney health and disease · 2018Article
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population.
objectiveWe aim to assess the barriers to PD utilization in Aboriginal patients with ESKD.
designThis article is a prospective observational cohort study.
settingThe setting involves 3 predialysis clinics in Winnipeg, Kingston, and Moose Factory. PATIENTS: The patients were 99 individuals (67 non-Aboriginal and 32 Aboriginal) who were at least 18 years of age with an estimated glomerular filtration rate of less than 30 mL/min/1.73m MEASUREMENTS: Patient demographics and comorbidities were documented. Barriers to PD, PD as modality choice, and Aboriginal status were assessed via patient survey upon study enrollment. PD use as the initial dialysis modality was assessed via monthly patient follow-up for 1 year after enrollment in the study.
methodsThe patient survey was created based on literature review of known barriers to PD, repaired based on direct patient feedback, and tested for reliability via the test-retest method. Differences in PD choice, barriers to PD, and PD use between Aboriginal and non-Aboriginal patients were determined by chi-square test and logistic regression.
resultsAll patients enrolled in the study completed the survey. Mean age was 65.5 versus 54.6 years for non-Aboriginals and Aboriginals, respectively. Barriers to PD significantly associated with Aboriginal status were lack of money (odds ratio [OR]: 21.3; 95% confidence interval [CI]: 5.3-86.4; LIMITATIONS: Small sample size was a limitation of this study.
conclusionsAboriginal people in Canada have a disproportionately large burden of ESKD, and PD could provide an alternative to in-center hemodialysis for those living in rural areas. Our study identified anxiety and lack of money as barriers to PD significantly associated with Aboriginal status. When choosing dialysis modality, shared decision making between physicians and patient is of key importance to weigh all potential benefits and risks and emphasize the Aboriginal patient's values and preferences. These results can be used to guide future research and to help devise interventions targeting barriers to PD in Aboriginals.
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