ArticleKidney medicine2026
Social Risk Factors and Peritoneal Dialysis Use Among Maintenance Dialysis Patients: A National Cross-Sectional Study.
Article in Kidney medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
Rationale & Objective: Peritoneal dialysis (PD) utilization remains lower in the United States compared with other countries. Data regarding the presence and association of patient-level social risk factors (SRFs) with PD use are lacking. Study Design: Multicenter cross-sectional study. Setting & Population: Maintenance dialysis patients receiving in-center hemodialysis or peritoneal dialysis with dialysis vintage <2 years who dialyzed between 2023 and 2025 at a medium-size, national dialysis provider. Exposures: Patient-level SRFs (housing, food, transportation, utility insecurity, and interpersonal safety) ascertained using the Accountable Health Communities Health-Related Social Needs Screening Tool. Outcome: Nonreceipt of PD at the time of social risk screening. Analytical Approach: Total SRF burden was tallied and categorized (0 (referent), 1, or >1). Adjusted logistic regression models accounted for demographics, comorbid conditions, dialysis vintage, and facility-level clustering. Sensitivity analysis were employed to explore the effect of an alternate definition of SRF burden. Results: Among 7,237 patients treated at 244 dialysis facilities, mean age was 64 ± 15 years, 43% were female, 26% were non-Hispanic Black, and 1,305 (18%) individuals received PD. One or more than 1 patient-level SRF was present in 9% and 3% of patients, respectively. Food insecurity (7%) and housing instability (4%) were most common. After adjustment, presence of 1 and more than 1 SRF was associated with higher odds of nonreceipt of PD as compared with no SRFs [adjusted odds ratio = 1.46 (95% confidence interval 1.10-1.92) and 2.27 (1.35-3.82), respectively]. Both housing instability and transportation insecurity were independently associated with nonreceipt of PD after adjustment. Limitations: Cross-sectional; residual confounding. Conclusions: Patient-level SRFs, including housing instability and transportation insecurity, are associated with nonreceipt of PD among maintenance dialysis patients. These findings should be explored in longitudinal analyses to identify potential patient- and policy-level interventions to improve PD utilization.
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