Patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis: A cross-sectional survey.

The study aimed at analyzing patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis. A telephone survey with 574 patients receiving care at six peritoneal dialysis centers of the Mexican Institute of Social Security was conducted: 64.3% were on peritoneal dialysis, and 35.7% had transitioned from peritoneal dialysis to hemodialysis. Data were collected on participants' sociodemographic and clinical characteristics, peritoneal dialysis center size, and nursing workload. Descriptive, bivariate, and multiple Poisson regression analyses were performed. Factors associated with an increased probability of switching from peritoneal dialysis to hemodialysis were a history of catheter dysfunction, peritonitis, and being treated in a large peritoneal dialysis center with a low (<50 patients per nurse per month) or high nursing workload (>70 patients per nurse per month) located in the State of Mexico, compared to a medium-size peritoneal dialysis center with a moderate workload (50-70 patients per nurse per month). To decrease the odds of switching from peritoneal dialysis to hemodialysis, improvement programs should aim to limit nurses' workload to 50-70 patients per nurse per month and implement evidence-based nursing interventions to prevent, detect, and manage peritonitis and peritoneal catheter dysfunction.