[Outcome Analysis of the Outpatient Pathway for Advanced Kidney Disease (MaReA): Focus on Dependent Patients].

Abstract

Introduction. Chronic Kidney Disease (CKD) represents a global health challenge. The Advanced Kidney Disease Outpatient Program (MaReA) is an organizational model that prepares patients for renal replacement therapy (RRT), promoting informed choice and timely initiation of treatment. Peritoneal dialysis (PD) is a home-based therapy that offers greater autonomy, but its applicability depends on several factors. Objective. The purpose of this study is to analyze the outcomes of a MaReA program, with a specific focus on assessing suitability for PD, patient autonomy, and the role of the caregiver. Materials and Methods. A retrospective analysis was conducted on a cohort of patients with CKD stage 5 enrolled in the MaReA program. The analysis focused on suitability for PD, the outcome of the program for eligible patients, the degree of autonomy achieved, and the availability and type of caregiver for dependent patients. Results. The evaluation showed that 61.2% of patients were deemed eligible for PD. Among eligible patients who completed the program, a high rate of PD adoption was observed. For the proportion of dependent patients, the presence of a caregiver is essential. Conclusions. The MaReA program is an effective tool for identifying candidates for PD and adequately preparing them. Caregivers play a critical role in accessing home care for a subpopulation of frail patients. It is necessary to develop support strategies and implement telemedicine and assisted peritoneal dialysis programs to expand access to PD.