Dissertation Prospectus

Determinants of Peritoneal and Hemodialysis Technique Failure in US Patients with End-Stage Renal Disease

Table of Contents

Problem Statement
Significance of the Study
Background
Theoretical Framework
Research Questions
Nature of the Study
Quantitative Research Design
Possible Types and Sources of Information or Data
References

Problem Statement-

In the first two years, End-Stage Renal Disease (ESRD) patients on peritoneal dialysis (PD) experience a better survival rate than those on hemodialysis (HD) while HD is associated with long-term survival after 2 years than PD. Technique failure of PD results from a loss of renal function and further dialysis on PD does not result in any improvement (Moriishi, Kawanishi, & Tsuchiya, 2010). For patients on PD, a timely switch to HD before technique failure occurs can lead to improved dialysis results and help maintain the patient's health status. However, there is a lack of evidence in the literature for the optimal temporal switch in techniques with the most effective long-term patient health outcomes. To complicate this further, previous results suggest that co-morbidities and social demographic determinants can impact the success of PD or HD alone (Shen et al., 2012; Weinhandl et al., 2010). Additionally, these previous findings were limited in generalizability due to sample size constraints. Hence, the purpose of this study is to determine which factors are significantly associated with the temporal failure of the PD technique and improved PD to HD technique switching on patient health outcomes in a large secondary dialysis population of patients across the United States.

Research Questions-

The study will be guided by the following research questions:

1. Do the treatments of PD alone, HD alone and switching from PD influence the survival rates of patients with ESRD?

2. Do social factors (age and gender) and presence of medical conditions (diabetes and CVD) influence technique failure of switching from PD to HD?