Important factors in the choice of dialysis modality among Japanese patients initiating peritoneal dialysis

BackgroundThe Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative identified core outcomes for patients receiving peritoneal dialysis (PD). However, this study included very few Japanese participants, raising concerns whether their findings applied to Japanese patients. This study aimed to identify important factors in the choice of dialysis modality from the SONG-PD list.MethodsParticipants comprised 199 patients receiving dialysis (mean age, 61 ± 12 years; male, 71.9%) who initiated PD between January 1, 2018, and September 30, 2024. Important factors in the choice of dialysis modality were investigated using a questionnaire and clinical data were obtained from medical records.ResultsImportant factors with high voting percentages included "Flexibility with time (ability to schedule dialysis according to one's day)" "Life participation (ability to work, study, do home duties)," "Mobility/fitness (ability to move without assistance, and to train to achieve physical goals)" and "Ability to travel." These findings, except for "Life participation," differed from the core outcomes identified in the SONG-PD study. Subgroup analysis showed that "Death" had a higher voting percentage in patients with diabetic nephropathy. Additionally, important factors varied partly depending on age and employment status.ConclusionImportant factors in the choice of dialysis modality among Japanese patients initiating PD, particularly regarding flexibility, daily activities, mobility, and travel, highlight specific needs that may not be fully captured by the internationally derived SONG-PD core outcomes, except for life participation itself. Important factors identified in this study may be included in clinical trials involving Japanese patients to support shared decision making.