Social Reintegration and Associated Factors Among Patients Receiving Peritoneal Dialysis: A Cross-Sectional Study

Background: Social reintegration is an important patient-centered outcome for patients receiving peritoneal dialysis (PD), reflecting their ability to maintain daily activities and social roles during long-term home-based treatment. However, evidence regarding social reintegration and its associated factors in patients receiving peritoneal dialysis remains limited. Objective: To evaluate social reintegration among adults receiving maintenance peritoneal dialysis and to identify associated clinical, nutritional, and functional factors. Methods: This single-center cross-sectional study included adults receiving maintenance PD in China. Social reintegration was assessed using the Social Reintegration Grading Method and classified as low or high. Nutritional status was assessed using the Subjective Global Assessment, and activities of daily living (ADL) using the Barthel Index. Univariable analyses were followed by Firth’s penalized logistic regression. Sensitivity analyses assessed the robustness of the findings. Results: Among 202 participants, 37 (18.3%) had low social reintegration and 165 (81.7%) had high social reintegration. Dialysis duration of more than 10 years was associated with lower odds of high social reintegration (OR = 0.293, 95% CI: 0.088– 0.975, P = 0.046). ADL dependence was also negatively associated with high social reintegration (OR = 0.236, 95% CI: 0.093– 0.561, P = 0.001). Sensitivity analyses supported these associations. Conclusion: The majority of patients receiving peritoneal dialysis were classified as having high social reintegration. However, dialysis duration of more than 10 years and dependence in activities of daily living were associated with lower odds of high social reintegration. These findings support incorporating social reintegration and functional assessment into routine peritoneal dialysis follow-up. Patients with prolonged dialysis duration or reduced functional independence may require additional support to maintain daily functioning and social roles. Keywords: peritoneal dialysis, social reintegration, activities of daily living, functional dependence, firth’s penalized logistic regression