Family caregiver-assisted peritoneal dialysis in Argentina: A multicenter descriptive study

Abstract

Assisted peritoneal dialysis (PD) enables home-based kidney replacement therapy for patients with physical, cognitive, or social limitations. Although structured-assisted PD programs exist internationally, little is known about their implementation in Argentina. We conducted a multicenter, cross-sectional study including adult patients (≥18 years) on assisted PD from 29 centers across the country between 28 July and 18 August 2025. Among 874 active PD patients, 184 (21%) were receiving assisted PD. Median age was 64 years (IQR: 45.5–75), and 75% initiated PD directly under assisted conditions. Most assistance was provided by family caregivers (90.8%), while professional support was uncommon (4.9% nurses; 3.3% paid caregivers). Motor impairment (45.1%), learning difficulties (38.6%), visual limitations (35.9%), and cognitive disorders (22.8%) were the most frequent indications for assistance. Patients reporting ≥3 contributing factors were significantly more likely to require complete assistance (p = 0.001). Older age was associated with complete assistance (p < 0.001), lower transplant listing rates (p < 0.001), and history of peritonitis (p = 0.033). Assistance type was not associated with peritonitis occurrence or dialysis adequacy (Kt/V ≥ 1.7). These findings show that assisted PD in Argentina relies predominantly on informal, family-based support rather than structured or funded professional programs. The model reflects unmet needs in training, caregiver support, and resource allocation. Strengthening formal-assisted PD programs may improve equity, ensure sustainable access to home dialysis and better support functionally dependent patients.