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Peritoneal Dialysis: The Right Question to Ask

Despite the increased incidence of patients affected by ESRD requiring dialysis, the technique of peritoneal dialysis is still underused. This is due to various reasons: besides the complexity and difficulty for the physician to organize a dedicated staff, the time spent for the training of the patient, the main problems related to the technique, and the lack of willingness of the physician to perform this more demanding treatment, we would like here to focus on the need of an overall change of the social substrate that characterizes our country. In Italy, the family is one of the knots of the net that link an individual to the social structure; however, families consist of a few members that often work in different and sometimes very far places; therefore, patients are getting older and either live alone or with a special caregiver. Thus, for socio-organizational reasons, as well as inadequate information, our patients choose the extracorporeal treatment, which seems more “comfortable” and “convenient”, especially for the family. An appropriate solution that may decrease the marginality of peritoneal dialysis could be the creation of halls of residence specialized for aging people. The creation of these structures that would include the presence of a medical-psychological support, coupled to the inevitable establishment of interpersonal ties, could not only ensure appropriate and continuous health care services to the elderly patient and families, but could also reduce the perception of loneliness that often characterizes this period of life. The realization of such a project not only could encourage the use of peritoneal dialysis, but may also be a dedicated tool for all aging people.