Global trends in rates of peritoneal dialysis

Abstract

Although there is a perception that the use of peritoneal dialysis is declining worldwide, compilations of global data are unavailable to test this hypothesis. We assessed longitudinal trends in the use of peritoneal dialysis from 1997 to 2008 in 130 countries. The preferred data sources were renal registries, followed by nephrology societies, health ministries, academic centers, national experts, and industry affiliates. In 2008, there were approximately 196,000 peritoneal dialysis patients worldwide, representing 11% of the dialysis population. In total, 59% were treated in developing countries and 41% in developed countries. Over 12 years, the number of peritoneal dialysis patients increased in developing countries by 24.9 patients per million population and in developed countries by 21.8 per million population. The proportion of all dialysis patients treated with peritoneal dialysis did not change in developing countries but significantly declined in developed countries by 5.3%. The use of automated peritoneal dialysis increased by 14.5% in developing countries and by 30.3% in developed countries. In summary, the number of patients treated with peritoneal dialysis rose worldwide from 1997 to 2008, with a 2.5-fold increase in the prevalence of peritoneal dialysis patients in developing countries. The proportion of all dialysis patients treated with this modality continues to decline in developed countries.

Figure 1.

Current number of peritoneal dialysis patients. Crude number of prevalent patients treated with peritoneal dialysis in (A) developing countries and (B) developed countries.

Figure 1.

Current number of peritoneal dialysis patients. Crude number of prevalent patients treated with peritoneal dialysis in (A) developing countries and (B) developed countries.

Figure 2.

Current peritoneal dialysis prevalence. Peritoneal dialysis prevalence per million population in (A) developing countries and (B) developed countries.

Figure 2.

Current peritoneal dialysis prevalence. Peritoneal dialysis prevalence per million population in (A) developing countries and (B) developed countries.

Figure 3.

Current proportion of total dialysis that is peritoneal dialysis. Proportion (%) of chronic dialysis patients treated with peritoneal dialysis in (A) developing countries and (B) developed countries.

Figure 3.

Current proportion of total dialysis that is peritoneal dialysis. Proportion (%) of chronic dialysis patients treated with peritoneal dialysis in (A) developing countries and (B) developed countries.

Figure 4.

Trends in peritoneal dialysis as a proportion of total dialysis. Trends in the proportion (%) of dialysis patients treated with peritoneal dialysis from 1997 to 2008 in (A) developing countries and (B) developed countries.

Figure 5.

Trends in peritoneal dialysis prevalence. Trends in the prevalence of peritoneal dialysis per million population from 1997 to 2008 in (A) developing countries and (B) developed countries.

Figure 6.

CAPD versus APD use. The types of peritoneal dialysis used in (A) developing countries and (B) developed countries.