Why are we Not Getting More Patients onto Peritoneal Dialysis? Observations From the United States with Global Implications
- PMID: 37849989
- PMCID: PMC10577320
- DOI: 10.1016/j.ekir.2023.07.012
Why are we Not Getting More Patients onto Peritoneal Dialysis? Observations From the United States with Global Implications
Abstract
Peritoneal dialysis (PD) offers lifestyle advantages over in-center hemodialysis (HD) and is less costly. However, in the United States, less than 12% of end-stage kidney disease (ESKD) patients are maintained on this modality. In this brief review, we discuss some of the factors underlying the low prevalence of PD. These include inadequate patient education, a shortage of sufficiently well-trained medical and nursing personnel, absence of infrastructure to support urgent start PD, and lack of support for assisted PD, among other factors. Understanding and addressing these various issues may help increase the prevalence of PD in the United States and globally.
Keywords: assisted PD; barriers to PD; home dialysis; incremental PD; peritoneal dialysis; prevalence.
© 2023 International Society of Nephrology. Published by Elsevier Inc.
Similar articles
-
Peritoneal Dialysis in Western Countries.Kidney Dis (Basel). 2015 Dec;1(3):157-64. doi: 10.1159/000437286. Epub 2015 Sep 3. Kidney Dis (Basel). 2015. PMID: 27536676 Free PMC article. Review.
-
Feasibility of Urgent-Start Peritoneal Dialysis in Older Patients with End-Stage Renal Disease: A Single-Center Experience.Perit Dial Int. 2018 Mar-Apr;38(2):125-130. doi: 10.3747/pdi.2017.00002. Epub 2017 Nov 21. Perit Dial Int. 2018. PMID: 29162677
-
The Association between Prevalence of Peritoneal Dialysis versus Hemodialysis and Patients' Distance to Dialysis-Providing Facilities.Kidney360. 2021 Oct 14;2(12):1908-1916. doi: 10.34067/KID.0004762021. eCollection 2021 Dec 30. Kidney360. 2021. PMID: 35419529 Free PMC article.
-
Changing the trend: a prospective study on factors contributing to the growth rate of peritoneal dialysis programs.Adv Perit Dial. 2001;17:122-6. Adv Perit Dial. 2001. PMID: 11510258
-
Peritoneal dialysis patient selection from a comorbidity perspective.Semin Dial. 2022 Jan;35(1):25-39. doi: 10.1111/sdi.12927. Epub 2020 Oct 22. Semin Dial. 2022. PMID: 33094512 Review.
Cited by
-
Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).Kidney Int Suppl (2011). 2024 Apr;13(1):83-96. doi: 10.1016/j.kisu.2024.01.003. Epub 2024 Apr 8. Kidney Int Suppl (2011). 2024. PMID: 38618503 Free PMC article. Review.
-
Neighborhood Built Environment and Home Dialysis Utilization: Varying Patterns by Urbanicity-Dependent Patterns and Implications for Policy.Am J Kidney Dis. 2025 Jun;85(6):737-744. doi: 10.1053/j.ajkd.2025.01.015. Epub 2025 Mar 11. Am J Kidney Dis. 2025. PMID: 40081754
-
The Intersectoral Coordination Unit for the Sustainable Intensification of Peritoneal Dialysis in Schleswig-Holstein (SKIP-SH) cohort study.BMC Nephrol. 2024 Mar 1;25(1):75. doi: 10.1186/s12882-024-03519-9. BMC Nephrol. 2024. PMID: 38429741 Free PMC article.
-
A Province-Wide Home Dialysis Program Review: Challenges, Strengths, and Future Strategies.Can J Kidney Health Dis. 2025 Mar 14;12:20543581251324560. doi: 10.1177/20543581251324560. eCollection 2025. Can J Kidney Health Dis. 2025. PMID: 40091890 Free PMC article.
-
Gut microbiome dynamics of patients on dialysis: implications for complications and treatment.Front Pharmacol. 2025 Apr 25;16:1470232. doi: 10.3389/fphar.2025.1470232. eCollection 2025. Front Pharmacol. 2025. PMID: 40351408 Free PMC article. Review.
References
-
- Brown E.A., Zhao J., McCullough K., et al. Burden of kidney disease, health-related quality of life, and employment among patients receiving peritoneal dialysis and in-center hemodialysis: findings from the DOPPS program. Am J Kidney Dis. 2021;78:489–500.e1. doi: 10.1053/j.ajkd.2021.02.327. - DOI - PubMed
-
- Register Federal. Advancing American Kidney Health. Executive Office. 2019
Publication types
LinkOut - more resources
Full Text Sources