Peritoneal dialysis patient selection: characteristics for success

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Therapy

Background:

• Peritoneal dialysis (PD) is a crucial renal replacement therapy.
• Patient selection is vital for optimizing PD outcomes.
• The
• PD first
• model has shown success in specific regions.

Purpose of the Study:

• To review patient selection strategies for peritoneal dialysis.
• To identify factors influencing PD success and patient survival.
• To highlight the importance of patient choice and tailored care in PD.

Main Methods:

• Review of published epidemiology studies.
• Analysis of observational data on PD patient selection.
• Synthesis of evidence regarding patient and technique survival.

Main Results:

• Most patients can undergo PD, with abdominal issues being the primary contraindication.
• Offering PD at dialysis initiation helps preserve residual renal function.
• PD generally offers survival advantages, especially in the early years, though long-term effects require monitoring.

Conclusions:

• Patient selection for PD should be broad, considering factors like comorbidities (diabetes), body size, membrane transport, age, and socioeconomic status.
• Regular patient reviews and adjustments to dialysis regimens are essential.
• Center size, staff training, and comprehensive clinical/psychosocial care significantly impact PD utilization and patient outcomes.