Expanding criteria for peritoneal dialysis use

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Public Health

Background:

• Growing global population with end-stage renal disease (ESRD) requires renal replacement therapy.
• Home-based dialysis, particularly peritoneal dialysis (PD), is identified as the most cost-effective treatment option.
• Despite numerous advantages, PD is significantly underutilized as a renal replacement therapy.

Purpose of the Study:

• To review the current status of peritoneal dialysis (PD) utilization worldwide.
• To analyze the costs, complications, and potential improvements associated with PD.
• To understand factors contributing to the low incidence and prevalence of PD.

Main Methods:

• Systematic literature review of peritoneal dialysis (PD) prevalence and incidence.
• Analysis of economic data comparing PD with other renal replacement therapies.
• Review of clinical outcomes and complication rates associated with PD.
• Exploration of policy and healthcare system changes aimed at increasing PD use.

Main Results:

• Peritoneal dialysis (PD) demonstrates significant cost advantages over other renal replacement therapies.
• Despite clinical and economic benefits, PD incidence and prevalence remain low globally.
• Various factors contribute to the underutilization of PD, including healthcare system structures and patient/physician perceptions.

Conclusions:

• Peritoneal dialysis (PD) is an underutilized but cost-effective renal replacement therapy with significant advantages.
• Addressing barriers and implementing strategies to enhance PD use is crucial for managing the growing ESRD population.
• Further research and policy interventions are needed to increase the adoption of PD worldwide.