Advances in peritoneal dialysis: a review

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Dialysis Modalities

Background:

• Peritoneal dialysis (PD) is a cost-effective renal replacement therapy.
• PD is underutilized in many countries, including the US.
• Recent literature reviews PD therapy, focusing on solutions, complications, and survival.

Purpose of the Study:

• To review recent publications on peritoneal dialysis (PD).
• To focus on biocompatible PD solutions, encapsulating peritoneal sclerosis, and PD vs. hemodialysis survival.
• To critically evaluate the evidence and methodological limitations in PD research.

Main Methods:

• Review of recent publications on PD.
• Analysis of studies on biocompatible PD solutions.
• Examination of literature on encapsulating peritoneal sclerosis.
• Assessment of survival analyses comparing PD and hemodialysis.

Main Results:

• Biocompatible PD solutions show inconsistent benefits regarding peritonitis reduction and clinical endpoints.
• Encapsulating peritoneal sclerosis remains a rare but serious complication, hindering research.
• Survival analyses comparing PD and hemodialysis are methodologically challenged.
• Recent data suggest similar survival rates between PD and hemodialysis, influenced by initiation circumstances.

Conclusions:

• Current evidence on biocompatible PD solutions is limited by trial design and confounding factors.
• Further research, potentially through registries, is needed for encapsulating peritoneal sclerosis.
• Survival data comparing PD and hemodialysis should be interpreted cautiously due to methodological limitations.
• PD and hemodialysis demonstrate comparable patient survival, with initiation context being a key determinant.