Why are we Not Getting More Patients onto Peritoneal Dialysis? Observations From the United States with Global Implications
Isaac Teitelbaum, Frederic O. Finkelstein
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.
Topics & Concepts
Peritoneal dialysisMedicineEconomic shortageHemodialysisIntensive care medicineEnd-stage kidney diseaseModality (human–computer interaction)DialysisHome hemodialysisKidney diseaseTreatment modalityDiseaseInternal medicineGovernment (linguistics)Human–computer interactionPhilosophyComputer scienceLinguisticsDialysis and Renal Disease ManagementCentral Venous Catheters and HemodialysisHealth Systems, Economic Evaluations, Quality of Life