Safety, autonomy, and quality of life for the patient are among the various merits
of peritoneal dialysis (PD) extolled by clinical leaders, professional societies,
and policymakers. As many as 85% of end-stage kidney disease (ESKD), excluding patients
who may have difficulty performing PD (e.g., stroke, vision impairment, abdominal
wounds), are medically eligible for PD.
1
However, PD remains a woefully underutilized modality in the United States, particularly
in underserved communities. It is a credit to educational efforts and policy makers
that increased awareness and provider incentives have resulted in a modest, but palpable
increase in PD adoption in the last decade, now near 11% of incident patients.
2
The ongoing challenge is the overall technique survival in the United States for
PD, which is low, roughly 50% after three years.
3
,4
Improving technique retention should be a priority because it will impact prevalent
rates of PD and can influence providers’ and patients’ perception about PD. The barriers
to technique retention in large urban areas with diverse patient populations are particularly
knotty and difficult to untangle. As Torres et al
5
have expertly illustrated, examining the reasons for technique failure is critical
particularly in special populations because they have to reveal factors that may not
be apparent and point to areas to focus further research and policy prescriptions.To read this article in full you will need to make a payment
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References
- The changing landscape of home dialysis in the United States.Curr Opin Nephrol Hypertens. 2014; 23: 586-591
- 2019 USRDS Annual Data Report: Epidemiology of kidney disease in the United States.National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD2019
- Peritoneal dialysis in the US: evaluation of outcomes in contemporary cohorts.Kidney Int. 2006; 70: S21-S26
- Determinants of peritoneal dialysis technique failure in incident us patients.Perit Dial Int. 2013; 33: 155-166
- Evaluating factors contributing to dropout in a large peritoneal dialysis program.Am J Med Sci. 2021; 361: 30-35https://doi.org/10.1016/j.amjms.2020.06.030
- Social determinants of racial disparities in CKD.JASN. 2016; 27: 2576-2595
- Causes for withdrawal in an urban peritoneal dialysis program.Int J Nephrol. 2015; 2015: 1-4
- Patient and physician predictors of peritoneal dialysis technique failure: a population based, retrospective cohort study.Perit Dial Int. 2011; 31: 565-573
- Home visit program improves technique survival in peritoneal dialysis.Blood Purif. 2014; 37: 286-290
- USRDS 2013 Annual Data Report: atlas of chronic kidney disease and end stage renal disease in the United States.National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA2013
- What do American nephrologists think about dialysis modality selection?.Am J Kidney Dis. 2001; 37: 22-29
- Predicting a patient's choice of dialysis modality:experience in a United Kingdom renal department.Am J Kidney Dis. 2001; 37: 981-986
- Association between quality of life and anxiety, depression, physical activity and physical performance in maintenance hemodialysis patients.Chronic Dis Transl Med. 2016; 2: 110-119
- Flexibility in peritoneal dialysis prescription: impact on technique survival.Perit Dial Int. 2020; https://doi.org/10.1177/0896860820911521
- International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis.Perit Dial Int. 2020; 40: 244-253https://doi.org/10.1177/0896860819895364
Article info
Publication history
Published online: November 13, 2020
Accepted:
October 23,
2020
Received:
August 28,
2020
Footnotes
Conflict of interest disclosure: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2020 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
