PD First: Peritoneal Dialysis as the Default Transition to Dialysis Therapy
Open Access
- 19 September 2013
- journal article
- review article
- Published by Wiley in Seminars in Dialysis
- Vol. 26 (6), 706-713
- https://doi.org/10.1111/sdi.12125
Abstract
Peritoneal dialysis (PD) and in‐center hemodialysis (HD) are accepted as clinically equivalent dialysis modalities, yet in‐center HD is the predominant renal replacement therapy (RRT) modality offered to new end‐stage renal disease (ESRD) patients in the United States and most other industrialized nations. This predominance has little to do with clinical outcomes, patient choice, cost, or quality of life. It has been driven by ease of HD initiation, physician experience and training, inadequate pre‐ESRD patient education, ample in‐center HD capacity, and lack of adequate infrastructure for PD‐related care. As compared with in‐center HD, PD is a widely applicable, yet underutilized modality of RRT that provides comparable clinical outcomes, superior quality of life measures, significant cost savings, and many other unmeasured advantages. A “PD First” approach not only has advantages for patients but also physicians, healthcare systems, and society. In this review, we will summarize evidence demonstrating that PD should be the default modality when new ESRD patients are transitioning to dialysis therapy when preemptive transplantation is not an option and highlight the essential infrastructural requirements to allow for a “PD First” model.This publication has 54 references indexed in Scilit:
- Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in CanadaNephrology Dialysis Transplantation, 2012
- Mortality Associated with Dose Response of Erythropoiesis-Stimulating Agents in Hemodialysis versus Peritoneal Dialysis PatientsAmerican Journal of Nephrology, 2012
- Hemodialysis Vascular Access Modifies the Association between Dialysis Modality and SurvivalJournal of the American Society of Nephrology, 2011
- Comparable outcome of acute unplanned peritoneal dialysis and haemodialysisNephrology Dialysis Transplantation, 2011
- Effect of an In-Hospital Chronic Kidney Disease Education Program among Patients with Unplanned Urgent-Start DialysisClinical Journal of the American Society of Nephrology, 2011
- Depressed Mood, Usual Activity Level, and Continued Employment after Starting DialysisClinical Journal of the American Society of Nephrology, 2010
- Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patientsNephrology Dialysis Transplantation, 2010
- Propensity-Matched Mortality Comparison of Incident Hemodialysis and Peritoneal Dialysis PatientsJournal of the American Society of Nephrology, 2010
- Relationship between Dialysis Modality and MortalityJournal of the American Society of Nephrology, 2009
- Dialysis Facility Characteristics and Variation in Employment RatesClinical Journal of the American Society of Nephrology, 2008