Changes in the worldwide epidemiology of peritoneal dialysis

Abstract

As the global burden of chronic kidney disease continues to increase, so does the need for a cost-effective renal replacement therapy. In many countries, patient outcomes with peritoneal dialysis are comparable to or better than those with haemodialysis, and peritoneal dialysis is also more cost-effective. These benefits have not, however, always led to increased utilization of peritoneal dialysis. Use of this therapy is increasing in some countries, including China, the USA and Thailand, but has proportionally decreased in parts of Europe and in Japan. The variable trends in peritoneal dialysis use reflect the multiple challenges in prescribing this therapy to patients. Key strategies for facilitating peritoneal dialysis utilization include implementation of policies and incentives that favour this modality, enabling the appropriate production and supply of peritoneal dialysis fluid at a low cost, and appropriate training for nephrologists to enable increased utilization of the therapy and to ensure that rates of technique failure continue to decline. Further growth in peritoneal dialysis use is required to enable this modality to become an integral part of renal replacement therapy programmes worldwide.

Implementing Assisted Peritoneal Dialysis in Renal Care: a Chinese-German Perspective

“…Nursing shortage along with growing population and the need of advanced care is also a trend in China which demands improvement in nursing training and education [16]. These and other conditions may impair penetration and utilization of assPD as recently decribed for the German situation [3,17,18] (Table 2, Fig. 1).…”

“…This development is significantly driven by raising awareness of chronic kidney disease (CKD), growing economic prosperity which make RRT affordable in many countries, and increase of life time in these populations [2]. Peritoneal dialysis (PD) compared to hemodialysis is a cost-effective treatment with similar or better outcome in many countries but utilization is different with increasing populations in China, Thailand, and US and a proportional decrease in Europe and Japan [3].…”

Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients

“…In particular, end-stage renal disease (ESRD) triggers premature mortality and is a substantial health economic burden [2]. It has been estimated that more than 10.8% of Chinese adults (around 130 million) have CKD with dialysis needed at some point in their lives [3]. The Chinese medical insurance scheme has now increased its coverage, making dialysis, especially peritoneal dialysis (PD), more affordable among Chinese patients with ESRD [4].…”

Dialysate Creatinine Response Patterns During Peritoneal Equilibration Test and the Association Between Cardiovascular Mortality: Findings from a Prospective Cohort Study

“…In particular, end-stage renal disease (ESRD) triggers premature mortality and a substantial health economic burden [2]. It has been estimated that more than 10.8% of Chinese adults (around 130 million) have CKD with dialysis needs at some point in their lives [3]. Increased coverage of Chinese medical insurance has made dialysis, especially peritoneal dialysis (PD), more affordable among Chinese patients with ESRD [4].…”