PD provides strong outcomes

PD offers a survival advantage

According to the United States Renal Data System (USRDS), Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD) patients have an early survival advantage over Hemodialysis (HD) for up to five years on dialysis.1

 



Reference 1 below

 



When the USRDS data is adjusted for additional factors, as in the Archives of Internal Medicine study "Similar Outcomes with Hemodialysis and Peritoneal Dialysis in Patients with End-Stage Renal Disease," the hazard ratios for mortality between Peritoneal Dialysis (PD) and HD patients shift depending on age, diabetic status and comorbidities.  According to the study, nondiabetic PD patients, regardless of age or comorbidities, have a lower or similar risk of death compared to HD patients.  Additionally, younger diabetic patients have a similar risk of death between PD and HD.2



PD can lower hospitalization rates due to certain infections

Hospital admissions related to bacteremia/septicemia are much lower for PD patients versus HD patients. The use of venous catheters in HD is a major factor for causing septicemia,resulting in a higher rate of hospitalization.4

 

 



Reference 4 below

 

A comparison of first-year dialysis patient catheter events illustrates the difference in risk for sepsis.5



Reference 5 below

 

Admission rates due to PD-related infections continue to decline consistently over time.6

 

 


VA = Vascular Access.
Reference 6 below

PD preserves vascular access

Because no vascular access is required, PD preserves these sites in case other procedures are necessary.

 

PD preserves residual kidney function

PD is better at preserving residual kidney function, which is linked to better survival rates.7-10 Patients who keep their remaining kidney function also experience other health benefits, including better nutritional status and reduced blood pressure.11-12

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1 US Renal Data System. USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Reference Tables: Section I (Patient Survival). Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010.
2 Mehrotra R, Chui YW, Kalantar-Zadeh K, et al. Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in the United States. Arch Intern Med. 2011;171:110-118.
3 Ishani A, Colins A, Herzog C, et al. Septicemia, Access and Cardiovascular Disease in Dialysis Patients: The USRDS wave 2 study. Kidney Int. 2005;68:311-318.
4 US Renal Data System. USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Vol. 2, Chapter 6: Morbidity and Mortality, Figure 6.4. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010.
5 US Renal Data System. USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Vol. 2, Chapter 5: Clinical Indicators, Figures 5.20, 5.23. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2009.  
6 US Renal Data System. USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Vol. 2, Chapter 6: Morbidity and Mortality, Figure 6.2. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010.
7 Moist L, Port F, Orzol S, et al. Predictors of Loss of Residual Renal Function Among New Dialysis Patients. J Am Soc Nephrol. 2000;11:556-564.
8 Jansen M, Hart A, Korevaar J, et al. Predictors of the Rate of Decline of Residual Renal Function in Incident Dialysis Patients. Kidney Int. 2002;62:1046-1053.
9 Misra M, Vonesh E, Van Stone J, et al. Effect of Cause and Time of Dropout on the Residual GFR: A Comparative Analysis of the Decline of GFR in Dialysis. Kidney Int. 2001;59:754-763.
10 Bergman J, Thorpe K, et al. Relative Contribution of Residual Renal Function and Peritoneal Clearance to Adequacy of Dialysis: A Reanalysis of the CANUSA Study. J Am Soc Nephrol. 2001;12:1259-2162.
11 Wang, A, Sea M, et al. Independent Effects of Residual Renal Function and Dialysis Adequacy on Actual Dietary Protein, Calorie, and Other Nutrient Intake in Patients on Continuous Ambulatory Peritoneal Dialysis. J Am Soc Nephrol. 2001;12:2450-2457.
12 Menon M, Naimark D, et al. Long-term Blood Pressure Control in a Cohort of Peritoneal Dialysis Patients and Its Association with Residual Renal Function. Nephrol Dial Transplant. 2001;16:2207-2213.