The treatment options for kidney failure, which includes people with end-stage renal disease (ESRD), are —
- Kidney transplant: an optimal solution; however, the lack of viable donors makes it an unrealistic option for most people with ESRD.
- Hemodialysis can only be performed in a clinic or hospital. It requires the person to travel to the center three to four times a week for approximately three to five hours sessions, during which time, the person is immobile.
- Peritoneal dialysis (PD) uses the peritoneum (membrane lining the abdomen) to filter blood inside the body. PD eliminates the need to travel to dialysis centers and provides flexibility to maintain everyday work and activities. At-home PD offers numerous benefits:
- Early survival advantage over hemodialysis for up to five years [note] 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.[/note]
- Improved residual kidney function preserved [note] Moist L, Port F, Orzol S, et al. Predictors of Loss of Residual Renal Function Among New Dialysis Patients. J Am Soc Nephrol. 2000;11:556564. 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;62:10461053. 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;59:754763. 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;12:12592162.[/note]
- Reduced blood pressure [note] 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;12:24502457. Menon M, Naimark D, et al. Longterm Blood Pressure Control in a Cohort of Peritoneal Dialysis Patients and Its Association with Residual Renal Function. Nephrol Dial Transplant. 2001;16:22072213.[/note]
- Needle-free treatments preserve vascular access
- Fewer negative side effects such as nausea, vomiting, cramping, weight gain
- Better patient experience and outlook regarding treatment
- Improved quality of life due to infrequent trips to the dialysis center
For the health care system, PD presents a more affordable treatment option.
Current PD solutions face known challenges that limit them from becoming the gold standard for patient treatment:
- bulky
- cumbersome setup and complicated treatment regimen
- person’s inability to perform the procedure
- may increase the risk of peritonitis