why pd

Clinical

Why PD? Flexible treatment options

Depending on a patient’s renal function, PD can be offered as urgent-start, incremental, or conventional therapy. Each treatment regimen offers its own benefits to patients.

 

When to prescribe

Treatment regimen

Patient benefit

 
 
conventional pd 1
conventional pd 2
conventional pd new

Conventional PD

The patient and the physician decide which PD option is appropriate.

Automated peritoneal dialysis (APD) OR continuous ambulatory peritoneal dialysis (CAPD)

The patient and his or her physician chooses the therapy modality that best suits the patient’s lifestyle.

Indications for conventional PD include initiation based on needed dialysis for end-stage kidney failure, or when more than 85% of renal function is lost (<15 GFR).1
 
incremental pd 1
incremental pd 2
incremental pd 3

Incremental PD

PD therapy is gradually introduced in patients with substantial renal function.2,3

Offers fewer exchanges than conventional PD2

Fewer trips to the clinic and a trend towards lower peritonitis incidence2,3

Incremental PD offers an effective modality with which to start PD, along with fewer exchanges than conventional PD when significant renal function is still present.2,3
 
urgent pd 1
urgent pd 2
urgent pd 3

Urgent-start PD

This type of therapy allows for a “PD-first” strategy despite the unplanned start.

PD may be initiated in a clinic or hospital setting to train the patient on how to perform the therapy.

Studies show that patients in the urgent-start PD pathway have been successfully discharged to home therapy.5

Urgent-start PD refers to the initiation of dialysis soon after PD catheter placement. This treatment option is available to late-referred patients with advanced kidney disease. According to a single-center, retrospective study, urgent-start PD may be an option for a patient when the dialysis center is experienced in urgent-start PD.4

GFR: glomerular filtration rate

Did you know?

pd-hd

In the U.S., PD use has increased at a greater rate than hemodialysis (HD) each year since 2009.6

48per

Since 2010, the number of PD patients has increased by 48%.

Why worldwide use of PD confirms therapy value

Distribution of the percentage of prevalent dialysis patients using PD in 20157,8

PD distribution

Source: Special analyses, USRDS ESRD Database. United Kingdom: England, Wales, and Northern Ireland (Scotland data reported separately). Data for Canada excludes Québec.

PD has a well-established market presence worldwide.


References:

  1. National Kidney Foundation. Available at https://www.kidney.org/patients/peers/dialysis. Accessed on November 30, 2017.
  2. De Vecchi AF, Scalamogna A, Finazzi S, et al. Preliminary evaluation of incremental peritoneal dialysis in 25 patients. Perit Dial Int. 2000;20:412-417.
  3. Sandrini M, Vizzardi V, Valerio F, et al. Incremental peritoneal dialysis: a 10-year single-centre experience. J Nephrol. 2016;29(6):871-879.
  4. Jin H, Fang W, Zhu M, et al. Urgent-start peritoneal dialysis and hemodialysis in ESRD Patients: complications and outcomes. PLoS One. 2016;11(11): e0166181.
  5. Arramreddy R, Zheng S, Saxena AB, et al. Urgent-start peritoneal dialysis: a chance for a new beginning. Am J Kidney Dis. 2014;63(3):390-395.
  6. United States Renal Data System. 2016 ADR Reference Tables: Table D1 - Treatment Modalities. Available at: https:// www.usrds.org/reference.aspx. Accessed on November 30, 2017.
  7. United States Renal Data System. 2017 ADR Chapters. ESRD Chapter 11. Available at: https://www.usrds.org/2017/view/v2_11.aspx. Accessed on August 1, 2018.
  8. United States Renal Data System. 2017 ADR Chapters. ESRD Chapter 11, Figure 11.15. Available at: https://www.usrds.org/2017/view/Default.aspx. Accessed on August 1, 2018.