Nurse with patient

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.

Conventional PD

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

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When to prescribe

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

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Treatment regimen

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

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Patient benefit

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

Incremental PD

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

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When to prescribe

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

incrementalpd-2

Treatment regimen

Offers fewer exchanges than conventional PD2

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Patient benefit

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

Urgent-start PD

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

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When to prescribe

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

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Treatment regimen

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

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Patient benefit

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

Did you know?

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

Hong Kong 70%
Mexico 51%
New Zealand 19.6%
Canada 19.6%
South Africa 16.1%
United Kingdom 13.1%
USA 9.8%

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.