Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States

Liu, Frank Xiaoqing; Ghaffari, Arshia; Dhatt, Harman; Kumar, Vijay; Balsera, Cristina; Wallace, Eric; Khairullah, Quresh; Lesher, Beth; Gào, Xīn; Henderson, Heather; LaFleur, Paula; Delgado, Edna Magaly Gamboa; Alvarez, Melissa M.; Hartley, Janett; McClernon, Marilyn; Walton, Surrey M.; Guest, Steven

doi:10.1097/md.0000000000000293

Cited by 55 publications

(28 citation statements)

References 22 publications

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“…In 2014, Liu et al 30 reviewed and compared the cost associated with urgent-start PD, urgent-start HD, and the dual approach (urgent-start HD followed by urgent-start DP) throughout the first 90 days of treatment. The estimated cost per patient for the first 90 days of urgent-start PD was USD 16,398, versus USD 19,352 and USD 19,400 for urgent-start HD and the dual approach (urgent start HD+PD), respectively.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal dialysis as the first dialysis treatment option initially unplanned

Mendes¹,

Alves²,

Bucuvic³

et al. 2017

Jornal Brasileiro De Nefrologia

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Section: Introductionmentioning

confidence: 99%

Peritoneal dialysis as the first dialysis treatment option initially unplanned

Mendes¹,

Alves²,

Bucuvic³

et al. 2017

Jornal Brasileiro De Nefrologia

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“…Although evidence is still accumulating, reports to date suggest that urgent-start PD is effective, safe and may offer cost savings compared with either urgent-start HD or urgent-start HD followed by PD. [31][32][33] Encourage patient choice and education regarding dialysis modality Following dialysis education, most patients should be given the modality choice between PD and HD. Self-preference for PD is associated with better long-term (>5 years) PD survival.…”

Section: Patient Selectionmentioning

confidence: 99%

Peritoneal dialysis practice in Australia and New Zealand: A call to sustain the action

et al. 2016

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This paper updates a previous ‘Call to Action’ paper (Nephrology 2011; 16: 19–29) that reviewed key outcome data for Australian and New Zealand peritoneal dialysis patients and made recommendations to improve care. Since its publication, peritonitis rates have improved significantly, although they have plateaued more recently. Peritoneal dialysis patient and technique survival in Australian and New Zealand have also improved, with a reduction in the proportion of technique failures attributed to ‘social reasons’. Despite these improvements, technique survival rates overall remain lower than in many other parts of the world. This update includes additional practical recommendations based on published evidence and emerging initiatives to further improve outcomes.

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“…A patient going directly to PD avoids receiving a tunneled venous catheter, with its inherent risk of bacteremia. Other than benefit to the patient, urgent-start PD may be associated with significant cost-savings to the health care system (33). In addition to ensuring that a patient starts on PD, which constitutes less expensive therapy for the same outcome, urgent-start PD is itself associated with an approximately $3000 savings in the first 90 days of therapy according to a recent economic model (33).…”

Section: Subsequent Coursementioning

confidence: 99%

Timing of Initiation of RRT and Modality Selection

Bargman¹

2015

Clinical Journal of the American Society of Nephrology

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There is no shortage of studies and registry data examining outcomes of patients on dialysis and those with a renal transplant. However, recently, there has been a greater focus on the events leading up to the institution of kidney replacement therapy. Associative data suggest that early and consistent predialysis care leads to better outcomes, including greater take-on to home-based therapy, diminished use of tunneled venous hemodialysis catheters, and improved early and even late survival. What transpires during predialysis visits is also important. Simple dissemination of facts to the unprepared patient is unlikely to be effective in moving the patient and family along in the process of the series of choices that have to be made around therapy. A more flexible and circumspect approach is needed, including recognizing when the patient is or is not ready for change. There seems to be no optimal timing of dialysis start that can be applied to the ESRD population as a whole, although the pendulum seems to be swinging back toward symptom-based rather than eGFR-based starts.

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Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States

Abstract: Supplemental Digital Content is available in the text

Cited by 55 publications

References 22 publications

Peritoneal dialysis as the first dialysis treatment option initially unplanned

Peritoneal dialysis as the first dialysis treatment option initially unplanned

Peritoneal dialysis practice in Australia and New Zealand: A call to sustain the action

Timing of Initiation of RRT and Modality Selection

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