Peritoneal Dialysis in Developing Countries

Nayak, K.S.; Prabhu, Mayoor V.; Sinoj, K.A.; Subhramanyam, Sreepada; Sridhar, GR

doi:10.1159/000223810

Cited by 19 publications

(16 citation statements)

References 9 publications

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“…6 Patients living in remote and rural locations could use PD as a home-based treatment option. 21,22 PD is sometimes thought to be more expensive than HD in the developing world because staffing costs for HD are low and the costs to import PD supplies are high. 1,3,7,9,22 However, the economics of dialysis vary between countries, and a paucity of well conducted studies makes it difficult to determine if this perception is reality.…”

Section: Resultsmentioning

confidence: 99%

“…21,22 PD is sometimes thought to be more expensive than HD in the developing world because staffing costs for HD are low and the costs to import PD supplies are high. 1,3,7,9,22 However, the economics of dialysis vary between countries, and a paucity of well conducted studies makes it difficult to determine if this perception is reality. 7,9 Several avenues to circumvent financial barriers have been suggested and include increasing local production of PD solutions and promoting international trade agreements to help importing countries avoid expensive tariffs and transportation costs.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Global Trends in Rates of Peritoneal Dialysis

Jain

Blake²,

Cordy³

et al. 2012

Journal of the American Society of Nephrology

460

403

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Although there is a perception that the use of peritoneal dialysis is declining worldwide, compilations of global data are unavailable to test this hypothesis. We assessed longitudinal trends in the use of peritoneal dialysis from 1997 to 2008 in 130 countries. The preferred data sources were renal registries, followed by nephrology societies, health ministries, academic centers, national experts, and industry affiliates. In 2008, there were approximately 196,000 peritoneal dialysis patients worldwide, representing 11% of the dialysis population. In total, 59% were treated in developing countries and 41% in developed countries. Over 12 years, the number of peritoneal dialysis patients increased in developing countries by 24.9 patients per million population and in developed countries by 21.8 per million population. The proportion of all dialysis patients treated with peritoneal dialysis did not change in developing countries but significantly declined in developed countries by 5.3%. The use of automated peritoneal dialysis increased by 14.5% in developing countries and by 30.3% in developed countries. In summary, the number of patients treated with peritoneal dialysis rose worldwide from 1997 to 2008, with a 2.5-fold increase in the prevalence of peritoneal dialysis patients in developing countries. The proportion of all dialysis patients treated with this modality continues to decline in developed countries. Chronic dialysis is a life-sustaining treatment for patients with ESRD. Access to dialysis remains limited in several regions of the world due to a lack of financial and clinical resources. [1][2][3][4][5][6][7][8][9] As countries look to develop dialysis programs to manage the growing burden of ESRD, it is important to place patterns of peritoneal dialysis (PD) use in the global context. This information is particularly helpful to individuals in member nations responsible for health care delivery to evaluate their PD programs through comparisons with countries of similar socioeconomic structure.A comprehensive global assessment of PD use to date has been lacking. One study suggested that 11% of chronic dialysis patients around the world are treated with PD. 10 Several renal registries report PD use at a national and regional level, 11-14 but not on a global scale. There is a perception that PD use is declining worldwide. However, studies that showed declining PD use in the developed world are limited by the number of countries considered and the length of time examined. 3,[15][16][17] No study has examined the global use of different PD modalities over a significant period of time, including continuous ambulatory PD (CAPD) and automated PD (APD). For these reasons, we assessed PD use worldwide by compiling data from multiple sources over a 12-year period. We examined the trends in PD use across developing and developed nations, focusing on crude numbers, prevalence per million population, and the proportion of dialysis patients who received PD. We hypothesized an increasing PD prevalence in the dev...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Global Trends in Rates of Peritoneal Dialysis

Jain

Blake²,

Cordy³

et al. 2012

Journal of the American Society of Nephrology

460

403

View full text Add to dashboard Cite

show abstract

“…In the PD group, infection predominated as the main cause of clinical complications and death (Figure 1). Infection is known to be a relevant issue in developing countries (32)(33)(34)(35). Nevertheless, the causes and their impacts on costs for infections must be further investigated.…”

Section: Discussionmentioning

confidence: 99%

A Cost Evaluation of Peritoneal Dialysis and Hemodialysis in the Treatment of End-Stage Renal Disease in São Paulo, Brazil

et al. 2012

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♦ Objective: Conventional hemodialysis (HD) predominates over peritoneal dialysis (PD) around the world. Prospective and comparative studies comparing the costs of these modalities are scarce. In the present prospective assessment, we describe the resources used and total patient costs for both HD and PD. ♦ Methodology: We assessed 249 patients on HD and 228 on PD. All patients were 18 years of age or older and on stable dialysis. The information was collected at three points over 1 year, using standard questionnaires. The sources for costs were the Brazilian public and private health care systems. Societal perspective was considered. ♦ Statistical Analysis: Core trends and dispersions were measured. Regression models assessed the impact of modality on the average total cost per patient per year. ♦ Results: Of the 249 HD patients and 228 PD dialysis patients, 189 (74%) and 160 (70%) respectively completed follow-up. The mean age for women was 55.8 years; for men, it was 59.8 years (p = 0.001). The average total cost per patient-year was US$28 570 for HD and US$27 158 for PD. By category, the costs consisted of direct medical-hospital costs (82.3% for HD, 86.5% for PD), direct nonmedical costs (5.3% for HD, 3.7% for PD), and indirect costs (12.4% for HD, 9.8% for PD). Overall costs were less for PD patients than for their HD counterparts (p = 0.025). ♦ Conclusions: Maintenance dialysis represented the most important source of costs for both modalities; loss of productivity incurred significant costs. Future studies should contemplate the social consequences arising from each modality.

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“…Moreover, the improvements observed in patient and technique survival in PD over the last decade have exceeded those observed in HD (2). PD also has many other advantages, including cost savings, preservation of residual renal function, relative high quality of life, and greater capacity to serve more ESRD patients due to its lower infrastructure requirements (3). Therefore, PD is the preferred modality of RRT in many dialysis units in China as it can meet the great demand for dialysis treatment of the rapidly increasing ESRD population.…”

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confidence: 99%