Despite their advantages, peritoneal dialysis and home hemodialysis remain unpopular modalities.
By the end of 2006, approximately 355,000 individuals were undergoing dialysis in the United States. Only 8.2% of them were on peritoneal dialysis (PD). The rest were on hemodialysis (HD), according to a 2008 U.S. Renal Data System (USRDS) report.
After a high of 9,407 new patients in 1995, the number of new PD users every year has fallen to 6,725 and accounts for just 6.2% of new dialysis patients—a number that continues to decline from a 1982-1985 peak of 15%, the report noted.
“Fundamentally there’s very limited enthusiasm among providers and companies for the use of peritoneal dialysis,” observes Rajnish Mehrotra, MD, associate professor of medicine at the David Geffen School of Medicine, University of California-Los Angeles (UCLA) and associate chief and director for peritoneal dialysis in the division of nephrology and hypertension at Harbor-UCLA Medical Center.
For Dr. Mehrotra, four main issues limit the use of PD:
Concerns about outcomes.
Lack of infrastructure.