title: Changes in the worldwide epidemiology of peritoneal dialysis.
abstract: As the global burden of chronic kidney disease continues to increase, so does the need for a cost-effective renal replacement therapy. In many countries, patient outcomes with peritoneal dialysis are comparable to or better than those with haemodialysis, and peritoneal dialysis is also more cost-effective. These benefits have not, however, always led to increased utilization of peritoneal dialysis. Use of this therapy is increasing in some countries, including China, the USA and Thailand, but has proportionally decreased in parts of Europe and in Japan. The variable trends in peritoneal dialysis use reflect the multiple challenges in prescribing this therapy to patients. Key strategies for facilitating peritoneal dialysis utilization include implementation of policies and incentives that favour this modality, enabling the appropriate production and supply of peritoneal dialysis fluid at a low cost, and appropriate training for nephrologists to enable increased utilization of the therapy and to ensure that rates of technique failure continue to decline. Further growth in peritoneal dialysis use is required to enable this modality to become an integral part of renal replacement therapy programmes worldwide.
authors.affiliation: Department of Medicine and Therapeutics, Carol &Richard Yu PD Research Centre, Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
authors.affiliation: Department of Medicine and Therapeutics, Carol &Richard Yu PD Research Centre, Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Kai Ming
authors.initials: KM
authors.lastname: Chow
authors.affiliation: ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Centre, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, Netherlands.
authors.forename: Moniek W M
authors.initials: MW
authors.lastname: Van de Luijtgaarden
authors.affiliation: Department of Nephrology, Division of Medicine, ARTS Building, University of Queensland at Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
authors.affiliation: ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Centre, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, Netherlands.
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.affiliation: Kidney Research Institute and Harborview Medical Center, Division of Nephrology, University of Washington, 325 9th Avenue, BOX 359606, Seattle, Washington 98104, USA.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Mehrotra
authors.affiliation: Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
authors.forename: Sarala
authors.initials: S
authors.lastname: Naicker
authors.affiliation: School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Xue Qing
authors.initials: XQ
authors.lastname: Yu
authors.affiliation: University Hospital Gent, 185, De Pintelaan, BE-9000 Gent, Belgium.
authors.forename: Norbert
authors.initials: N
authors.lastname: Lameire
mesh_terms: D014943:Global Health; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends