The Future of Peritoneal Dialysis in the United States

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Abstract
Peritoneal dialysis (PD) has been used to treat patients with stage V chronic kidney disease since 1976. However, despite this long history, as of 2008 versus center hemodialysis has been improving, tending to favor those on PD for longer and longer periods of time. Infectious complications have also been markedly reduced. It is anticipated that changes in government reimbursement, such as the bundling of dialysis-related services, will stimulate a renewed interest in home therapies. Currently most home dialysis units are small, and some have minimal clinical experience with PD. If trends in reimbursement do favor a renewed interest in PD, for patient outcomes on PD to continue to improve, there will likely need to be further educational activities focused on PD, and perhaps, consolidation of PD programs may needed.