الفهرس | Only 14 pages are availabe for public view |
Abstract Peritoneal dialysis has the advantages of better survival than that of hemodialysis patients during the first few years on dialysis, PD is cheaper than HD except in the countries that import PD solutions cost more than HD, slower deterioration of residual kidney function, improved quality of life, better cardiovascular stability, lower prevalence of HCV infection, PD is an effective dialysis modality for elderly and suitable for patients in remote areas. Although these advantages of PD it is underutilized allover the world and utilization rate is falling except in some countries as Mexico and Hong Kong. The causes of underutilization of PD are the higher cost of PD in the countries that import PD solutions due to lack of indigenous facilities to manufacturing PD fluids, lack of education for nephrologists and nursing, high peritonitis rate and technique failure. Increase PD utilization requires decrease PD cost by local manufacturing of PD solutions, prevention of peritonitis and preservation of residual renal function, prevention of membrane alterations by better dialysis solution or by drugs, providing PD teaching and training for healthcare system, More information about choice of dialysis modalities prior to start of renal replacement therapy may lead to more patients choose PD. |