Hemodialysis versus peritoneal dialysis in resource-limited settings

Current Opinion in Nephrology and Hypertension
Abdou NiangValerie A Luyckx

Abstract

To assess the use, access to and outcomes of hemodialysis and peritoneal dialysis in low-resource settings. Hemodialysis tends to predominate because of costs and logistics, however services tend to be located in larger cities, often paid for out of pocket. Outcomes of dialysis-requiring acute kidney injury and end-stage kidney disease may be similar with hemodialysis and peritoneal dialysis, and therefore choice of therapy is dominated by availability, accessibility and patient or physician choice. Some countries have implemented peritoneal dialysis-first policies to reduce costs and improve access, because peritoneal dialysis requires less infrastructure, can be scaled up more easily and can be cheaper when fluids are manufactured locally. Access to both hemodialysis and peritoneal dialysis remains highly inequitable in lower-resource settings. Although challenges associated with dialysis in low-resource settings are similar, and there are more adults who require dialysis in low-resource settings, addressing hemodialysis and peritoneal dialysis needs of children in low-resource settings requires attention as the global inequities are greatest in this area. Lower-income countries are increasingly seeking to improve access to d...Continue Reading

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Citations

Jan 30, 2020·BMJ : British Medical Journal·Yot TeerawattananonWanrudee Isaranuwatchai
Oct 3, 2020·Nature Reviews. Nephrology·Mignon McCullochWilliam E Smoyer
Oct 30, 2020·International Journal of Nephrology and Renovascular Disease·Kevin R MitchellGeorge Bayliss
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Apr 12, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sushmita BanerjeeMelvin Bonilla-Felix
Jun 8, 2021·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Joel Monárrez-EspinoGastón Ramírez-García

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