The Advantages of Peritoneal Dialysis over Hemodialysis

Abstract

Although kidney transplantation is the definitive treatment of kidney failure, for many reasons, most of patients need dialysis treatment. Despite significant advantages of PD over HD, HD commonly used modality all over the world. PD patients have better survival relative to HD patients in the first year of dialysis. A recent study has shown that the risk of all-cause mortality and infection death were higher in the unplanned HD group than in the unplanned PD group during 1-year follow up. Because of prolonged and gentle removal of body fluids and toxins ,PD reduces the risk of hemodynamic instability. Therefore, PD may be preferred in the treatment of critically ill patients with acute kidney injury (AKI) or end-stage renal disease (ESRD). In a study compared PD with continuous renal replacement therapy in critically ill patient with AKI. Patients in the PD group had lower mortality rate at 28 days, less complication of infections and faster recovery of renal function. Therefore, PD can be applied effectively and safely in critically ill patients with AKI and requiring dialysis. PD confers better quality of life (autonomy, flexibility, avoidance of regular hospital visits for the patients and relatives, travel easily, more free time). PD can be done while sleeping, this allowing patient to travel and do daily activities. PD preserves the residual renal function over HD. PD has freedom of pain in vascular access sites from repeated cannulation for HD and preserves this sites for the future HD. PD has significant economic advantage over HD globally. There is no need for a large number of healthcare workers, dialysis machines, protective equipment and clean water in PD. A meta-analysis has shown that pretransplant