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International Journal of Nephrology
Volume 2011 (2011), Article ID 434608, 7 pages
http://dx.doi.org/10.4061/2011/434608
Review Article

Peritoneal Dialysis Drop-out: Causes and Prevention Strategies

1Division of Nephrology, Harry S. Truman Veterans Medical Center, Columbia, MO 65203, USA
2Division of Nephrology, Department of Internal Medicine, University of Missouri, 1 Hospital Drive, CE 422, Columbia, MO 65212, USA

Received 30 June 2011; Revised 22 August 2011; Accepted 28 August 2011

Academic Editor: Alejandro Martín-Malo

Copyright © 2011 Kunal Chaudhary. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peritoneal dialysis (PD) as a renal replacement therapy (RRT) has become wide spread since its inception more than twenty-five years back. Since then, several advances have been made and PD has been accepted as an alternative therapy to hemodialysis (HD), with excellent survival, lower cost, and improved quality of life. In spite of comparable survival of HD and PD, improved PD techniques over the last few years, and lower health care costs with PD, PD prevalence remains low in many countries. An important reason for the low PD prevalence is patient dropouts, that is, transfer to HD. The reasons for dropouts are multifactorial, that is, modality related, system related, and patient related. These include episodes of peritonitis, catheter-related problems, ultrafiltration failure, patient fatigue, and provider comfort. This review discusses the various factors that contribute to PD dropout and the strategies to prevent it.