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January 24, 2011

Choice of Dialysis Modality in the United States

Arch Intern Med. 2011;171(2):107-109. doi:10.1001/archinternmed.2010.370

Over 100 000 patients started dialysis in 2007, the most recent year for which data are available.1 Although kidney transplantation is considered the best choice for renal replacement therapy on the basis of survival and quality of life, many patients are not eligible for transplantation. This factor, plus a shortage of available organs, means that many patients with end-stage renal disease (ESRD) undergo prolonged dialysis therapy. Most patients who need renal replacement therapy start on some form of dialysis, either hemodialysis (HD), usually performed in-center 3 times per week, or peritoneal dialysis (PD), usually done by the patient at home. Which modality is preferable, and for which patients, has been the subject of controversy since the inception of PD in the 1970s.