kidney disease (ESRD) is a condition in which the kidneys completely fail to
function. A normally functioning kidney removes wastes and excess water from
the body. ESRD usually walks in when chronic kidney disease has reduced the
functionality of kidney to less than 10 % of normal. Diabetes and high blood
pressure (Hypertension) are two common causes for ESRD. Patients with ESRD
often require dialysis. Dialysis is a process where blood is cleansed by
passing through a membrane. Thus the cleansing action of kidney is artificially
done. There are two types of dialysis: Haemodialysis (HD) and peritoneal
haemodialysis (HD) harmful wastes of the body such as extra salt and water are
filtered off from the blood using an osmosis process of filteration that is
monitored by an electronically run machine; while in peritoneal dialysis (PD)
the natural lining of the abdomen (called peritoneal membrane) are used for the
exchange. In peritoneal dialysis, a fluid is
introduced into the abdomen by a tube. This fluid extracts water, salts and
waste products from the blood through osmosis and then the fluid is drained out
of the body through the same tube..
is less expensive when compared to HD in some countries as it does not involve
hospitalisation or a caregiver and can be done by the patient at home. However
there were doubts regarding the risks associated with PD, especially the risk
of infection. This doesn't mean that HD is a relatively safer method. Thus both PD and HD have benefits and
While in HD the patient has to be hospitalised for short duration of
the day three-four times a week, PD is done daily
upto thrice a day.
The study looked at data from three
3-year cohorts (1996 - 1998, 1999 - 2001, and 2002 - 2004) in the US Renal Data
System. Earlier studies pointed to higher risks
for death in patients treated with PD, but this has been proved wrong.
There is no significant difference in
the risk for death for HD and PD patients through 5 years of follow-up.
The study authors conclude that "However, the improvement in
PD outcomes may have been a result of more selective assignment of patients to
the therapy over the last decade. Thus, should such an expansion of PD use be
undertaken, close monitoring of outcomes of patients treated with different
dialysis modalities should continue."