Which is better Peritoneal Dialysis or Hemodialysis?
PD, HD, and kidney transplant offer alternative and complementary means to treat ESKD. Most comparative analyses of observational registry studies have demonstrated similar outcomes for PD and HD in patients. A number of studies have shown better early survival (6 to 24 months) for patients treated with PD compared with those treated with HD (lower relative risk of death or higher survival probability favoring PD). While patient involvement in the decision-making process is key, clinician guidance in development of an integrated “ESKD Life Plan” can optimize clinical and lifestyle outcomes when the full spectrum of renal replacement therapies is appropriately sequenced. When possible, initial treatment with PD has the potential to improve early survival, improve transplant results, preserve vasculature for future access, and maintain more downstream renal replacement options. A “PD First” or preferred policy exists in many countries based on clinical as well as economic benefits.