With its ambulatory nature and freedom from complicated and expensive technology, chronic peritoneal dialysis (PD) is the ideal renal replacement therapy for resource-poor India. Despite being available for more than 15 years, PD has been limited in its growth because of economic factors, inadequate government policies, nephrologist bias, and lack of adequate pre-dialysis care. The number of patients initiated on therapy has increased in recent years, but the number of early dropouts remains high. Single-center studies suggest that contributors to poor outcome include gram-negative peritonitis, malnutrition, and failure to increase the dialysis dose as residual renal function declines. Development of a national PD registry and increased educational activities to position PD as part of integrated therapy for end-stage kidney disease would improve utilization of the PD modality.
United Nations Development Programme (UNDP). Human Development Report 2006. Beyond Scarcity: Power, Poverty and the Global Water Crisis.New York: UNDP; 2006. [Available online at: hdr.undp.org/en/reports/global/hdr2006/; cited 3 January 2008]
2.
ChughKSJhaV.Differences in the care of ESRD patients worldwide: required resources and future outlook. Kidney Int Suppl1995; 50:S7–13.
3.
ChughKSJhaVChughS.Economics of dialysis and renal transplantation in the developing world. Transplant Proc1999; 31:3275–7.
4.
JhaV.End-stage renal care in developing countries: the India experience. Ren Fail2004; 26:201–8.
5.
JhaVChughKS. Dialysis in developing countries: priorities and obstacles. Nephrology (Carlton)1996; 2:65–72.
6.
ModiGKJhaV.The incidence of end-stage renal disease in India: a population-based study. Kidney Int2006; 70:2131–3.
7.
SakhujaVJhaVGhoshAKAhmedSSahaTK. Chronic renal failure in India. Nephrol Dial Transplant1994; 9:871–2.
8.
LacsonEJrKuhlmannMKLevinNWShahKYosinoM.Outcomes and economics of ESRF. In: El-NahasM, ed. Kidney Diseases in the Developing World and Ethnic Minorities.New York: Taylor and Francis; 2005: 15–37.
9.
De VecchiAFDratwaMWiedemannME. Healthcare systems and end-stage renal disease (ESRD) therapies—an international review: costs and reimbursement/funding of ESRD therapies. Nephrol Dial Transplant1999; 14(Suppl 4):31–41.
NissensonARPrichardSBChengIKPGokalRKubotaMMaiorcaR. Non-medical factors that impact on ESRD modality selection. Kidney Int1993; 43(Suppl 40):S120–7.
12.
Cueto–ManzanoAM. Peritoneal dialysis in Mexico. Kidney Int Suppl2003; 83:S90–2.
13.
Santiago–DelpinEACangianoJL. Renal disease and dialysis in Latin America. Transplant Proc1991; 23:1851–4.
14.
MahajanSTiwariSCKalraVBhowmikDMAgarwalSK. Factors affecting the use of peritoneal dialysis among the ESRD population in India: a single-center study. Perit Dial Int2004; 24:538–41.
15.
AbrahamGMathewMGopalakrishnanPSankarasubbaiyanSShroffS.Are three exchanges suitable for Asian patients on peritoneal dialysis?Perit Dial Int2003; 23(Suppl 2):S45–7.
16.
Trevino–BecerraAMaimoneMA. Peritoneal dialysis in the developing world: the Mexican scenario. Artif Organs2002; 26:750–2.
17.
SinghNPGuptaSChandraJAnuradhaSKohliRRizviSN. Continuous ambulatory peritoneal dialysis (CAPD)—an initial Indian experience. J Indian Med Assoc2005; 103:22,24,26 passim.
18.
Keithi–ReddySRGuptaKLJhaVSudKSinghSKKohliHS. Spectrum and sensitivity pattern of gram-negative organisms causing CAPD peritonitis in India. Perit Dial Int2007; 27:205–7.
19.
PrasadNGuptaASharmaRKPrasadKNGulatiSSharmaAP. Outcome of gram-positive and gram-negative peritonitis in patients on continuous ambulatory peritoneal dialysis: a single-center experience. Perit Dial Int2003; 23(Suppl 2):S144–7.
20.
PirainoBBailieGRBernardiniJBoeschotenEGuptaAHolmesC. on behalf of the ISPD Ad Hoc Advisory Committee. Peritoneal dialysis-related infections recommendations: 2005 update. Perit Dial Int2005; 25:107–31.
21.
PrasadKNPrasadNGuptaASharmaRKVermaAKAyyagariA.Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single centre Indian experience. J Infect2004; 48:96–101.
22.
AgarwalDKSharmaAPGuptaASharmaRKPandeyCMKumarR. Peritoneal equilibration test in Indian patients on continuous ambulatory peritoneal dialysis: does it affect patient outcome?Adv Perit Dial2000; 16:148–51.
23.
MahajanSTiwariSCKalraVBhowmikDMAgarwalSKDashSC. Effect of local mupirocin application on exit-site infection and peritonitis in an Indian peritoneal dialysis population. Perit Dial Int2005; 25:473–7.
24.
PrasadNGuptaASharmaRKSinhaAKumarR.Impact of nutritional status on peritonitis in CAPD patients. Perit Dial Int2007; 27:42–7.
25.
PrasadNGulatiSGuptaASharmaRKKumarAKumarR. Continuous peritoneal dialysis in children: a single-centre experience in a developing country. Pediatr Nephrol2006; 21:403–7.
