Although several studies have demonstrated the clinical and economic benefits of peritoneal dialysis (PD) compared to hemodialysis (HD), PD as the initial modality is offered at much less than HD patients, causing in Italy the current annual prevalence rate of less than 10%. Making PD the default transition to dialysis therapy not only has clinical benefits for patients, but also for healthcare systems and society. This approach requires a cultural shift in the nephrologist and national and regional health systems, but it is time to make this shift. This article summarizes the views on how to increase the utilization of PD to improve on clinical and economic management of patients with ESRD.
VanholderR., DavenportA., HannedoucheT.. Reimbursement of Dialysis: a Comparison of Seven Countries.J Am Soc Nephrol2012; 23: 1291–8.
13.
Supplemento ordinario n.8 alla Gazzetta Ufficiale, Serie generale, n. 23, Prestazioni specialistiche ambulatoriali. 28–1–2013.
14.
PonceP., MarcelliD., GuerreiroA.. Converting to a capitation system for dialysis payment: the Portuguese experience.Blood Purif2012; 34: 313–24.
15.
MadduxF.W.. Impact of the bundled End-Stage Renal Disease payment system on patient care.Blood Purif2012; 33: 107–11.
16.
CastraleC., EvansD., VergerC.. Peritoneal dialysis in elderly patients: report from the French Peritoneal Dialysis Registry (RDPLF).Nephrol Dial Transplant2010; 25: 255–62.
