Prioritize PD to extend residual kidney function

Residual Kidney Function (RKF) is associated with improved survival

The majority of patients starting dialysis have residual kidney function (RKF).

RKF is associated with better patient survival

Prospective randomized trials of dialysis adequacy and observational studies have confirmed an association between the presence of RKF and improved patient survival during chronic PD therapy

Each 250 mL increase in daily urine volume is associated with a 36% lower relative risk of death¹
A residual GFR increase of 1 mL/min/1.73 m2 has been shown to give a 12% reduction in relative risk of death²

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PD allows a better preservation of RKF than Hemodialysis (HD), favoring starting on PD first

Evidence shows that patients treated with PD compared with those treated with HD have:

A slower rate of decline of residual glomerular filtration rate (rGFR) and creatinine clearance³
A longer time to loss of RKF^1-3

THE TIME IS RIGHT FOR PD

References

Jansen MA, et al. Predictors of the rate of decline of residual renal function in incident dialysis patients. Kidney Int. 2002;62:1046-1053.
Bargman, J. M., Thorpe, K. E. and Churchill, D. N. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: a reanalysis of the CANUSA study. J Am Soc Nephrol. 2001; 12(10): 2158-2162.
Termorshuizen, F., Korevaar, J. C., Dekker, F. W., van Manen, J. G., et al. The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. Am J Kidney Dis. 2003b; 41(6): 1293-1302.