Choice of Hemodialysis or Peritoneal Dialysis for Kidney Replacement Therapy

The choice of dialysis modality at the initiation of kidney replacement therapy has also been studied and discussed extensively in recent decades. There is still no final consensus on whether hemodialysis (HD) or peritoneal dialysis (PD) treatment modality gives the best results. This chapter gives an overview of the current literature on the optimal timing of dialysis initiation and on the best dialysis modality choice. Important outcomes for the evaluation of initial dialysis modality are patient survival, Quality of Life, and values of biochemical parameters. Differences in dialysis modality-specific practice patterns between continents or countries may influence modality-specific patient survival. The chapter presents a comparison of mortality between HD and PD patients: a selection of recent large studies based on renal registry data. Patients should be educated about potential advantages and disadvantages of both treatment modalities before the start of dialysis, so that they can make a well-informed choice together with their physician.