Surprising results for use of dialysis for kidney failure in developing world

Researchers at Lawson Health Research Institute have discovered that developing countries have faster growing rates of use of home-based dialysis (called peritoneal dialysis) for kidney failure than the developed world. Despite home-based dialysis' reduced cost and better outcomes, developed countries (including Canada) are using this form of therapy less.

The study by Dr. Arsh Jain, Lawson researcher and Nephrologist at London Health Sciences Centre, was published in the Journal of American Society Nephrology (JASN) last month. Peritoneal dialysis represents only 11 per cent of dialysis patients worldwide.

While the overall use of peritoneal dialysis for kidney failure is climbing world wide, rates are climbing quickly in developing countries. According to Dr. Jain, peritoneal dialysis is more cost effective than hospital-based dialysis (called hemodialysis). Dr. Jain and his colleagues analyzed records from 1997 to 2008 in 130 countries in order to come up with the conclusion that developed countries are using peritoneal dialysis less.

The study found that 59 per cent of peritoneal patients were treated in developing countries as opposed to 41 per cent in developed countries. Throughout the 12 years of the study, peritoneal dialysis patients in developing countries increased by 24.9 patients per million populations and in developed countries only 21.8 per million populations. Despite this increase the overall proportion of all dialysis patients that are treated with peritoneal dialysis in developed countries has in fact declined by 5.3 per cent, while developing countries have had no change.

"Our findings may impact future business and research innovations," said Dr. Jain. "It may be the developing world and not the developed world that drives future medical innovations in peritoneal dialysis." These results also serve as a call to action for developed countries to increase the use of this effective therapy.