Underutilization of Home Dialysis in the United States: missed opportunities for quality improvement.

Abstract

Peritoneal dialysis may offer many potential advantages over in-center hemodialysis: lower cost, better quality of care and lower mortality. However, the United States Renal Data System (USRDS) which is a national data system that collects, analyzes, and distributes information about chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States, indicates that the incidence and prevalence of home dialysis remains under-utilized compared with in-center hemodialysis. Future changes in national policy on dialysis may bring about an increase in home dialysis and potentially improve the care and cost in dialysis. This paper is mostly based on the 2017 USRDS Annual Report and centered on the potential missed opportunity caused by the underuse of peritoneal dialysis in the US.