Peritoneal Dialysis as Long Term Treatment: Comparison of Technique Survival between Asian and Western Populations

O wing to a lack of precise information from each country and to wide variations in patient selec tion, cost of treatment, supply of consumables, transplantation system, and number of medical staff for continuous ambulatory peritoneal dialysis (CAPD) patients, it was difficult to compare the outcomes of CAPD between Asian and Western countries. Thus, this report deals with the four outstanding centers in Asian and Western countries that had technique survivals of better than 50% for patients 5 years after commencing CAPD. The countries reviewed are Japan (1), Italy (2), the U.K. (3), and Spain (4). The centers in those countries showed very close technique survival for CAPD (Figure 1). I would like to explore the reasons and specific situations that led to patient drop-out at those centers, to find a way to establish longevity of the CAPD modality. By analyzing the causes resulting in dropout, I hope to clarify what we need to do and to develop in future for longevity of CAPD. The current use of peritoneal dialysis (PD) shows wide variation in the selected countries, from the highest use (44%) in the U.K., to 13% in Italy and 8% in Spain, down to the lowest use (5%) in Japan. Regarding PD systems, the "bag-free system" has spread to around 60% -70% of patients. Automated peritoneal dialysis (APD) use was high except in the U.K., and the prevalence of"original straightline systems"was very low in the countries under consideration (Table 1). The most common reasons for withdrawal from CAPD were peritoneal membrane failure (presenting as ultrafiltration (UF) loss and inadequate dialysis),