What question did this study set out to answer?

The aim is to describe national trends in the adoption and growth of peritoneal dialysis programs in the U.S. from 2010 to 2021.

May 11, 2026Kidney Medicine0 citationsOpen Access

The Changing Landscape of Peritoneal Dialysis in America: A Facility-Level Analysis of Growth

ASAnkur D. Shah SSSandipan Shringi AAAfzal Ariff

Key Points

The aim is to describe national trends in the adoption and growth of peritoneal dialysis programs in the U.S. from 2010 to 2021.
Retrospective serial cross-sectional study of Medicare-certified dialysis facilities from 2010 to 2021.
Analyzed changes in facility PD program presence and mean census using mixed-effects logistic and negative binomial models.
Adjusted for region, organizational size, profit status, and urbanicity.
The percentage of U.S. dialysis facilities with active PD programs increased from 38.4% in 2010 to 44.6% in 2021.
Facilities providing PD had higher odds of initiating programs (OR 1.61, 95% CI 1.35-1.92).
Active PD programs treated 50% more patients over the years (IRR 1.50, 95% CI 1.45-1.56), with regional variations noted.

Abstract

Rationale (2) PD census among facilities with active PD programs.Analytical Approach: We applied mixed-effects logistic and negative binomial models with random facility effects to estimate changes in PD program presence and mean census over time.Models adjusted for region, organizational size, profit status, and urbanicity, and included interaction terms to test for heterogeneity in temporal trends. Results:The number of U.S. dialysis facilities with active PD program increased from 38.4% to 44.6% between 2010 and 2021 and amongst those programs, mean PD census rose from 14.7 to 18.2.Relative to 2010, facilities in 2021 had higher odds of providing PD (OR 1.61, 95% CI 1.35-1.92),and active programs treated substantially more patients (IRR 1.50, 95% CI 1.45-1.56).Non-profit and small dialysis organizations showed the greatest likelihood of initiating PD programs, whereas for-profit and large organizations demonstrated stronger census growth.Regional differences were observed, with the West showing the largest increases in program size.

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