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Kidney and Dialysis
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Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead
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Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead

A special issue of Kidney and Dialysis (ISSN 2673-8236).

Deadline for manuscript submissions: closed (30 March 2025) | Viewed by 1896

Special Issue Editors

Prof. Dr. Jaime Uribarri

E-Mail Website
Guest Editor
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Interests: diabetes; chronic kidney disease; dietary advanced glycation end products; dietary phosphorus; acid–base metabolism
Special Issues, Collections and Topics in MDPI journals
Dr. Osama El Shamy

E-Mail Website
Guest Editor
Department of Medicine, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA
Interests: peritoneal dialysis; hemodialysis; chronic kidney disease; acute kidney injury

Special Issue Information

Dear Colleagues,

The Special Issue “Procedure & Physiology, Complications, and the Future Ahead” aims to compile an insightful collection of manuscript reviews centered around peritoneal dialysis (PD), a vital kidney replacement therapy for patients with chronic kidney disease or end-stage renal disease.

This Special Issue will explore the current state of clinical practices and outcomes in peritoneal dialysis, highlighting its role in the management of kidney disease, as well as explore future challenges and current research. Topics to be discussed will include, but not be limited to: the intricacies of the PD procedure, modality options [Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD)], the development of more efficient dialysate solutions, and innovative approaches to minimize the risk of infections and other complications. Additionally, this issue will address outcomes and results of PD, focusing on its efficacy in waste removal, the impact on nutritional status and the quality of life it offers to patients.

We welcome you to submit your latest original articles or reviews to provide clinicians with the latest insights related to this field.

Prof. Dr. Jaime Uribarri
Dr. Osama El Shamy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Kidney and Dialysis is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • peritoneal dialysis
  • complications
  • innovation
  • infection

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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10 pages, 424 KiB  
Article
Anemia Is a Predictor of Withdrawal from Peritoneal Dialysis in Stable Peritoneal Dialysis Patients
by Kenta Torigoe, Emiko Otsuka, Kiyokazu Tsuji, Ayuko Yamashita, Mineaki Kitamura, Takahiro Takazono, Noriho Sakamoto, Kumiko Muta, Hiroshi Mukae and Tomoya Nishino
Kidney Dial. 2025, 5(2), 15; https://doi.org/10.3390/kidneydial5020015 - 14 Apr 2025
Viewed by 229
Abstract
Introduction: The association between anemia and peritoneal dialysis (PD) withdrawal in patients with stable PD remains poorly established. Herein, we investigated the relationship between anemia and PD withdrawal in patients with stable PD. Materials and Methods: We included 43 patients undergoing PD for [...] Read more.
Introduction: The association between anemia and peritoneal dialysis (PD) withdrawal in patients with stable PD remains poorly established. Herein, we investigated the relationship between anemia and PD withdrawal in patients with stable PD. Materials and Methods: We included 43 patients undergoing PD for at least 6 months between October 2011 and December 2022. Patients were categorized based on their hemoglobin (Hb) levels at the time of their first peritoneal equilibration test (PET) during the study period as follows: Hb ≥ 11 g/dL and Hb < 11 g/dL. The PD withdrawal rates were compared between these groups. Patients were followed up until death or 31 July 2023. Results: During the follow-up, 36 patients discontinued treatment. Patients with Hb < 11 g/dL had a significantly higher PD withdrawal rate than those with Hb ≥ 11 g/dL. Cox proportional hazards analysis identified Hb level as a risk factor for PD withdrawal. Furthermore, Hb levels negatively correlated with the annual decline in urine volume. Conclusions: Our findings suggest anemia as a predictor of PD withdrawal in patients with stable PD. The negative correlation between Hb levels and the annual decline in urine volume implies that anemia may contribute to PD withdrawal via the deterioration of residual renal function. Full article
(This article belongs to the Special Issue Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead)
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Review

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14 pages, 1068 KiB  
Review
Artificial Intelligence and Its Future Impact on Peritoneal Dialysis
by Hailey E Yetman and Lili Chan
Kidney Dial. 2025, 5(2), 20; https://doi.org/10.3390/kidneydial5020020 - 14 May 2025
Viewed by 137
Abstract
Artificial intelligence (AI) has become commonplace in our everyday lives and in healthcare. Peritoneal dialysis (PD) is a cost-effective method of treatment for kidney failure that is preferred by many patients, but its uptake is limited by several barriers. With the rapid advancements [...] Read more.
Artificial intelligence (AI) has become commonplace in our everyday lives and in healthcare. Peritoneal dialysis (PD) is a cost-effective method of treatment for kidney failure that is preferred by many patients, but its uptake is limited by several barriers. With the rapid advancements in AI, researchers are developing new tools that could mitigate some of these barriers to promote uptake and improve patient outcomes. AI has the capacity to assist with patient selection and management, predict patient technique failure, predict patient outcomes, and improve accessibility of patient education. Patients already have access to some open-source AI tools, and others are being rapidly developed for implementation in the dialysis space. For ethical implementation, it is essential for providers to understand the advantages and limitations of AI-based approaches and be able to interpret the common metrics used to evaluate their performance. In this review, we provide a general overview of AI with information necessary for clinicians to critically evaluate AI models and tools. We then review existing AI models and tools for PD. Full article
(This article belongs to the Special Issue Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead)
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12 pages, 856 KiB  
Review
Phosphate Homeostasis in Chronic Kidney Disease with Emphasis in Peritoneal Dialysis
by Jaime Uribarri
Kidney Dial. 2025, 5(2), 17; https://doi.org/10.3390/kidneydial5020017 - 2 May 2025
Viewed by 253
Abstract
Hyperphosphatemia in dialysis patients is associated with adverse outcomes including bone mineral disease, increased total mortality, and cardiovascular mortality. Therefore, maintaining serum phosphate levels within limits is an important aspect of the clinical care of peritoneal dialysis patients. Unfortunately, hyperphosphatemia is commonly seen [...] Read more.
Hyperphosphatemia in dialysis patients is associated with adverse outcomes including bone mineral disease, increased total mortality, and cardiovascular mortality. Therefore, maintaining serum phosphate levels within limits is an important aspect of the clinical care of peritoneal dialysis patients. Unfortunately, hyperphosphatemia is commonly seen in the majority of dialysis patients, at least in the USA, despite apparent optimal dietary and pharmacological intervention and adequate dialysis. Herein, we review major aspects of body phosphate homeostasis in healthy subjects and in dialysis patients in order to provide a good background understanding for a more rational approach to manage serum phosphate. Of note, the phosphate concentration measured in blood by clinical laboratories represents a minute portion of the total body phosphate content but the only one that we can easily access at present; this aspect is discussed in detail in this review. We emphasize the curtailment not only of the total oral phosphate intake but also the intake of highly bioavailable phosphate; this, together with the right use of oral phosphate binders and appropriate dialysis, is an important tool. Emerging therapies with agents that block intestinal absorption of phosphate may offer a promising four-pronged approach to phosphate management. Full article
(This article belongs to the Special Issue Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead)
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12 pages, 524 KiB  
Review
Prescribing Peritoneal Dialysis for Elderly Patients Starting Peritoneal Dialysis
by Andrew Davenport
Kidney Dial. 2025, 5(2), 13; https://doi.org/10.3390/kidneydial5020013 - 7 Apr 2025
Viewed by 231
Abstract
Increased availability of dialysis services has led to both an increase in the number of elderly, frail, co-morbid patients with advanced chronic kidney disease now being offered dialysis and starting dialysis with residual kidney function. Traditionally, these patients would have been offered in-centre [...] Read more.
Increased availability of dialysis services has led to both an increase in the number of elderly, frail, co-morbid patients with advanced chronic kidney disease now being offered dialysis and starting dialysis with residual kidney function. Traditionally, these patients would have been offered in-centre haemodialysis. However, the introduction of an assisted peritoneal dialysis service has allowed more of these elderly patients to be considered for peritoneal dialysis, a home-based treatment, with the exchanges performed by family members or visiting health care staff. It is now realised that the amount of dialytic clearance any individual requires varies, and as such, treatment targets have changed over time from achieving minimum clearance targets to a more holistic approach, considering patient lifestyles, and adapting dialysis prescriptions and schedules to the needs of the individual patient. As dietary intake is often lower in the elderly, coupled with the physiological loss of muscle mass, this results in a reduced generation of waste products of metabolism and consequently requires less dialytic clearance. Thus, this allows many elderly patients to benefit from an incremental approach to starting peritoneal dialysis, potentially beginning with only one or two continuous ambulatory peritoneal dialysis exchanges, or an overnight cycler for only a few nights/week. Full article
(This article belongs to the Special Issue Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead)
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Other

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10 pages, 422 KiB  
Commentary
Annotated Barriers to Peritoneal and Home Hemodialysis in the U.S.
by Thomas A. Golper
Kidney Dial. 2025, 5(2), 18; https://doi.org/10.3390/kidneydial5020018 - 9 May 2025
Viewed by 176
Abstract
In the last decade, barriers to the growth and utilization of home dialysis have been described in mainstream and significant Nephrology journals. Since then, the suggested solutions have received little attention or have proven ineffective. This situation is even more significant because, in [...] Read more.
In the last decade, barriers to the growth and utilization of home dialysis have been described in mainstream and significant Nephrology journals. Since then, the suggested solutions have received little attention or have proven ineffective. This situation is even more significant because, in 2019, President Trump issued an executive order to increase the utilization of home dialysis and transplantation. The reasons for failing to achieve the stated goals of the executive order are numerous and can be attributed to barriers at many levels in the health care system. Some of the barriers are unique to the United States and learning from foreign systems would be beneficial. This correspondence attempts to describe and annotate these barriers. I classify them such that local institutions can identify and prioritize solutions. Home dialysis growth can only occur with all stakeholders committing to that end. Full article
(This article belongs to the Special Issue Peritoneal Dialysis: Procedure & Physiology, Complications, and the Future Ahead)
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