Abstract
Variation in Peritoneal Dialysis (PD) Utilization among Large Dialysis Organizations (LDOs):An Explanation for PD Decrease? Osman Khawar, Kamyar Kalantar-Zadeh, Uyen Duong, Linda Fried, Keith Norris, Allen Nissenson and Rajnish Mehrotra LA BioMed at Harbor-UCLA, Torrance, CA, David Geffen School of Medicine at UCLA, Los Angeles, CA, Charles Drew University, Los Angeles, CA, VA Pittsburgh Health Care System, Pittsburgh, PA Background: PD use in the US has declined significantly over the last decade, while dialysis delivery has become consolidated in LDOs. We examined the PD utilization in LDOs over a 9-year period (1996-2004) and the effects of consolidation of dialysis delivery on modality distribution. Methods: Using data of all incident patients from United States Renal Data System, dialysis modality on day 90 of ESRD and odds ratio for PD use were determined, using non-chain units as the reference. Results: A progressive decline in the proportion of incident ESRD patients undergoing treatment in non-chain unit occurred from 61% in 1996 to 37% in 2004. In 2004, 24% of incident patients were treated in Fresenius, 14% in DaVita and 13% in Gambro. The Multivariate adjusted odds for PD were examined (Figure):
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