Abstract: FR-PO0526
Peritoneal Dialysis Growth in the United States, 2010-2021: Differential Patterns by Facility Type and Region
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- Ariff, Afzal Asan, Brown University, Providence, Rhode Island, United States
- Sammartino, Cara, Johnson & Wales University, Providence, Rhode Island, United States
- Raker, Christina A., Rhode Island Hospital, Providence, Rhode Island, United States
- Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background
Peritoneal dialysis (PD) utilization has increased substantially in the United States over the past decade. However, it remains unclear whether this growth has occurred through proliferation of new programs, expansion of existing programs, or both, and how these patterns vary across different facility types.
Methods
We conducted a retrospective serial cross-sectional study analyzing nationwide trends in PD utilization using data from CMS Dialysis Facility Reports. We examined the proportion of facilities offering PD services and mean PD census among active programs, analyzing trends by facility characteristics using mixed-effects regression models.
Results
The proportion of facilities with PD patients increased from 38.4% to 44.6% (2010-2021), while mean census among facilities offering PD rose from 14.7 to 18.2 patients. In adjusted analyses, facilities had 46% higher odds of offering PD services in 2021 compared to 2010 (OR 1.46, 95% CI 1.23-1.73), and among facilities with PD programs, adjusted PD census increased by 50% (IRR 1.50, 95% CI 1.45-1.55). Non-profit facilities showed larger increases in program initiation (OR 4.11, 95% CI 2.53-6.68), while for-profit facilities demonstrated greater census growth (IRR 1.53, 95% CI 1.47-1.58). Regional variations were observed, with the South showing the highest odds of new program initiation (OR 1.80, 95% CI 1.40-2.32) and the West demonstrating the largest increase in PD census (IRR 1.71, 95% CI 1.58-1.85).
Conclusion
PD growth occurred through both establishment of new programs and expansion of existing ones, with non-profit and smaller organizations prioritizing program establishment, while for-profit and larger organizations emphasized expanding existing programs.
Funding
- Other NIH Support