Can Peritoneal Dialysis Be The First-Line Treatment For End-Stage Kidney Disease? A SWOt Analysis
DOI:
https://doi.org/10.57218/jkj.Vol4.Iss2.1896Kata Kunci:
Kidney replacement therapy, Peritoneal dialysis, SWOT analysisAbstrak
End-stage kidney disease (ESKD) is a global health challenge, with kidney transplantation being the preferred treatment. However, due to a shortage of donor organs and medical complications, many patients rely on dialysis. Peritoneal dialysis (PD) is a promising alternative but is underused compared to hemodialysis (HD). This study explores whether PD could be considered a first-line treatment for ESKD, using a SWOT analysis to assess its strengths, weaknesses, opportunities, and threats. Method Systematic literature review (2015–2025) with SWOT framework. PD improves patients' quality of life with treatment flexibility and better preservation of kidney function. However, the risk of infection such as peritonitis is a weakness in the widespread use of PD therapy in the elderly and remote areas. The development of PD use requires government support in equalizing the distribution of healthcare professionals skilled in PD and providing reasonable cost reimbursement. PD has the potential to be an effective first-line treatment for ESKD, but its widespread use is constrained by various challenges. Addressing these barriers could enhance its accessibility and efficacy.
Referensi
Afrilia, L. C., Atmojo, J. T., & Syauqi, A. (2024). Efektifitas Continuous Ambulatory Peritoneal Dialysis (CAPD) Pada Penderita Gagal Ginjal: Litelatur Review. Journal of Language and Health, 5.
Bello, A. K., Okpechi, I. G., Osman, M. A., Cho, Y., Cullis, B., Htay, H., Jha, V., Makusidi, M. A., McCulloch, M., Shah, N., Wainstein, M., & Johnson, D. W. (2022). Epidemiology of peritoneal dialysis outcomes. In Nature Reviews Nephrology (Vol. 18, Issue 12, pp. 779–793). Nature Research. https://doi.org/10.1038/s41581-022-00623-7
Bitar, W., Helve, J., Kanerva, M., Honkanen, E., Rauta, V., Haapio, M., & Finne, P. (2023). Severe infections in peritoneal dialysis and home hemodialysis patients: An inception cohort study. PLoS ONE, 18(6). https://doi.org/10.1371/journal.pone.0286579
Chander, S., Luhana, S., Sadarat, F., Parkash, O., Rahaman, Z., Wang, H. Y., Kiran, F., Lohana, A. C., Sapna, F., & Kumari, R. (2024). Mortality and mode of dialysis: meta-analysis and systematic review. BMC Nephrology, 25(1). https://doi.org/10.1186/s12882-023-03435-4
Cheng, L., Hu, N., Song, D., & Chen, Y. (2024). Mortality of Peritoneal Dialysis versus Hemodialysis in Older Adults: An Updated Systematic Review and Meta-Analysis. Gerontology, 70(5), 461–478. https://doi.org/10.1159/000536648
Chuasuwan, A., Chuasuwan, A., Pooripussarakul, S., Thakkinstian, A., Ingsathit, A., Ingsathit, A., & Pattanaprateep, O. (2020). Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: A systematic review and meta-analysis. Health and Quality of Life Outcomes, 18(1). https://doi.org/10.1186/s12955-020-01449-2
Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (Pico) as a search strategy tool on literature search quality: A systematic review. Journal of the Medical Library Association, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345
Feng, X., Hou, N., Chen, Z., Liu, J., Li, X., Sun, X., & Liu, Y. (2023). Secular trends of epidemiologic patterns of chronic kidney disease over three decades: an updated analysis of the Global Burden of Disease Study 2019. BMJ Open, 13(3). https://doi.org/10.1136/bmjopen-2022-064540
Karkar, A., & Wilkie, M. (2023). Peritoneal dialysis in the modern era. In Peritoneal Dialysis International (Vol. 43, Issue 4, pp. 301–314). SAGE Publications Inc. https://doi.org/10.1177/08968608221114211
Khan, S. F. (2023). Updates on Infectious and Other Complications in Peritoneal Dialysis: Core Curriculum 2023. In American Journal of Kidney Diseases (Vol. 82, Issue 4, pp. 481–490). W.B. Saunders. https://doi.org/10.1053/j.ajkd.2023.03.011
Li, P., Cao, X., Liu, W., Zhao, D., Pan, S., Sun, X., Cai, G., Zhou, J., & Chen, X. (2023). Peritoneal Dialysis Care in Mainland China: Nationwide Survey. JMIR Public Health and Surveillance, 9. https://doi.org/10.2196/39568
Lok, C. E., Yuo, T., & Lee, T. (2025). Hemodialysis Vascular Access: Core Curriculum 2025. In American Journal of Kidney Diseases (Vol. 85, Issue 2, pp. 236–252). W.B. Saunders. https://doi.org/10.1053/j.ajkd.2024.05.021
Lubitz, A., & Woo, K. (2024). Choice of dialysis access: Catheter, peritoneal, or hemodialysis. Seminars in Vascular Surgery, 37(4), 369–374. https://doi.org/10.1053/j.semvascsurg.2024.09.003
Matrisch, L., & Rau, Y. (2024). Center Hemodialysis Versus Peritoneal Dialysis: A Cost-Utility Analysis. CUREUS JOURNAL OF MEDICAL SCIENCE, 16(3). https://doi.org/10.7759/cureus.55667
Morelle, J., Lambie, M., Öberg, C. M., & Davies, S. (2024). The Peritoneal Membrane and Its Role in Peritoneal Dialysis. Clinical Journal of the American Society of Nephrology, 19(2), 244–253. https://doi.org/10.2215/CJN.0000000000000282
Moura-Neto, J. A., Modelli de Andrade, L. G., Moura, A. F., & Cruz, C. M. S. (2025). A Decade of Change in Peritoneal Dialysis in Brazil: Challenges and Perspectives in the Public Health System. Healthcare (Switzerland), 13(3). https://doi.org/10.3390/healthcare13030337
Novelia, E., Nugraha, R. R., & Thabrany, H. (2017). Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis. Jurnal Ekonomi Kesehatan Indonesia, 1(3). https://doi.org/10.7454/eki.v1i3.1776
Okpechi, I. G., Jha, V., Cho, Y., Ye, F., Ijezie, C. I., Jindal, K., Klarenbach, S., Makusidi, M. A., Okpechi-Samuel, U. S., Okwuonu, C., Shah, N., Thompson, S., Tonelli, M., Johnson, D. W., & Bello, A. K. (2022). The case for increased peritoneal dialysis utilization in low- and lower-middle-income countries. Nephrology, 27(5), 391–403. https://doi.org/10.1111/nep.14024
Park, B. H., Shin, H. S., Kim, J., Lee, J., Park, J. H., Ko, G. J., Hwang, W. M., Kim, D. H., & Lee, Y. K. (2024). Effects of shared decision-making on the prognosis of peritoneal dialysis patients. Medicine, 103(47), e40659. https://doi.org/10.1097/MD.0000000000040659
Puyt, R. W., Lie, F. B., & Wilderom, C. P. M. (2023). The origins of SWOT analysis. Long Range Planning, 56(3). https://doi.org/10.1016/j.lrp.2023.102304
Sahib, A., Choudhury, C., Wani, I. A., & Wani, M. M. (2024). Evaluation of Inflammatory Status in Chronic Kidney Disease Patients and a Comparison Between Hemodialysis and Peritoneal Dialysis Patients. Cureus. https://doi.org/10.7759/cureus.69443
Sitjar-Suñer, M., Suñer-Soler, R., Bertran-Noguer, C., Masià-Plana, A., Romero-Marull, N., Reig-Garcia, G., Alòs, F., & Patiño-Masó, J. (2022). Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis. Healthcare (Switzerland), 10(11). https://doi.org/10.3390/healthcare10112144
Ting, R., Borkum, M., Ni, L. T., & Levin, A. (2025). Patient screening and assessment for home dialysis therapies: A scoping review. In Peritoneal Dialysis International (Vol. 45, Issue 1, pp. 7–16). SAGE Publications Inc. https://doi.org/10.1177/08968608241266130
Tjahjodjati, T., Kuddah, Y., & Wijayanti, Z. (2023). Continuous Ambulatory Peritoneal Dialysis Cost-Effectiveness in National Health Insurance Era of Indonesia. Majalah Kedokteran Bandung, 55(4), 260–263. https://doi.org/10.15395/mkb.v55n4.2372
Walker, R. C., Walker, C., Reynolds, A., Haselden, R., Hay, S., & Palmer, S. C. (2024). Consumer values, perspectives and experiences of psychological health when living with dialysis at home: An in-depth interview study. Peritoneal Dialysis International, 44(3), 185–193. https://doi.org/10.1177/08968608231202899
Yang, Y., Chen, H. H., Quinn, R. R., Dubin, J. A., & Oliver, M. J. (2025). Predictive models on patients’ eligibility for peritoneal dialysis. Peritoneal Dialysis International. https://doi.org/10.1177/08968608251317463.
