The following is a summary of “Effect of End-Stage Renal Disease Prospective Payment System on Utilization of Peritoneal Dialysis in Patients with Kidney Allograft Failure,” published in the May 2024 issue of Nephrology by Gardezi et al.
In 2011, the Center for Medicare and Medicaid Services (CMS) launched the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) to encourage home dialysis use, such as Peritoneal dialysis (PD). Studies found PD increased post-PPS, but its effect on kidney allograft failure patients remains unclear.
Researchers conducted a retrospective study to examine PPS’s impact on PD use in kidney transplant patients with allograft failure.
They analyzed United States Renal Data System (USRDS) data from 2005 to 2019, comparing PD use before (2005-2010) and after (2014-2019) PPS for early (within 90 days) and late (91-365 days) PD experience.
The results showed that 27,507 patients started dialysis. There was no significant difference in early PD use pre- and post-PPS (0.3% increase; 95% CI; -1.95% to 2.54%, P=0.79) or rate of change over time (0.28% increase per year, 95% CI: -0.16% to 0.72%, P=0.18). Some increase in PD use was seen post-PPS in for-profit and large-volume dialysis units, especially those with low pre-PPS PD experience and late PD experience.
Investigators concluded that PPS did not notably boost PD use in patients starting dialysis after allograft failure.
