Peritoneal dialysis and its role in the demography and epidemiology of chronic kidney disease.

In a population of patients who have undergone renal replacement therapy, the 21st century brought a rise in the number of elderly people as well as patients with obesity, with renal complications of systemic diseases, especially diabetes and hypertension, and a constantly increasing number of patients with congestive heart failure who require intermittent or permanent dialysis support. In keeping with the concept of an integrated approach to renal replacement therapy, peritoneal dialysis should be the first option in renal replacement treatment, especially in patients with residual renal function. This paper summarizes the current evidence supporting the view that the changing demography and epidemiology of chronic kidney disease imposes an introduction of patient-friendly modifications of therapeutic options available in these patient groups.