Peritoneal dialysis clinical trials: A critical appraisal

Abstract

As is frequently pointed out, the record for clinical trials in patients treated with dialysis is poor, and this is especially the case for peritoneal dialysis. The reasons are complex and include a relatively small patient population, a lack of critical mass (with some exceptions) in trial methodology and infrastructure leading to an overreliance on industry support, the relatively complex outcomes and endpoints that affect patients treated with the modality, and a low repertoire of novel interventions. It would also be fair to say that the outcomes of patients treated with peritoneal dialysis over the last 30 years have improved considerably without these trials, largely because we have learned a lot about the therapy from a number of key observational studies and registry data analyses.