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Feature Story

Baxter Helps Expand Treatment Access and Options for End-Stage Kidney Disease Patients

As the prevalence of end-stage kidney disease continues to rise worldwide, Baxter is helping expand access to life-sustaining treatment options. Teeramanas Tanaekakarapong of Bangkok is one of thousands of patients in Thailand and across Asia Pacific relying on Baxter's peritoneal dialysis products to help manage this condition.

Patients with end-stage kidney disease commonly utilize either hemodialysis or peritoneal dialysis to cleanse their blood of the toxins and waste products normally removed by healthy kidneys. Hemodialysis is typically administered in a hospital or dialysis center (also referred to as in-center hemodialysis), while peritoneal dialysis can be readily administered in a home setting.

Peritoneal dialysis offers a number of clinical benefits that can help position new end-stage kidney disease patients for long-term success on dialysis. For example, patients treated with peritoneal dialysis have a better early survival rate, and remaining kidney function may be better preserved in patients treated with peritoneal dialysis.1,2,3,4,5  A study published in February 2012 in the Clinical Journal of the American Society of Nephrology found that patients treated with peritoneal dialysis before transplantation had better post-transplant survival rates than those treated with in-center hemodialysis.6,7

In 2008, the government of Thailand implemented a "PD First" policy, encouraging the use of peritoneal dialysis when appropriate in order to expand access to treatment options. The result has been a sharp increase in the number of peritoneal dialysis patients in Thailand, from about 1,000 in January 2008 to nearly 12,000 at the end of 2012.

Teeramanas is a 46-year-old singer who also works as an entertainment manager in a Bangkok club. When he was diagnosed with acute worsening of his chronic kidney failure in 2009, he was sent to a private hospital for emergency hemodialysis treatment; but the expense and inconvenience of ongoing hemodialysis would prove difficult to manage. Thailand's PD First policy pointed the way to an alternate therapy option. "So I registered myself, and I have been on peritoneal dialysis under the National Access Program since April 2009," he says.

While Teeramanas had some initial concerns when moving to peritoneal dialysis, the transition proved simple. "In fact, the operation to place a catheter in my abdomen took only 15 minutes," he recalls. "Just a week after the operation, I could start singing again."

He says the flexibility of peritoneal dialysis has allowed him to continue singing for a living. He administers treatment three times daily in a routine that fits his working schedule of 8 p.m. to 2 a.m. "I always change the solution using methods that my nurse recommends," he says. "I take care of myself by eating nutritious food, doing light exercises, and keeping a happy mind."

Baxter projects the number of peritoneal dialysis patients in Thailand to reach 35,000 in the next five years. Several other countries throughout the Asia Pacific region, including Malaysia, Taiwan, India and Vietnam, are also evaluating and implementing policies that encourage the use of peritoneal dialysis to help increase access and manage the growing need for renal disease treatment with limited healthcare resources. In Hong Kong, which has a longstanding PD First policy in place, PD penetration is estimated at about 80 percent.

Teeramanas sees clear financial and convenience benefits in peritoneal dialysis therapy. The freedom to administer therapy at home is especially relevant for patients living in a city like Bangkok, where the daily norm of traffic jams can mean long travel times to and from a treatment center to receive hemodialysis. He says, "PD allows me to travel throughout Thailand for work and leisure when I please."

As the leading global provider of peritoneal dialysis products, Baxter will continue working to bring the benefits of this home-based therapy option to a growing number of patients around the world.


1
Yeates K, Zhu N, Vonesh E, Trpeski L, Blake P, Fenton S. Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transplant. 2012:advance access.

2Mehrotra R, Chiu YW, Kalantar-Zadeh K, Bargman J, Vonesh E. Similar outcomes with
hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Arch Intern Med.
2011;171:110-118 (supplemental online content).

3Heaf JG, Løkkegaard H, Madsen M. Initial survival advantage of peritoneal dialysis relative to
haemodialysis. Nephrol Dial Transplant. 2002;17(1):112-117.

4Liem YS, Wong JB, Hunink MGM, de Charro FTh, Winkelmayer WC. Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands. Kidney Int. 2007;71(2):153-158.

5Jansen MA, Hart AA, Korevaar JC, Dekker FW, Boeschoten EW, Krediet RT. Predictors of the rate of decline of residual renal function in incident dialysis patients. Kidney Int. 2002;62:1046-1053.

6Molnar MZ, Mehrotra R, Duong U, et al. Dialysis modality and outcomes in kidney transplant recipients. Clin J Am Soc Nephrol. 2012 Feb;7(2):332-41. Epub 2011 Dec 8.

7Schwenger V, Dohler B, Morath C, Zeier M, Opelz G. The role of pretransplant dialysis modality on renal allograft outcome. Nephrol Dial Transplant. 2011;26:3761-3766.