• More people around the world have access to kidney replacement therapies than ever before, yet most people with kidney failure still die because of failure to access or sustain treatment.
• Non-medical factors are the primary determinants of variability in use of different dialysis therapies:

o Macro-governmental policies and reimbursement

o Micro-physician training and bias

• We need an “all of the above” approach to close the coverage gap:

o PD offers unique cost and environmental advantages that will allow more people to be treated in face of budgetary constraints that are now near-universal.

• Newer technologies of ambulatory dialysis have the potential to change the face of kidney replacement therapies.