Has peritoneal dialysis peaked? The impact of the CANUSA study. The Canadian-USA Multicenter study.

We previously summarized evidence that an increase of dialysis dose is associated with better protein intake and better nutritional status. The CANUSA study suggests that higher dialysis doses are associated with better patient survival rates. It is imperative that we design prescriptions and techniques to provide greater dialysis doses compatible with a reasonable quality of existence. The reasons why U.S. dialysis patients may have higher mortality rates than in other countries for both hemodialysis and CPD may relate to factors other than dialysis adequacy and commonly appreciated morbidity factors; this needs further attention.