Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2025; 16(3): 100592
Published online Mar 15, 2025. doi: 10.4239/wjd.v16.i3.100592
Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings
Arun Prabhahar, Akshey Batta, Juniali Hatwal, Vivek Kumar, Raja Ramachandran, Akash Batta
Arun Prabhahar, Department of Telemedicine (Internal Medicine and Nephrology), Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Akshey Batta, Department of Urology and Renal Transplant, Neelam Hospital, Rajpura 140401, Punjab, India
Juniali Hatwal, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Vivek Kumar, Raja Ramachandran, Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Author contributions: Prabhahar A, Batta Aks and Batta Aka designed the editorial; Prabhahar A, Batta Aks and Hatwal J performed the literature review and data collection; Kumar V and Ramachandran R supervised the manuscript and provided key feedback and suggestions; Prabhahar A, Batta Aks and Batta Aka analyzed the data and wrote the manuscript and subsequently revised it. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, DM, MD, Assistant Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Received: August 21, 2024
Revised: December 18, 2024
Accepted: December 27, 2024
Published online: March 15, 2025
Processing time: 153 Days and 19.9 Hours
Abstract

Diabetes is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) worldwide. While both haemodialysis (HD) and peritoneal dialysis (PD) are commonly used treatment options for ESKD, the choice of dialysis modality in diabetic ESKD patients remains a critical decision influenced by various patient-related, healthcare system, and socio-economic factors. This article examines the factors influencing the selection of dialysis modalities for diabetic patients, with a focus on the challenges and opportunities in low-resource settings. Key considerations include the impact of comorbidities such as peripheral arterial disease and CKD-related mineral bone disorder (MBD), as well as patient preferences, caregiver burden, and the availability of healthcare infrastructure. The article highlights the need for personalized approaches to dialysis selection, considering both clinical outcomes and quality of life. It also emphasizes the potential benefits of home dialysis, including home HD and PD, in improving patient autonomy and long-term survival. The article advocates for better government policies, increased awareness, and improved support systems to enhance the accessibility and efficacy of dialysis treatments, particularly in underserved populations. Further research comparing the outcomes of different dialysis modalities across diverse settings is essential to guide global treatment strategies for diabetic ESKD patients.

Keywords: Diabetes; Haemodialysis; Peritoneal dialysis; Peripheral arterial disease, Mineral bone disorder; Caregiver burden; India

Core Tip: The choice of dialysis modality in diabetic patients with end-stage kidney disease should be individualized, considering factors such as comorbidities (e.g., peripheral arterial disease, chronic kidney disease-related mineral bone disorder), patient preferences, healthcare infrastructure, and caregiver support. In low-resource settings, promoting home dialysis options and improving access to peritoneal dialysis can enhance patient outcomes and quality of life. Healthcare policies, education, and better support systems are key to optimizing dialysis choices, particularly for diabetic populations in underserved areas.