options. Epidemiology As of 2017, hemodialysis is the most widely available renal replacement modality found in 96% of countries whereas peritoneal dialysis (PD) is only available in 75% of countries. In 2016, the proportion of people receiving peritoneal dialysis (PD) was estimated at 11% with wide differences between different countries and regions. In Hong Kong and Mexico, PD is more common than the world average, with Mexico conducting most of its dialysis through PD, while Japan and Germany have rates lower than the world average. Peritoneal dialysis first models, patients requiring renal replacement therapy are placed on PD first, and financial incentives for using PD are associated with increase uptake of PD in multiple countries. East and Southeast Asia Hong Kong has the highest rate of PD use worldwide at 71.9% in 2014, while in Mainland China had 20% in 2014, 23% in Thailand during 2012, and 10-20% in Vietnam during 2011. Hong Kong had a PD-first model since 1985, Thailand began a PD-first model since 2008 which increased their levels of PD from <10%. Americas Prevalence in of PD use was 9.7% in USA during 2013 and 16.3% in Canada during 2013. The lower PD rates in the USA are due to higher availability of large corporate owned hemodialysis centers. There have been recent increase in PD uptake in the USA due to changes to medicare reimbursement such as bundled payment for dialysis this incentivizes use of PD which is a less costly modality for dialysis. Overall, prevalence of PD use is 24.6% in Latin America during 2011. Within Latin America, hemodialysis has a higher growth rate in use compared to PD between 1994 - 2010. In 2010, the most prevalent use of PD were in Mexico 55.9% and El Salvador 67.6%. Between 2000 - 2010, Columbia's PD rate dropped from 54% to 31.3%. History Peritoneal dialysis was first carried out in the 1920s; however, long term use did not come into medical practice until the 1960s. The timeline was 1923 - Georg Ganter perform the first peritoneal dialysis. 1968 - Henry Tenckhoff created the Tenckhoff catheter avoiding the need to replace the catheter in the abdomem for every therapy treatment. Comparison to Hemodialysis Compared to hemodialysis, PD allows greater patient mobility, produces fewer swings in symptoms due to its continuous nature, and phosphate compounds are better removed, but large amounts of albumin are removed which requires constant monitoring