apparent in developed economies. there is insufficient research to adequately compare the risks and benefits between capd and apd; a cochrane review of three small clinical trials found no difference in clinically important outcomes (i.e. morbidity or mortality) for patients with end stage renal disease, nor was there any advantage in preserving the functionality of the kidneys. the results suggested apd may have psychosocial advantages for younger patients and those who are employed or pursuing an education. pd may also be used for patients with cardiac instability as it does not result in rapid and significant alterations to body fluids, and for patients with insulin-dependent diabetes mellitus due to the inability to control blood sugar levels through the catheter. society and culture economics the cost of dialysis treatment is related to how wealthy the country is. in the united states peritoneal dialysis costs the government about $53,400 per person per year.