BUILDING THE EVIDENCE IN PERITONEAL DIALYSIS: USE OF RANDOMIZED CONTROLLED TRIALS, AND OBSERVATIONAL AND REGISTRY DATA

Renal replacement therapy (RRT) has achieved wide-spread acceptance without being subjected to the rigors of randomized controlled clinical trials (RCCTs). The RCCT remains the “gold standard ” of evidenced-based medi-cine, but ethical, logistic, and financial limitations mean that not all questions are amenable to a RCCT. Renal registries collect, aggregate, analyze, and inter-pret data on the occurrence and outcome of renal failure in a defined population. Observational data can be used only to show associations, not causality. Nevertheless, most clinical practice guidelines in nephrology are de-rived from observational data. The nephrology community needs to join forces to de-cide the questions that deserve the time, energy, and re-sources of an RCCT. Prospective observational data ca