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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Rubin and colleagues¹ reported that patients receiving peritoneal dialysis rated their care higher than did patients receiving hemodialysis. We are concerned that the authors did not account for several factors related to the choice of peritoneal dialysis vs hemodialysis.

First, patients receiving peritoneal dialysis in this study were more likely to be white and to have graduated from high school; thus, they were also more likely to be employed and to have health insurance. This is important because white patients were more likely to rate their care better, as were patients with fewer comorbidities.

Second, it is not clear how patients selected one type of dialysis over the other. Approximately 50% of patients would choose peritoneal dialysis if this option were adequately explained,^2-3 but as many as 20% would in fact not be good candidates for it.^3-4 Also, there is a gradual rate of conversion from . . . [Full Text of this Article]

Mahesh Goel, MD
mahesh_goel@hotmail.com
Cleveland Clinic Foundation
Cleveland, Ohio

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