Comparison of the Impact of Dialysis Treatment Type on Patient Survival

1. Male or female patients who are at least 18 years of age.
2. Patients who have read, understood and given written informed consent after the nature of the study has been explained.
3. Patients who have a diagnosis of ESRD (GFR ≤ 10 ml/min), without a permanent access for dialysis.
4. Patients who are able to comprehend a modality education program.
5. Patients who are judged as capable of being trained for home based PD.
6. Patients as justified by their physicians requiring dialysis treatment within 6 weeks after randomization (Patients who require urgent temporary dialysis before randomization may also be eligible for recruitment after being stabilized with temporary HD or PD)
7. Patients who are expected to remain on dialysis for at least 6 months.
8. Patients must have a negative HIV test at screening. -

Exclusion Criteria:

1. Patients that have already received a permanent catheter or access that is intended for permanent therapy use before receiving modality information, or have already received permanent dialysis (If an access is present within 4 weeks prior to screening for back-up purposes, or for acute treatment for life threatening uremic symptoms, electrolyte abnormalities or fluid overload, this does not exclude the patient from enrollment).
2. Patients who previously have received renal transplantation and are still prescribed immunosuppressive therapy.
3. Patients who are unwilling or unable to follow the protocol.
4. Patients with concomitant participation in any other interventional study, or who have received any investigational drug, biologic or device within five half-lives of the physiological action or 30 days, whichever is longer, prior to screening.

5. Patients justified as not eligible for either PD or HD due to:

   • PD: documented extensive intra-peritoneal adhesions, severe infective skin disorder, or other situation contradicting PD (eg., active inflammatory bowel disease)
   • HD: severe cardiac instability and inability to a gain permanent vascular access.
6. Patients who have a history of drug or alcohol abuse within the six months prior to entering the study
7. Patients who have active systemic infections, such as tuberculosis, septicemia or systemic fungal infections.
8. Patients who have malignancies requiring active chemotherapy or radiation therapy.
9. The presence of other terminal illness likely to cause death within 6 months
10. Patients who have any other serious acute or active conditions that in the investigator's opinion would preclude their participation in the study.
11. Female patients who are pregnant, lactating or planning on becoming pregnant during the study period.
12. Patients who are allergic to starch-based polymers, maltose or isomaltose
13. Patients who have glycogen storage disease.
14. Patients who have a significant psychiatric disorder or mental disability that could interfere with the patient's ability to provide informed consent and/or comply with protocol procedures -