Abstract
Peritoneal dialysis (PD) has some advantages, such as hemodynamic stability and volume regulation, compared with hemodialysis (HD). However, the influence of the dialysis modality on survival is still controversial. This study assessed the mortality of incident patients undergoing HD versus PD using a propensity score approach. This study enrolled 873 subjects who began dialysis therapy at Gachon University Gil Hospital in Korea between January 2000 and June 2009. A propensity score comprising demographic, clinical, and laboratory variables was used to select a 1:1 matched cohort. The overall 1-, 2-, 3-, and 5-year survival rates for the HD patients (n = 212) were 95.1, 89.6, 82.5, and 65.3%, respectively, whereas the equivalent survival rates for the PD patients (n = 212) were 93.6, 83.1, 73.9, and 48.4%, respectively (P = 0.002 by log rank test). In patients without diabetes or patients with a low modified Charlson comorbidity index (MCCI), including hypertension, cardiovascular disease, liver disease, etc., there was no difference in mortality between PD and HD. However, PD was associated with a higher mortality for diabetic patients (HR, 2.86; 95% CI, 1.73-4.74) and for patients with a high MCCI (HR, 2.54; 95% CI 1.57-4.10). These data suggest that survival for PD may be comparable with that for HD in incident dialysis patients without diabetes or high MCCI and that HD could be more beneficial in patients with diabetes or high MCCI in this propensity score-matched cohort.
| Original language | English |
|---|---|
| Pages (from-to) | 271-277 |
| Number of pages | 7 |
| Journal | Tohoku Journal of Experimental Medicine |
| Volume | 229 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2013 May 21 |
| Externally published | Yes |
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Keywords
- Diabetes
- End stage renal disease
- Hemodialysis
- Mortality
- Peritoneal dialysis
ASJC Scopus subject areas
- Medicine(all)
- Biochemistry, Genetics and Molecular Biology(all)
Cite this
Hemodialysis leads to better survival in patients with diabetes or high comorbidity, compared to peritoneal dialysis. / Chang, Jae Hyun; Sung, Ji Yoon; Ahn, Shin Young; Ko, Kwang Pil; Ro, Han; Jung, Ji Yong; Lee, Hyun Hee; Chung, Wookyung; Kim, Sejoong.
In: Tohoku Journal of Experimental Medicine, Vol. 229, No. 4, 21.05.2013, p. 271-277.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hemodialysis leads to better survival in patients with diabetes or high comorbidity, compared to peritoneal dialysis
AU - Chang, Jae Hyun
AU - Sung, Ji Yoon
AU - Ahn, Shin Young
AU - Ko, Kwang Pil
AU - Ro, Han
AU - Jung, Ji Yong
AU - Lee, Hyun Hee
AU - Chung, Wookyung
AU - Kim, Sejoong
PY - 2013/5/21
Y1 - 2013/5/21
N2 - Peritoneal dialysis (PD) has some advantages, such as hemodynamic stability and volume regulation, compared with hemodialysis (HD). However, the influence of the dialysis modality on survival is still controversial. This study assessed the mortality of incident patients undergoing HD versus PD using a propensity score approach. This study enrolled 873 subjects who began dialysis therapy at Gachon University Gil Hospital in Korea between January 2000 and June 2009. A propensity score comprising demographic, clinical, and laboratory variables was used to select a 1:1 matched cohort. The overall 1-, 2-, 3-, and 5-year survival rates for the HD patients (n = 212) were 95.1, 89.6, 82.5, and 65.3%, respectively, whereas the equivalent survival rates for the PD patients (n = 212) were 93.6, 83.1, 73.9, and 48.4%, respectively (P = 0.002 by log rank test). In patients without diabetes or patients with a low modified Charlson comorbidity index (MCCI), including hypertension, cardiovascular disease, liver disease, etc., there was no difference in mortality between PD and HD. However, PD was associated with a higher mortality for diabetic patients (HR, 2.86; 95% CI, 1.73-4.74) and for patients with a high MCCI (HR, 2.54; 95% CI 1.57-4.10). These data suggest that survival for PD may be comparable with that for HD in incident dialysis patients without diabetes or high MCCI and that HD could be more beneficial in patients with diabetes or high MCCI in this propensity score-matched cohort.
AB - Peritoneal dialysis (PD) has some advantages, such as hemodynamic stability and volume regulation, compared with hemodialysis (HD). However, the influence of the dialysis modality on survival is still controversial. This study assessed the mortality of incident patients undergoing HD versus PD using a propensity score approach. This study enrolled 873 subjects who began dialysis therapy at Gachon University Gil Hospital in Korea between January 2000 and June 2009. A propensity score comprising demographic, clinical, and laboratory variables was used to select a 1:1 matched cohort. The overall 1-, 2-, 3-, and 5-year survival rates for the HD patients (n = 212) were 95.1, 89.6, 82.5, and 65.3%, respectively, whereas the equivalent survival rates for the PD patients (n = 212) were 93.6, 83.1, 73.9, and 48.4%, respectively (P = 0.002 by log rank test). In patients without diabetes or patients with a low modified Charlson comorbidity index (MCCI), including hypertension, cardiovascular disease, liver disease, etc., there was no difference in mortality between PD and HD. However, PD was associated with a higher mortality for diabetic patients (HR, 2.86; 95% CI, 1.73-4.74) and for patients with a high MCCI (HR, 2.54; 95% CI 1.57-4.10). These data suggest that survival for PD may be comparable with that for HD in incident dialysis patients without diabetes or high MCCI and that HD could be more beneficial in patients with diabetes or high MCCI in this propensity score-matched cohort.
KW - Diabetes
KW - End stage renal disease
KW - Hemodialysis
KW - Mortality
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=84877830624&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877830624&partnerID=8YFLogxK
U2 - 10.1620/tjem.229.271
DO - 10.1620/tjem.229.271
M3 - Article
C2 - 23603422
AN - SCOPUS:84877830624
VL - 229
SP - 271
EP - 277
JO - Tohoku Journal of Experimental Medicine
JF - Tohoku Journal of Experimental Medicine
SN - 0040-8727
IS - 4
ER -