Format

Send to

Choose Destination
Arch Intern Med. 2011 Jan 24;171(2):110-8. doi: 10.1001/archinternmed.2010.352. Epub 2010 Sep 27.

Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease.

Author information

1
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA. rmehrotra@labiomed.org

Abstract

BACKGROUND:

The annual payer costs for patients treated with peritoneal dialysis (PD) are lower than with hemodialysis (HD), but in 2007, only 7% of dialysis patients in the United States were treated with PD. Since 1996, there has been no change in the first-year mortality of HD patients, but both short- and long-term outcomes of PD patients have improved.

METHODS:

Data from the US Renal Data System were examined for secular trends in survival among patients treated with HD and PD on day 90 of end-stage renal disease (HD, 620 020 patients; PD, 64 406 patients) in three 3-year cohorts (1996-1998, 1999-2001, and 2002-2004) for up to 5 years of follow-up using a nonproportional hazards marginal structural model with inverse probability of treatment and censoring weighting.

RESULTS:

There was a progressive attenuation in the higher risk for death seen in patients treated with PD in earlier cohorts; for the 2002-2004 cohort, there was no significant difference in the risk of death for HD and PD patients through 5 years of follow-up. The median life expectancy of HD and PD patients was 38.4 and 36.6 months, respectively. Analyses in 8 subgroups based on age (<65 and ≥65 years), diabetic status, and baseline comorbidity (none and ≥1) showed greater improvement in survival among patients treated with PD relative to HD at all follow-up periods.

CONCLUSION:

In the most recent cohorts, patients who began treatment with HD or PD have similar outcomes.

Comment in

PMID:
20876398
DOI:
10.1001/archinternmed.2010.352
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center