The hazards of the changing hazard of dialysis modalities

The impact of the dialysis modality on patient survival has received considerable epidemiological attention, with most studies suggesting an early benefit favoring peritoneal dialysis over hemodialysis. Kumar et al. report the relative outcomes of the two modalities in incident patients followed by an accountable care organization. Using advanced statistical techniques for non-proportional hazards survival models, the authors corroborate the early benefit of peritoneal dialysis for the first 3 years and equivalent outcomes thereafter.