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Survival of patients on chronic hemodialysis versus chronic peritoneal dialysis
Wilmer Guzman-Ventura1,2, José Caballero-Alvarado3,4
1Hospital Víctor Lazarte Echegaray, Seguro Social de Salud, Trujillo, Perú.
Insights
Survival rates for patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) or peritoneal dialysis (PD) were similar. Key mortality factors included older age and diabetes mellitus as the cause of CKD.
Area of Science:
- Nephrology
- Internal Medicine
- Public Health
Background:
- Chronic kidney disease (CKD) affects millions globally, necessitating renal replacement therapy.
- Hemodialysis (HD) and peritoneal dialysis (PD) are primary treatment modalities for end-stage renal disease.
- Understanding survival outcomes for HD versus PD is crucial for patient management.
Purpose of the Study:
- To compare the survival rates of patients with CKD treated with hemodialysis (HD) versus peritoneal dialysis (PD).
Main Methods:
- Retrospective cohort study of 540 adult patients (368 HD, 172 PD) from 2015-2019.
- Survival analysis using Kaplan-Meier curves and Cox proportional hazards models.
- Covariates analyzed included age, sex, diabetes mellitus, and initial vascular access.
Main Results:
- No significant difference in overall survival between HD and PD groups (p=0.719).
- Median survival was 32 months for HD and 32.5 months for PD.
- Older age (≥60 years) and diabetes mellitus were associated with increased mortality risk.
Conclusions:
- Survival outcomes for CKD patients on HD and PD are comparable.
- Age and diabetes mellitus are significant predictors of mortality in dialysis patients.
Objective.:
To compare the survival of patients with chronic kidney disease (CKD) on hemodialysis (HD) versus peritoneal dialysis (PD).
Materials And Methods.:
Survival analysis of a retrospective cohort of patients ≥ 18 years who started HD versus PD at the Victor Lazarte Echegaray Hospital from 2015 to 2019. We analyzed the following covariates: age, sex, diabetes mellitus as cause of CKD, temporary central venous catheter (CVC) as initial vascular access and glomerular filtration rate. Survival was calculated with Kaplan-Meier curves for the overall cohort and for age ≥ 60 years, diabetes mellitus as a cause of CKD and CVC. The risk of death was estimated by Hazard Ratio (HR) according to the Cox proportional hazards model for each covariate adjusted for dialysis type in a bivariate and multivariate analysis considering significant difference if the p-value < 0.05.
Results.:
We included 368 patients on HD of whom 129 (35.1%) died, and 172 patients on PD of whom 66 (38.4%) died (p=0.455). The cumulative probability of survival at 60 months for HD was 30% and for PD was 37% with similar survival curves (p=0.719). The median survival time for HD was 32 months (IQR: 20-53) and for PD was 32.5 months (IQR: 18-57) (p=0.999). The covariates associated with higher mortality adjusted for dialysis type were age ≥60 years (HR 1.77; p<0.001) and diabetes mellitus as a cause of CKD (HR 1.63; p=0.002).
Conclusions.:
Survival of patients with CKD on HD and PD was similar.
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