Differing dialysis treatment strategies and outcome

Area of Science:

• Nephrology
• Renal Replacement Therapy

Background:

• Dialysis treatment selection is multifactorial, encompassing medical and non-medical considerations.
• Access to transplantation and various dialysis modalities (extracorporeal and peritoneal) is crucial for comprehensive care.

Purpose of the Study:

• To compare the long-term outcomes and suitability of different dialysis modalities, specifically continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD).
• To evaluate the impact of patient age and clinical background on the choice and success of dialysis treatments.

Main Methods:

• Analysis of single-centre patient data comparing outcomes on CAPD and HD.
• Assessment of patient survival rates, risk of death, and drop-out rates across different age groups and clinical conditions.

Main Results:

• Ten-year patient survival is comparable between CAPD and HD.
• CAPD shows an initial lower risk of death for patients aged 75 and above.
• Drop-out from CAPD is increasing, primarily due to patient/partner burnout, but is lower in the elderly. The difference in modality changes between CAPD and HD diminishes with age.

Conclusions:

• CAPD is a viable and potentially advantageous option for the elderly population and adults awaiting kidney transplantation.
• Clinical factors such as diabetes, cardiovascular disease, dyslipidemia, and obesity significantly influence the selection of the optimal dialysis modality.