Comparing Patient Survival of Home Hemodialysis and Peritoneal Dialysis Patients

被引:8
作者
Choi, Soo Jeong [1 ,2 ]
Obi, Yoshitsugu [1 ]
Ko, Gang Jee [1 ,3 ]
You, Amy S. [1 ]
Eriguchi, Rieko [1 ]
Wang, Mengjing [1 ,4 ]
Rhee, Connie M. [1 ]
Kalantar-Zadeh, Kamyar [1 ,5 ,6 ]
机构
[1] Univ Calif Irvine, Sch Med, Div Nephrol & Hypertens & Kidney Transplantat, Orange, CA 92868 USA
[2] Soonchunhyang Univ, Dept Internal Med, Div Nephrol, Coll Med, Bucheon, South Korea
[3] Korea Univ, Dept Internal Med, Coll Med, Seoul, South Korea
[4] Fudan Univ, Huashan Hosp, Dept Med, Div Nephrol, Shanghai, Peoples R China
[5] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Los Angeles, CA USA
[6] Tibor Rubin Vet Affairs Med Ctr, Sect Nephrol, Long Beach, CA USA
关键词
Home dialysis; Peritoneal dialysis; Home hemodialysis; IN-CENTER HEMODIALYSIS; TECHNIQUE FAILURE; SIMILAR OUTCOMES; MORTALITY; HOSPITALIZATION; MODALITY; ACCESS; RISK; COHORT;
D O I
10.1159/000504691
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: It is not clear whether peritoneal dialysis (PD) and home hemodialysis (HHD) have similar outcomes, and little is known about how mortality associated with HHD versus PD differs according to the duration of dialysis. Methods: We examined a national cohort of incident end-stage renal disease patients that was comprised of 1,993 and 16,514 patients transitioning to HHD and PD, respectively, from 2007 to 2011. The HHD patients were matched with PD patients using propensity score (PS). Demographics, comorbidities, duration of dialysis, and body mass index were adjusted for in logistic regression models using PS matching. We matched 1,915 HHD patients with 1,915 PD patients based on the PS. The patients were categorized by their vintage (duration of dialysis) at the time of the transition to HHD or PD (<3, 3 to <12, and >= 12 months). Results: In the matched cohort, 237 and 359 deaths occurred in the HHD and PD patients, respectively (cumulative incidence 9.6 vs. 12.9/100 patient-years, p < 0.001). PD patients who transitioned within 12 months of starting dialysis had similar mortality risks, while PD patients who transitioned >12 months after starting dialysis had an 83% higher risk for mortality (hazard ratio 1.83; 95% CI 1.33-2.52). Conclusions: Whereas there was no meaningful survival difference in the first 12 months between HHD and PD, patients who transitioned to PD after 12 months of dialysis had worse survival than their HHD counterparts. Additional studies are warranted to investigate clinical implications of these differences.
引用
收藏
页码:192 / 200
页数:9
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