A COMPARISON OF MORTALITY BETWEEN PATIENTS TREATED WITH HEMODIALYSIS AND PERITONEAL-DIALYSIS

被引:0
|
作者
BLOEMBERGEN, WE
PORT, FK
MAUGER, EA
WOLFE, RA
机构
[1] UNIV MICHIGAN, SCH MED, DEPT INTERNAL MED, ANN ARBOR, MI USA
[2] UNIV MICHIGAN, SCH PUBL HLTH, DEPT EPIDEMIOL, ANN ARBOR, MI 48109 USA
[3] UNIV MICHIGAN, SCH PUBL HLTH, DEPT BIOSTAT, ANN ARBOR, MI 48109 USA
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 1995年 / 6卷 / 02期
关键词
END-STAGE RENAL DISEASE; DEATH RATES; CONTINUOUS AMBULATORY PERITONEAL DIALYSIS; CONTINUOUS CYCLER-ASSISTED PERITONEAL DIALYSIS; DIALYSIS; DIALYSIS MODALITY;
D O I
暂无
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
Patients with ESRD treated with dialysis have a high mortality rate, Controversy exists as to whether this high mortality rate is affected by modality choice. The purpose of this epidemiologic study was to compare mortality in prevalent hemodialysis-treated (HD) and peritoneal dialysis-treated (PD) patients in a large national sample, adjusting for demographic characteristics. Data were obtained from the U.S. Renal Data System for patients prevalent on January 1 of the years 1987, 1988, and 1989, each with 1 yr of followup. Patients were censored at transplantation. Death rates per 100 patient years were compared between HD and PD, adjusting for age, race, gender, cause of ESRD (diabetes versus nondiabetes) and <1 yr or >1 yr of prior ESRD, by the use of Poisson regression, There were 42,372 deaths occurring over 170,700 patient years at risk. On average, prevalent patients treated with PD had a 19% higher adjusted mortality risk (relative risk (RR) = 1.19; P < 0.001) than did those treated with HD, This risk was found to be insignificant (P > 0.05) and small for ages <55 and increasingly large and significant for ages >55 yr. It was accentuated in diabetics (RR = 1.38; P < 0.001) but was also present in nondiabetics (RR = 1.11; P < 0.001). Although present in both males and females, this risk was accentuated in females (RR = 1.30 versus 1.11; both P < 0.001). In this national study of prevalent U.S. dialysis patients, treatment assignment to PD was associated with a 19% higher all-cause mortality rate than HD. Further studies are necessary to separate the effect of patient selection, differential dose of dialysis, nutrition, patient compliance, and/or medical quality of care from a possible true adverse treatment effect of PD.
引用
收藏
页码:177 / 183
页数:7
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