Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease

Rajnish Mehrotra*, Yi Wen Chiu, Kamyar Kalantar-Zadeh, Joanne Bargman, Edward Vonesh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

300 Scopus citations

Abstract

Background: The annual payer costs for patients treated with peritoneal dialysis (PD) are lower than with hemodialysis (HD), but in 2007, only 7% of dialysis patients in the United States were treated with PD. Since 1996, there has been no change in the first-year mortality of HD patients, but both short- and long-term outcomes of PD patients have improved. Methods: Data from the US Renal Data System were examined for secular trends in survival among patients treated with HD and PD on day 90 of end-stage renal disease (HD, 620 020 patients; PD, 64 406 patients) in three 3-year cohorts (1996-1998, 1999-2001, and 2002-2004) for up to 5 years of follow-up using a nonproportional hazards marginal structural model with inverse probability of treatment and censoring weighting. Results: There was a progressive attenuation inthe higher risk for death seen in patients treated with PD in earlier cohorts; for the 2002-2004 cohort, there was no significant difference in the risk of death for HD and PD patients through 5years of follow-up. The median life expectancy of HD and PD patients was 38.4 and 36.6 months, respectively. Analyses in 8 subgroups based on age (<65 and ≥65 years), diabetic status, and baseline comorbidity (none and ≥1) showed greater improvement in survival among patients treated with PD relative to HD at all follow-up periods. Conclusion: In the most recent cohorts, patients who began treatment with HD or PD have similar outcomes.

Original languageEnglish (US)
Pages (from-to)110-118
Number of pages9
JournalArchives of Internal Medicine
Volume171
Issue number2
DOIs
StatePublished - Jan 24 2011

ASJC Scopus subject areas

  • Internal Medicine

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