Abstract
Comparison of the Mortality between Japanese Peritoneal Dialysis and Hemodialysis Patients: 4-Year Follow-Up Multicenter Study
Objectives: To examine the effect of dialysis modality on the prognosis of Japanese dialysis patients, we conducted a prospective multicenter study.
Methods: Two groups of patients—84 on peritoneal dialysis (PD) and on 84 hemodialysis (HD)—matched for age, sex, and clinical parameters (average age: 64.7 years; men, 54.5%; diabetes, 23.5% overall) were followed for 4 years. The all-cause, cardiovascular, and non cardiovascular mortalities were compared between the PD and HD patients.
Results: During the follow-up period, 13 PD patients died (7 cardiovascular, 6 non cardiovascular deaths) and 21 HD patients died (11 cardiovascular, 10 non cardiovascular deaths). Kaplan–Meier analysis revealed that the difference in all-cause (15.5% vs. 25.0%, p = 0.210), cardiovascular (8.3% vs. 13.1%, p = 0.406), and non cardiovascular (7.1% vs. 11.9%, p = 0.346) mortalities between PD and HD were not statistically significant. In subgroup analyses, as compared with HD, PD showed a significantly lower rate of all-cause mortality in men (12.0% vs. 31.7%, p = 0.036) and a marginally lower rate in nondiabetic patients (11.6% vs. 24.1%, p = 0.095). In multivariate Cox analysis, the independent predictor for death was serum albumin level, not dialysis modality.
Conclusions: This study showed that overall mortality was not significantly different between PD and HD patients. However, there is a possibility that dialysis modality might affect prognosis in some types of dialysis patients.