Association of metabolic changes with mortality of patients treated by peritoneal dialysis or hemodialysis

Abstract

Aim: The aim of this study was to determine the survival of patients treated by peritoneal dialysis (PD) and hemodialysis (HD) and to detect any association with the type of metabolic changes. Methods: The outcome of clinical treatment of 407 dialysis patients was analyzed over a 4-year period. This included the demographic characteristics, the duration of dialysis, smoking, residual renal function, existence of metabolic syndrome and malnutrition, waist girth, body mass index (BMI), comorbidity, and routine biochemical parameters. Results: The overall mortality of the treated patients during the 4-year period was 53%, 37% for HD patients and 65% for PD patients. Metabolic syndrome was the dominant metabolic disorder affecting more than half of the HD patients, as well as being a predictive mortality parameter (β = 0.560; p = 0.045). The PD-treated patients had an equal prevalence of metabolic syndrome and malnutrition, whereas statistically significant predictors of mortality outcome were BMI (β = 0.088; p = 0.002) and waist girth (β = 0.023; p = 0.031). The median survival value was significantly higher for HD patients [108 months; 95% confidence interval (CI) 65–151]. Residual renal function in PD patients was significantly related to mortality (p = 0.045). Conclusion: Metabolic syndrome is a predictive parameter of mortality for HD patients, whereas for PD patients it is the waist girth and BMI. Preserved residual renal function in patients on PD is an important factor in reducing mortality.