Comparison of Mortality between Japanese Peritoneal Dialysis and Hemodialysis Patients: A 5-Year Multicenter Follow-Up Study

Kazuko Suzuki,Ikuto Masakane,Hiroko Sato,Hiroki Niino,Isao Kubota,Masato Hoshikawa,Kosuke Kudo,Kazunobu Ichikawa,Toshiyuki Takahashi,Minoru Ito,Tsuneo Konta,Ami Ikeda,Hiroshi Abiko,Noriyuki Degawa,Tomohito Matsunaga

doi:10.1155/2012/231018

Abstract

To examine the relationship between dialysis modality and prognosis in Japanese patients, we conducted a prospective multicenter observational study. We recruited 83 background-matched peritoneal dialysis (PD) and 83 hemodialysis (HD) patients (average age, 64.9 years; men, 53.6%; diabetic patients, 22.9%; median duration of dialysis, 48 months in all patients) and followed them for 5 years. During the follow-up period, 27 PD patients (16 cardiovascular and 11 non-cardiovascular deaths) and 27 HD patients died (14 cardiovascular and 13 non-cardiovascular deaths). There were 8 PD patients switched to HD, and 6 PD patients received renal transplantation. Kaplan-Meier analysis revealed that the crude survival rate was not significantly different at the end of 5 years (PD 67.5% versus 67.5%, log-rank P = 0.719). The difference in cardiovascular and non-cardiovascular mortalities between PD and HD was not statistically significant. Multivariate Cox analysis showed that the independent predictors for death were age and serum albumin levels, but not the dialysis modality. This study showed that the overall mortality was not significantly different between PD and HD patients, which suggests that dialysis modality might not be an independent factor for survival in Japanese patients.

Highlights

The number of end-stage renal disease patients requiring renal replacement therapy is increasing worldwide
Other studies show that peritoneal dialysis (PD) patients have a higher survival rate than HD patients [3, 4]
Another report indicated that the survival rates of PD and HD patients varied greatly depending on the characteristics of patients and observational period [8]

Summary

Introduction

The number of end-stage renal disease patients requiring renal replacement therapy is increasing worldwide. In Japan peritoneal dialysis (PD) and hemodialysis (HD) are the two major dialysis modalities. The prognosis associated with these modalities is a clinically important issue and has been debated for a long time. Some studies show that PD is associated with a higher mortality than HD [1, 2]. Other studies show that PD patients have a higher survival rate than HD patients [3, 4]. Comprehensive analysis, including the results of largescale and prospective studies, revealed that the HD and PD patients have a similar overall survival [5,6,7]. Another report indicated that the survival rates of PD and HD patients varied greatly depending on the characteristics of patients and observational period [8]

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