Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities

Peritoneal dialysis has optimal intradialytic hemodynamics and preserves residual renal function: Why isn't it better than hemodialysis?

“…For example, a study by Wong et al compared only those incident patients who were suitable for both modalities and started either HD or PD as an outpatient (thereby excluding those with unplanned dialysis initiation). Groups were well‐matched, and in line with overall themes, results showed equivalent survival between HD and PD . While survival may be broadly similar between PD and HD, it is also clear that mortality and cardiovascular disease remain significantly higher in patients on either modality as compared to patients without ESKD .…”

“…Groups were well-matched, and in line with overall themes, results showed equivalent survival between HD and PD. 7 While survival may be broadly similar between PD and HD, it is also clear that mortality and cardiovascular disease remain significantly higher in patients on either modality as compared to patients without ESKD. 8 Importantly, the mechanisms that drive excessive cardiovascular risk and adverse outcomes may differ significantly between HD and PD due to fundamental differences in the dialysis process, and this may have relevance to individualized patient decision-making.…”

Dialysis Modality Survival Comparison: Time to End the Debate, It’s a Tie

“…As examples, patients with ESRD who are referred late to dialysis therapy and who are sicker are more likely to be initiated on HD therapy with a dialysis catheter, resulting in an initial observed survival advantage for PD as compared to HD. 10 In this issue of AJKD, Wong et al 11 have taken us one step further in the study of survival comparison between HD and PD patients. The authors conducted a retrospective cohort study between January 2004 and December 2013, limited to 7 dialysis centers from the province of Ontario, Canada.…”

Briefly Noted

“…A study of new HD and PD patients (N = 1579 and 453, respectively) found that survivals were similar in both modalities after excluding the one third of HD patients deemed ineligible for PD. Without this exclusion, PD had a lower risk for death in patients <65 years old …”

“…Without this exclusion, PD had a lower risk for death in patients <65 years old. 10 A study of 76 meat, poultry and fish products most frequently consumed by dialysis patients found that the nine foods listing potassium additives on the label had a median of 575 mg/100 g more potassium than foods without such additives. Two products had 1100 mg/100 g of potassium, more than half of the common A study of 151 HD patients found that 49% met the definition of frail and that greater waist circumference (a measure of visceral adiposity) strongly predicted such frailty.…”