No difference in survival rates was found among new patients who choose hemodialysis vs. peritoneal dialysis, according to data published in the American Journal of Kidney Diseases.
“The effect of modality on survival does not appear to change over time,” Ben Wong, MD, of the department of community health sciences at the University of Calgary and the department of medicine at Headwaters Health Care Center in Orangeville, Ontario, Canada, and colleagues wrote.
The research was conducted at seven regional dialysis centers in Ontario. Although peritoneal dialysis costs less to the Canadian health care system compared to in-center hemodialysis, it remains an underused therapy.
“Neither modality has been consistently shown to confer a clear benefit to patient survival,” the authors stated. They also noted that in previous studies, patients were not restricted to those eligible for both treatments.
In this study, all adults who developed end-stage renal disease between January 2004 and December 2013 at the aforementioned dialysis centers were eligible. All patients had received at least one outpatient dialysis treatment and had completed a multidisciplinary modality assessment.
Study results, based on incident patients with end-stage renal disease who chose hemodialysis (1,579) vs. peritoneal dialysis (453), showed peritoneal dialysis was associated with lower risk for death among patients younger than 65 years.
“However, after excluding approximately one-third of all incident patients deemed to be ineligible for [peritoneal dialysis] PD, the modalities were associated with similar survival regardless of age. This finding was also observed in analyses that were restricted to patients initiating dialysis therapy electively as outpatients,” the authors wrote. “The impact of modality on survival did not vary over time.”
The multidisciplinary team at each dialysis center determined patients’ peritoneal dialysis eligibility, the authors noted. – by Mark E. Neumann
Wong B, et al. Am J Kidney Dis. 2017;doi:10.1053/j.ajkd.2017.08.028.