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Impact of dialysis modality on the survival of end-stage renal disease patients with or without cardiovascular disease.
J Nephrol. 2013 Mar-Apr; 26(2):331-41.JN

Abstract

BACKGROUND

The question of which modality, either peritoneal dialysis (PD) or hemodialysis (HD), confers the survival advantage for incident ESRD patients with pre-existing cardiovascular disease (CVD) remains unanswered.

METHODS

Data used in this study were extracted from the National Health Insurance Research Database in Taiwan. From 1997 to 2007, incident ESRD patients who underwent dialysis longer than three months were selected. The established dialysis modality at day 90 was used to analyze the impact of dialysis modality on survival. For each PD patient indentified, five HD patients matched for age, sex, and year in which the patients received their first dialysis treatment were randomly selected. Finally, a total of 35 664 patients including 29 720 HD patients and 5944 PD patients were selected. The primary outcome was death after commencing dialysis.

RESULTS

For diabetic ESRD patients with or without coronary artery disease (CAD) or congestive heart failure (CHF), patients receiving PD had inferior survival compared with those receiving HD (P<.001, adjusted HR=1.34 to 1.43). For nondiabetic patients with CAD or CHF, patients receiving PD also had inferior survival compared with those receiving HD (adjusted HR=1.30, CI: 1.08 to 1.57; adjusted HR=1.31, CI: 1.11 to 1.55). For nondiabetic ESRD patients without CAD or CHF, there was no statistically significant difference in survival between PD and HD (adjusted HR=1.00, CI: 0.92 to 1.09; adjusted HR=0.98, CI: 0.90 to 1.07).

CONCLUSIONS

PD was associated with poorer survival among ESRD patients with CVD or diabetes mellitus compared with HD.

Authors+Show Affiliations

Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22476965

Citation

Wang, I-Kuan, et al. "Impact of Dialysis Modality On the Survival of End-stage Renal Disease Patients With or Without Cardiovascular Disease." Journal of Nephrology, vol. 26, no. 2, 2013, pp. 331-41.
Wang IK, Kung PT, Kuo WY, et al. Impact of dialysis modality on the survival of end-stage renal disease patients with or without cardiovascular disease. J Nephrol. 2013;26(2):331-41.
Wang, I. K., Kung, P. T., Kuo, W. Y., Tsai, W. C., Chang, Y. C., Liang, C. C., Chang, C. T., Yeh, H. C., Wang, S. M., Chuang, F. R., Wang, K. Y., Lin, C. Y., & Huang, C. C. (2013). Impact of dialysis modality on the survival of end-stage renal disease patients with or without cardiovascular disease. Journal of Nephrology, 26(2), 331-41. https://doi.org/10.5301/jn.5000149
Wang IK, et al. Impact of Dialysis Modality On the Survival of End-stage Renal Disease Patients With or Without Cardiovascular Disease. J Nephrol. 2013 Mar-Apr;26(2):331-41. PubMed PMID: 22476965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of dialysis modality on the survival of end-stage renal disease patients with or without cardiovascular disease. AU - Wang,I-Kuan, AU - Kung,Pei-Tseng, AU - Kuo,Wei-Yin, AU - Tsai,Wen-Chen, AU - Chang,Yi-Chih, AU - Liang,Chih-Chia, AU - Chang,Chiz-Tzung, AU - Yeh,Hung-Chieh, AU - Wang,Shu-Ming, AU - Chuang,Feng-Rong, AU - Wang,Kwua-Yun, AU - Lin,Ching-Yuang, AU - Huang,Chiu-Ching, Y1 - 2012/03/30/ PY - 2012/03/01/accepted PY - 2012/4/6/entrez PY - 2012/4/6/pubmed PY - 2013/9/14/medline SP - 331 EP - 41 JF - Journal of nephrology JO - J Nephrol VL - 26 IS - 2 N2 - BACKGROUND: The question of which modality, either peritoneal dialysis (PD) or hemodialysis (HD), confers the survival advantage for incident ESRD patients with pre-existing cardiovascular disease (CVD) remains unanswered. METHODS: Data used in this study were extracted from the National Health Insurance Research Database in Taiwan. From 1997 to 2007, incident ESRD patients who underwent dialysis longer than three months were selected. The established dialysis modality at day 90 was used to analyze the impact of dialysis modality on survival. For each PD patient indentified, five HD patients matched for age, sex, and year in which the patients received their first dialysis treatment were randomly selected. Finally, a total of 35 664 patients including 29 720 HD patients and 5944 PD patients were selected. The primary outcome was death after commencing dialysis. RESULTS: For diabetic ESRD patients with or without coronary artery disease (CAD) or congestive heart failure (CHF), patients receiving PD had inferior survival compared with those receiving HD (P<.001, adjusted HR=1.34 to 1.43). For nondiabetic patients with CAD or CHF, patients receiving PD also had inferior survival compared with those receiving HD (adjusted HR=1.30, CI: 1.08 to 1.57; adjusted HR=1.31, CI: 1.11 to 1.55). For nondiabetic ESRD patients without CAD or CHF, there was no statistically significant difference in survival between PD and HD (adjusted HR=1.00, CI: 0.92 to 1.09; adjusted HR=0.98, CI: 0.90 to 1.07). CONCLUSIONS: PD was associated with poorer survival among ESRD patients with CVD or diabetes mellitus compared with HD. SN - 1724-6059 UR - https://www.unboundmedicine.com/medline/citation/22476965/Impact_of_dialysis_modality_on_the_survival_of_end_stage_renal_disease_patients_with_or_without_cardiovascular_disease_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -