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A comparative assessment of survival between propensity score-matched patients with peritoneal dialysis and hemodialysis in Taiwan.

Abstract

Studies comparing mortality for Asian populations with end-stage renal disease (ESRD) on hemodialysis (HD) and peritoneal dialysis (PD) are limited. We compared mortality between patients treated with PD and HD in Taiwan, the population with the highest incidence of ESRD worldwide. Using the population-based insurance claims data of Taiwan from 1997 to 2006, we identified 4721 patients treated with PD and randomly selected 4721 patients treated with HD who were frequency-matched to the PD patients based on their propensity scores. In follow-up analyses we measured mortalities and hazard ratios associated with comorbidities in 2 different 5-year cohorts (1997-2001 and 2002-2006).In the 10-year period from 1997 to 2006, the overall mortality rates were similar in patients treated with PD and in patients treated with HD (12.0 vs. 11.7 per 100 person-years, respectively), with a PD-to-HD hazard ratio of 1.02 (95% confidence interval [CI], 0.96-1.08). In the first 5-year period (1997-2001), the hazard ratio for mortality was higher for PD (1.33; 95% CI, 1.21-1.46), but there was no difference between PD and HD in the 2002-2006 cohort. Of note, younger patients who received PD had better survival than younger patients who received HD; this was especially true for patients aged younger than 40 years.In summary, in this Asian population, no significant survival differences were noted between propensity score-matched PD and HD patients. The selection of a dialysis modality must be tailored to the individual patient. Studies in which patients who are appropriate for either modality are randomly assigned to HD or PD may provide helpful information to clinicians and patients.

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  • Authors+Show Affiliations

    ,

    Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.

    , , , , ,

    Source

    Medicine 91:3 2012 May pg 144-51

    MeSH

    Cohort Studies
    Comorbidity
    Humans
    Kidney Failure, Chronic
    Logistic Models
    Peritoneal Dialysis
    Propensity Score
    Proportional Hazards Models
    Renal Dialysis
    Retrospective Studies
    Survival Analysis
    Taiwan
    Treatment Outcome

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    22525667

    Citation

    Chang, Yu-Kang, et al. "A Comparative Assessment of Survival Between Propensity Score-matched Patients With Peritoneal Dialysis and Hemodialysis in Taiwan." Medicine, vol. 91, no. 3, 2012, pp. 144-51.
    Chang YK, Hsu CC, Hwang SJ, et al. A comparative assessment of survival between propensity score-matched patients with peritoneal dialysis and hemodialysis in Taiwan. Medicine (Baltimore). 2012;91(3):144-51.
    Chang, Y. K., Hsu, C. C., Hwang, S. J., Chen, P. C., Huang, C. C., Li, T. C., & Sung, F. C. (2012). A comparative assessment of survival between propensity score-matched patients with peritoneal dialysis and hemodialysis in Taiwan. Medicine, 91(3), pp. 144-51. doi:10.1097/MD.0b013e318256538e.
    Chang YK, et al. A Comparative Assessment of Survival Between Propensity Score-matched Patients With Peritoneal Dialysis and Hemodialysis in Taiwan. Medicine (Baltimore). 2012;91(3):144-51. PubMed PMID: 22525667.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A comparative assessment of survival between propensity score-matched patients with peritoneal dialysis and hemodialysis in Taiwan. AU - Chang,Yu-Kang, AU - Hsu,Chih-Cheng, AU - Hwang,Shang-Jyh, AU - Chen,Pei-Chun, AU - Huang,Chiu-Chin, AU - Li,Tsai-Chung, AU - Sung,Fung-Chang, PY - 2012/4/25/entrez PY - 2012/4/25/pubmed PY - 2012/7/26/medline SP - 144 EP - 51 JF - Medicine JO - Medicine (Baltimore) VL - 91 IS - 3 N2 - Studies comparing mortality for Asian populations with end-stage renal disease (ESRD) on hemodialysis (HD) and peritoneal dialysis (PD) are limited. We compared mortality between patients treated with PD and HD in Taiwan, the population with the highest incidence of ESRD worldwide. Using the population-based insurance claims data of Taiwan from 1997 to 2006, we identified 4721 patients treated with PD and randomly selected 4721 patients treated with HD who were frequency-matched to the PD patients based on their propensity scores. In follow-up analyses we measured mortalities and hazard ratios associated with comorbidities in 2 different 5-year cohorts (1997-2001 and 2002-2006).In the 10-year period from 1997 to 2006, the overall mortality rates were similar in patients treated with PD and in patients treated with HD (12.0 vs. 11.7 per 100 person-years, respectively), with a PD-to-HD hazard ratio of 1.02 (95% confidence interval [CI], 0.96-1.08). In the first 5-year period (1997-2001), the hazard ratio for mortality was higher for PD (1.33; 95% CI, 1.21-1.46), but there was no difference between PD and HD in the 2002-2006 cohort. Of note, younger patients who received PD had better survival than younger patients who received HD; this was especially true for patients aged younger than 40 years.In summary, in this Asian population, no significant survival differences were noted between propensity score-matched PD and HD patients. The selection of a dialysis modality must be tailored to the individual patient. Studies in which patients who are appropriate for either modality are randomly assigned to HD or PD may provide helpful information to clinicians and patients. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/22525667/A_comparative_assessment_of_survival_between_propensity_score_matched_patients_with_peritoneal_dialysis_and_hemodialysis_in_Taiwan_ L2 - http://Insights.ovid.com/pubmed?pmid=22525667 DB - PRIME DP - Unbound Medicine ER -