Unveiling Nuances in Revascularization: A Call for Focused Exploration in Peritoneal Dialysis Patients

We appreciate the comprehensive study conducted by Pan et al1Pan S.-Y. Yang J.-Y. Teng N.-C. et al.Percutaneous coronary intervention with a drug-eluting stent versus coronary artery bypass grafting in patients receiving dialysis: a national study From Taiwan.Kidney Med. 2024; 6100768Abstract Full Text Full Text PDF Scopus (2) Google Scholar comparing percutaneous coronary intervention (PCI) with a drug-eluting stent versus coronary artery bypass grafting (CABG) in patients receiving dialysis. The authors presented compelling data suggesting that CABG may not be superior and could pose potential harm compared with PCI. Although we acknowledge the limitations highlighted by Tuttle and Weiner2Tuttle M.L. Weiner D.E. Coronary artery bypass grafting versus percutaneous coronary intervention in patients receiving dialysis: Is CABG worth the risk?.Kidney Med. 2024; 6100787Abstract Full Text Full Text PDF Scopus (1) Google Scholar, we wish to emphasize a notable strength of the study, namely, having the highest number of patients who received peritoneal dialysis (PD) in the CABG versus PCI literature. This aspect is particularly significant because revascularization debates predominantly focus on patients receiving hemodialysis. The scarcity of PD data in revascularization studies necessitates further exploration, because meta-analyses often exclude PD because of insufficient data.3Li Y. Hou X. Liu T. et al.Comparison of coronary artery bypass grafting and drug-eluting stent implantation in patients with chronic kidney disease: a propensity score matching study.Front Cardiovasc Med. 2022; 9802181Google Scholar The authors' conclusion on the similarity of hemodialysis and PD subgroups warrants additional attention. Despite statistically nonsignificant P values, the unique characteristics of patients receiving PD, as evident in Figure S3 (wide confidence intervals), suggest potential insights into in-hospital mortality. A dedicated subgroup analysis or a subsequent paper with expanded individuals focusing solely on patients receiving PD could unveil valuable nuances. In light of the limited revascularization data in PD literature, such an endeavor would contribute significantly. We express our gratitude to Pan et al1Pan S.-Y. Yang J.-Y. Teng N.-C. et al.Percutaneous coronary intervention with a drug-eluting stent versus coronary artery bypass grafting in patients receiving dialysis: a national study From Taiwan.Kidney Med. 2024; 6100768Abstract Full Text Full Text PDF Scopus (2) Google Scholar and anticipate further details on their patients who received PD, hoping for a swift response. The author declares that he has no relevant financial interests. Received January 23, 2024. Accepted January 31, 2024 after editorial review by the Editor-in-Chief. Percutaneous Coronary Intervention With a Drug-Eluting Stent Versus Coronary Artery Bypass Grafting in Patients Receiving Dialysis: A National Study From TaiwanKidney MedicineVol. 6Issue 2The Authors' Reply to "Revascularization in Peritoneal Dialysis: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting"Kidney Medicine