Key result
Peritoneal dialysis shows no survival benefit over hemodialysis in stage 5 CKD.
Why the study?
It is controversial whether the mode of dialysis or preexisting comorbidities influence prognosis in patients with chronic kidney disease stage 5.
Does peritoneal dialysis improve survival compared to hemodialysis in patients with chronic kidney disease stage 5?
Case-Control (n=100)
Does peritoneal dialysis improve survival compared to hemodialysis in patients with chronic kidney disease stage 5?
The mode of dialysis (peritoneal vs hemodialysis) does not significantly influence survival in patients with CKD stage 5; rather, age and comorbidities like diabetes are the primary predictors of mortality.
No survival difference by dialysis modality in CKD stage 5; leaves open confirmation in randomized trials beyond age and comorbidities.
It is still controversial whether the mode of dialysis or preexisting comorbidities may influence the prognosis of patients with chronic kidney disease stage 5. Therefore, we performed a prospective case control study to evaluate whether the mode of dialysis may influence outcome. We found 25 cases on peritoneal dialysis (PD) treatment and 75 age and sex-matched controls on hemodialysis (HD) treatment for more than 3 months. Analysis was by intention-to-treat. During the follow up of 58 months, 6 out of 25 patients (24%) died in the PD group, whereas in the HD group 26 out of 75 patients (35%) died (relative risk 0.69 [95% CI 0.32 to 1.49]; P = 0.46). Survival was not significantly different between the groups as indicated by Mantel-Cox log-rank test (hazard ratio 0.52 [95% CI 0.25 to 1.10]; P = 0.11). Multiple variable regression showed that age and diabetes mellitus, but not mode of dialysis, predicted death in patients with chronic kidney disease. It is concluded that age and comorbidities but not mode of dialysis are important to predict survival in patients with chronic kidney disease stage 5.
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Maier et al. (2009) conducted a case-control in Chronic Kidney Disease Stage 5 (n=100). Peritoneal dialysis vs. Hemodialysis was evaluated on Death (HR 0.52, 95% CI 0.25 to 1.10, p=0.11). Peritoneal dialysis was not associated with a significant difference in survival compared to hemodialysis in patients with chronic kidney disease stage 5 (HR 0.52; 95% CI 0.25 to 1.10; P=0.11).
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