Key result
Initial hemodialysis shows no mortality difference over peritoneal dialysis in patients with heart failure.
Why the study?
Prior studies reported lower mortality with hemodialysis compared to peritoneal dialysis in patients with heart failure, but contemporary data with comparable groups were lacking.
Does hemodialysis compared to peritoneal dialysis improve all-cause mortality in incident dialysis patients with a history of heart failure?
Population
2,199 adults age 50-80 with heart failure initiating maintenance dialysis in Ontario, Canada
Comparison
Initial hemodialysis vs initial peritoneal dialysis
Design
Retrospective cohort study using administrative databases
Follow-up
Median 2.4 years (HD) and 2.5 years (PD)
Authors
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No mortality difference supports modality selection by preference in heart failure; leaves open randomized confirmation.
Cohort (n=2,199)
Does hemodialysis compared to peritoneal dialysis improve all-cause mortality in incident dialysis patients with a history of heart failure?
Hazard Ratio: 1 (95% CI 0.9–1.1)
Absolute Event Rate: 67.8% vs 68.1%
In incident dialysis patients with pre-existing heart failure, there is no difference in all-cause mortality between hemodialysis and peritoneal dialysis, supporting modality selection based on patient preference.
Molnar et al. (2020) conducted a cohort in Heart failure (n=2,199). Hemodialysis vs. Peritoneal dialysis was evaluated on all-cause mortality (HR 1.0, 95% CI 0.9-1.1). Initiating hemodialysis versus peritoneal dialysis was not associated with a difference in all-cause mortality among patients with pre-existing heart failure (HR 1.0; 95% CI 0.9-1.1).
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