OBJECTIVE: We investigated the clinical condition and complications of patients on peritoneal dialysis (PD) and on hemodialysis (HD) for more than 12 years. DESIGN: This retrospective review was carried out in the renal unit of the Tung Wah Hospital, Hong Kong. PATIENTS AND METHODS: Of 103 HD and 341 PD patients who started dialysis before 1990, 14 HD and 22 PD patients were dialyzed for more than 12 years. We evaluated basic demography at the 12th year of dialysis and at the most recent follow-up, and assessed the prevalence of cardiovascular disease, bone disease, dialysis-related amyloidosis (DRA), and acquired cystic disease (ACD). Outcomes and mortality were recorded. RESULTS: The 36 patients in the study included 22 women and 14 men. The PD patients were older (p = 0.021) and had lower levels of serum phosphate and calcium x phosphate product. Only 3 patients were diabetic. Cardiovascular disease was present in 30 patients (83.3%), the most common types being ischemic heart disease (IHD, n = 11) and left ventricular hypertrophy (LVH, n = 22). Symptomatic DRA was found in 13 patients (36.1%), more commonly in the HD group (p = 0.014). Bone disease was present in 32 patients (88.9%), with parathyroidectomy being more frequently performed in the PD patients (p = 0.048). Symptomatic ACD occurred in 5 patients (13.9%). At the most recent follow-up, 26 patients were still on dialysis, 3 patients had undergone renal transplantation, and 7 patients had died, the causes of death being sudden death (n = 3), cerebrovascular accident (n = 1), chest infection (n = 2), and peritonitis (n = 1). Patient survival was similar in the PD and HD groups. Age at commencement of dialysis predicted mortality (p = 0.012), but mode of dialysis, sex, and presence of diabetes mellitus did not. CONCLUSIONS: Long-term survival is possible for both dialysis modalities (PD and HD), particularly for young, non diabetic patients. Symptomatic DRA is less common in PD patients, but the prevalence of other long-term complications is similar for both groups. Cardiovascular-related problems remain the leading cause of death.
OBJECTIVE: We investigated the clinical condition and complications of patients on peritoneal dialysis (PD) and on hemodialysis (HD) for more than 12 years. DESIGN: This retrospective review was carried out in the renal unit of the Tung Wah Hospital, Hong Kong. PATIENTS AND METHODS: Of 103 HD and 341 PDpatients who started dialysis before 1990, 14 HD and 22 PDpatients were dialyzed for more than 12 years. We evaluated basic demography at the 12th year of dialysis and at the most recent follow-up, and assessed the prevalence of cardiovascular disease, bone disease, dialysis-related amyloidosis (DRA), and acquired cystic disease (ACD). Outcomes and mortality were recorded. RESULTS: The 36 patients in the study included 22 women and 14 men. The PDpatients were older (p = 0.021) and had lower levels of serum phosphate and calcium x phosphate product. Only 3 patients were diabetic. Cardiovascular disease was present in 30 patients (83.3%), the most common types being ischemic heart disease (IHD, n = 11) and left ventricular hypertrophy (LVH, n = 22). Symptomatic DRA was found in 13 patients (36.1%), more commonly in the HD group (p = 0.014). Bone disease was present in 32 patients (88.9%), with parathyroidectomy being more frequently performed in the PDpatients (p = 0.048). Symptomatic ACD occurred in 5 patients (13.9%). At the most recent follow-up, 26 patients were still on dialysis, 3 patients had undergone renal transplantation, and 7 patients had died, the causes of death being sudden death (n = 3), cerebrovascular accident (n = 1), chest infection (n = 2), and peritonitis (n = 1). Patient survival was similar in the PD and HD groups. Age at commencement of dialysis predicted mortality (p = 0.012), but mode of dialysis, sex, and presence of diabetes mellitus did not. CONCLUSIONS: Long-term survival is possible for both dialysis modalities (PD and HD), particularly for young, non diabeticpatients. Symptomatic DRA is less common in PDpatients, but the prevalence of other long-term complications is similar for both groups. Cardiovascular-related problems remain the leading cause of death.