BACKGROUND: The annual payer costs for patients treated with peritoneal dialysis (PD) are lower than with hemodialysis (HD), but in 2007, only 7% of dialysis patients in the United States were treated with PD. Since 1996, there has been no change in the first-year mortality of HD patients, but both short- and long-term outcomes of PD patients have improved. METHODS: Data from the US Renal Data System were examined for secular trends in survival among patients treated with HD and PD on day 90 of end-stage renal disease (HD, 620 020 patients; PD, 64 406 patients) in three 3-year cohorts (1996-1998, 1999-2001, and 2002-2004) for up to 5 years of follow-up using a nonproportional hazards marginal structural model with inverse probability of treatment and censoring weighting. RESULTS: There was a progressive attenuation in the higher risk for death seen in patients treated with PD in earlier cohorts; for the 2002-2004 cohort, there was no significant difference in the risk of death for HD and PD patients through 5 years of follow-up. The median life expectancy of HD and PD patients was 38.4 and 36.6 months, respectively. Analyses in 8 subgroups based on age (<65 and ≥65 years), diabetic status, and baseline comorbidity (none and ≥1) showed greater improvement in survival among patients treated with PD relative to HD at all follow-up periods. CONCLUSION: In the most recent cohorts, patients who began treatment with HD or PD have similar outcomes.
BACKGROUND: The annual payer costs for patients treated with peritoneal dialysis (PD) are lower than with hemodialysis (HD), but in 2007, only 7% of dialysis patients in the United States were treated with PD. Since 1996, there has been no change in the first-year mortality of HDpatients, but both short- and long-term outcomes of PDpatients have improved. METHODS: Data from the US Renal Data System were examined for secular trends in survival among patients treated with HD and PD on day 90 of end-stage renal disease (HD, 620 020 patients; PD, 64 406 patients) in three 3-year cohorts (1996-1998, 1999-2001, and 2002-2004) for up to 5 years of follow-up using a nonproportional hazards marginal structural model with inverse probability of treatment and censoring weighting. RESULTS: There was a progressive attenuation in the higher risk for death seen in patients treated with PD in earlier cohorts; for the 2002-2004 cohort, there was no significant difference in the risk of death for HD and PDpatients through 5 years of follow-up. The median life expectancy of HD and PDpatients was 38.4 and 36.6 months, respectively. Analyses in 8 subgroups based on age (<65 and ≥65 years), diabetic status, and baseline comorbidity (none and ≥1) showed greater improvement in survival among patients treated with PD relative to HD at all follow-up periods. CONCLUSION: In the most recent cohorts, patients who began treatment with HD or PD have similar outcomes.
Authors: Jeffrey Perl; Ron Wald; Philip McFarlane; Joanne M Bargman; Edward Vonesh; Yingbo Na; S Vanita Jassal; Louise Moist Journal: J Am Soc Nephrol Date: 2011-04-21 Impact factor: 10.121
Authors: Jennifer E Flythe; Tandrea Hilliard; Elena Lumby; Graciela Castillo; Jazmine Orazi; Emaad M Abdel-Rahman; Amy Barton Pai; Matthew Bertrand Rivara; Wendy L St Peter; Steven Darrow Weisbord; Caroline M Wilkie; Rajnish Mehrotra Journal: Clin J Am Soc Nephrol Date: 2018-11-05 Impact factor: 8.237
Authors: Paungpaga Lertdumrongluk; Elani Streja; Connie M Rhee; Jongha Park; Onyebuchi A Arah; Steven M Brunelli; Allen R Nissenson; Daniel Gillen; Kamyar Kalantar-Zadeh Journal: Am J Nephrol Date: 2014-04-26 Impact factor: 3.754
Authors: Virginia Wang; Cynthia J Coffman; Linda L Sanders; Shoou-Yih D Lee; Richard A Hirth; Matthew L Maciejewski Journal: Clin J Am Soc Nephrol Date: 2018-11-19 Impact factor: 8.237
Authors: Eric L Wallace; Rachel B Fissell; Thomas A Golper; Peter G Blake; Adriane M Lewin; Matthew J Oliver; Rob R Quinn Journal: Perit Dial Int Date: 2015-10-22 Impact factor: 1.756