Impact of dialysis modality on technique survival in end-stage renal disease patients

Korean Journal of Internal Medicine 2016³â 31±Ç 1È£ p.106 ~ p.115

ÀÌÁ¾ÇÐ(Lee Jong-Hak) - Kyungpook National University School of Medicine Department of Internal Medicine
¹Ú¼øÈñ(Park Sun-Hee) - Kyungpook National University Hospital Department of Internal Medicine
ÀÓÁ¤ÈÆ(Lim Jeong-Hoon) - Kyungpook National University School of Medicine Department of Internal Medicine
¹Ú¿µÀç(Park Young-Jae) - Kyungpook National University School of Medicine Department of Internal Medicine
±è»ó¿î(Kim Sang-Un) - Kyungpook National University School of Medicine Department of Internal Medicine
ÀÌ°æÈñ(Lee Kyung-Hee) - Kyungpook National University School of Medicine Department of Internal Medicine
±è°æÈÆ(Kim Kyung-Hoon) - Kyungpook National University School of Medicine Department of Internal Medicine
¹Ú½ÂÂù(Park Seung-Chan) - Kyungpook National University School of Medicine Department of Internal Medicine
Á¤Èñ¿¬(Jung Hee-Yeon) - Kyungpook National University School of Medicine Department of Internal Medicine
(Kwon Owen) - Kyungpook National University School of Medicine Department of Internal Medicine
ÃÖÁö¿µ(Choi Ji-Young) - Kyungpook National University School of Medicine Department of Internal Medicine
Á¶ÀåÈñ(Cho Jang-Hee) - Kyungpook National University School of Medicine Department of Internal Medicine
±èÂù´ö(Kim Chan-Duck) - Kyungpook National University School of Medicine Department of Internal Medicine
±è¿ë¸²(Kim Yong-Lim) - Kyungpook National University School of Medicine Department of Internal Medicine

Abstract

Background/Aims: This study analyzed the risk factors for technique survival in dialysis patients and compared technique survival rates between hemodialysis (HD) and peritoneal dialysis (PD) in a prospective cohort of Korean patients.

Methods: A total of 1,042 patients undergoing dialysis from September 2008 to June 2011 were analyzed. The dialysis modality was defined as that used 90 days after commencing dialysis. Technique survival was compared between the two dialysis modalities, and the predictive risk factors were evaluated.

Results: The dialysis modality was an independent risk factor predictive of technique survival. PD had a higher risk for technique failure than HD (hazard ratio [HR], 10.8; 95% confidence interval [CI], 1.9 to 62.0; p = 0.008) during a median follow-up of 11.0 months. In the PD group, a high body mass index (BMI) was an independent risk factor for technique failure (HR, 1.3; 95% CI, 1.0 to 1.8; p = 0.036). Peritonitis was the most common cause of PD technique failure. The difference in technique survival between PD and HD was more prominent in diabetic patients with a good nutritional status and in non-diabetic patients with a poor nutritional status.

Conclusions: In a prospective cohort of Korean patients with end-stage renal disease, PD was associated with a higher risk of technique failure than HD. Diabetic patients with a good nutritional status and non-diabetic patients with a poor nutritional status, as well as patients with a higher BMI, had an inferior technique survival rate with PD compared to HD.

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Survival, Hemodialysis, Peritoneal dialysis, Body mass index, Diabetes
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The risk of technique failure was higher for peritoneal dialysis (PD) than hemodialysis; PD was associated with a higher risk of technique failure than HD.
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