Liver cirrhosis leads to poorer survival in patients with end-stage renal disease

Korean Journal of Internal Medicine 2016³â 31±Ç 4È£ p.730 ~ p.738

±è¾ÖÁø(Kim Ae-Jin) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
ÀÓÇýÁø(Lim Hye-Jin) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
³ëÇÑ(Ro Han) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
Á¤Áö¿ë(Jung Ji-Yong) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
ÀÌÇöÈñ(Lee Hyun-Hee) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
Á¤¿ì°æ(Chung Woo-Kyung) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine
ÀåÁ¦Çö(Chang Jae-Hyun) - Gachon University Graduate School of Medicine Gachon University Gil Medical Center Department of Internal Medicine

Abstract

Background/Aims: Liver cirrhosis (LC) is an important problem in patients withend-stage renal disease (ESRD). Few studies have investigated the inf luence ofLC on mortality in patients with ESRD. This study investigated the associationbetween LC and mortality among patients with ESRD and compare mortality betweentwo dialysis modalities.

Methods: Adult patients (¡Ã 18 years of age) starting dialysis for ESRD were enrolledin the present study from 2000 to 2011. We analyzed 1,069 patients withESRD; of these, 742 patients were undergoing hemodialysis (HD) and 327 patientswere undergoing peritoneal dialysis (PD).

Results: The prevalence of LC was 44 of 1,069 patients (4.1%). The cumulative 1-,3-, and 5-year survival rates of noncirrhotic patients were 93%, 83%, and 73%, respectively,whereas the equivalent survival rates of cirrhotic patients were 90%,68%, and 48%, respectively (p = 0.011). After adjustment, LC was an independentrisk factor for death in patients with ESRD. No difference in mortality associatedwith LC was found between the HD and PD subgroups.

Conclusions: Of the patients with ESRD, cirrhotic patients had poorer survivalthan noncirrhotic patients. Among patients with ESRD and LC, survival of patientsundergoing PD may be comparable with that of patients undergoing HD.

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Hemodialysis, Liver cirrhosis, Mortality, Peritoneal dialysis
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LC was an independent risk factor for death in patients with ESRD. No difference in mortality associated with LC was found between the HD and PD subgroups.
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