A population-based approach indicates an overall higher patient mortality with peritoneal dialysis compared to hemodialysis in Korea.

Kim, Hyunwook; Kim, Kyoung Hoon; Park, Kisoo; Kang, Shin-Wook; Yoo, Tae-Hyun; Ahn, Song Vogue; Ahn, Hyeong Sik; Hann, Hoo Jae; Lee, Shina; Ryu, Jung-Hwa; Kim, Seung-Jung; Kang, Duk-Hee; Choi, Kyu Bok; Ryu, Dong-Ryeol
Kidney international
2014Nov ; 86 ( 5 ) :991-1000.
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Kim, Hyunwook - Department of Internal Medicine, Wonkwang University College of Medicine Sanbon Hospital, Gunpo, Korea.
Kim, Kyoung Hoon - Department of Public Health, Graduate School, Korea University, Seoul, Korea.
Park, Kisoo - Department of Preventive Medicine, School of Medicine and Health Science Institute, Gyeongsang National University, Jinju, Korea.
Kang, Shin-Wook - Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
Yoo, Tae-Hyun - Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
Ahn, Song Vogue - Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
Ahn, Hyeong Sik - Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
Hann, Hoo Jae - Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.
Lee, Shina - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Ryu, Jung-Hwa - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Kim, Seung-Jung - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Kang, Duk-Hee - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Choi, Kyu Bok - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Ryu, Dong-Ryeol - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
ABSTRACT
To date, only a few large-scale studies have measured the effect of dialysis modality on mortality in Asian populations. Here, we sought to compare survival between incident hemodialysis (HD) and peritoneal dialysis (PD) patients using the Korean Health Insurance Review & Assessment Service database. This enabled us to perform a population-based complete survey that included 32,280 incident dialysis patients and followed them for a median of 26.5 months. To reduce biases due to nonrandomization, we first matched 7049 patient pairs with similar propensity scores. Using the log-rank test, we found the mortality rate in PD patients was significantly higher than that in HD patients. Subsequent subgroup analyses indicated that in older patients (55 years and older), with the exception of the subgroup of patients with no comorbidities and the subgroup of patients with malignancy, PD was consistently associated with a higher mortality rate. In younger patients (under 55 years), regardless of the covariates, the survival rate of PD patients was comparable to that of HD patients. Thus, while the overall mortality rate was higher in incident PD patients, mortality rates of some incident PD and HD patients were comparable in Korea.
hemodialysis; mortality; peritoneal dialysis
MESH
Adult, Age Factors, Aged, Asian Continental Ancestry Group, Comorbidity, Female, Humans, Incidence, Kaplan-Meier Estimate, Kidney Failure, Chronic/diagnosis/ethnology/*mortality/*therapy, Male, Middle Aged, Peritoneal Dialysis/adverse effects/*mortality, Prevalence, Propensity Score, Proportional Hazards Models, Registries, Renal Dialysis/adverse effects/*mortality, Republic of Korea/epidemiology, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome
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The overall mortality rate was higher in incident PD patients; mortality rates of some incident PD and HD patients were comparable in Korea.
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DOI
10.1038/ki.2014.163
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ICD 03
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