Abstract: FR-OR057

Comparing Mortality between Incident Peritoneal Dialysis and Home Hemodialysis Patients

Session Information

  • Home Hemodialysis
    November 03, 2017 | Location: Room 295, Morial Convention Center
    Abstract Time: 06:18 PM - 06:30 PM

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Choi, Soo Jeong, UC Irvine, Orange, California, United States
  • Obi, Yoshitsugu, UC Irvine, Orange, California, United States
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Rhee, Connie, UC Irvine, Orange, California, United States
  • Streja, Elani, UC Irvine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States
Background

The use of home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis (HHD), has recently increased. Although HHD differs from PD in terms of setting, frequency and patient preference, prior studies have shown that HHD patients have lower mortality risk than PD, in which we sought to examine using propensity scores in a large contemporary cohort of home dialysis patients.

Methods

We retrospectively examined a cohort of 1,993 HHD and 16,515 PD patients who initiated home dialysis from 2007-2011. HHD patients were matched with 2 PD patients using propensity score (PS) matching. Demographics, comorbidities, vintage and body mass index were included in logistic regression model for PS matching. We matched 1,988 HHD with 3,876 PD patients. Patients were stratified by vintage at the time of home modality initiation (<3 months (M), 3-<12M, and >12M).

Results

In the matched cohort, 244 and 699 deaths occurred in HHD and PD patients, respectively (cumulative incidence rate: 9.4 vs 12.0/100 patient year, p = 0.002). But, PD patients who transitioned within 12M of vintage had similar mortality risk. Only PD patients who transitioned after 12M of vintage had higher risk for mortality (HR, 1.62; 95% CI, 1.18-2.20).

Conclusion

Whereas there appears to be no survival difference among those who started home dialysis in the first 12 M, patients who transitioned to PD after 12 M of vintage had worse survival than those who transitioned to HHD after 12 M of vintage. Additional studies are warranted to further investigate these differences.

Funding

  • NIDDK Support