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Abstract: PO1049

Comparison of 5-Year Survival Rate Between Hemodialysis and Peritoneal Dialysis Patients: A Prospective Cohort Study with Propensity Score Matching

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Miyazaki, Mami, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
  • Doi, Shigehiro, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
  • Nakashima, Ayumu, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
  • Doi, Toshiki, Harada Hospital, Hiroshima, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
Background

Chronic Kidney Disease patients who require dialysis have increased worldwide. However, whether hemodialysis (HD) or peritoneal dialysis (PD) independently affects prognosis is still controversial.

Methods

A multicenter prospective observational study was conducted from 1 January 2012 to 31 March 2018. Total of 646 HD patients and 72 PD patients were enrolled from Hiroshima Chronic kidney disease outcomes cohort study (Hi-COCS) in Japan. We excluded patients whose follow-up period was less than 3 months. One to one propensity score matching was performed to compare the survival rates between HD and PD patients and to find the factors that would affect prognosis.

Results

Of 621 HD patients and 71 PD patients, the mean average age was 74.2±12.5, 49.7% patients had DM, and 19.2% patients had CVD. The median follow-up period was 41 months. Total of 130 patients were selected with 1:1 propensity score matching (65 HD patients and 65 PD patients). In the PS matched cohort, there was no difference between the two groups in the 5-year survival rates of the overall events. (HD 71.2% vs PD 71.2%, respectively, P = 0.97) PD group had better survival rate of CVD events and it was significantly different between the two groups (P = 0.043). Multivariate Cox proportional hazard model showed that adjusted hazard ratio (HR) of overall events and CVD events were 1.06 (95% confidence interval (CI); 0.53-2.10, P = 0.96) and 4.90 (95% CI 1.37-23.8, P = 0.014), respectively. Age, non-HDL cholesterol and CRP were associated with prognosis in overall events. Only non-HDL cholesterol was associated with prognosis in CVD events.

Conclusion


In this study, we found out that 5-year survival rate was not significantly different between the HD and PD patients in overall events. However, PD group had better survival rate of CVD events than that of HD patients. It suggests that PD may potentially have treatment advantage for patients who have high risk factors of CVD events.