Abstract: TH-PO0880
Association Between Initial Kidney Replacement Therapy Modality and Mortality in Patients with CKD at a Public Referral Hospital in Mexico
Session Information
- Dialysis: Prescription, Physiology, and Treatment Optimization
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- De La Paz, Sofía Velázquez, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Rodriguez Alvarez, Karen Guadalupe, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Galindo, Pablo E., Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Reyna-Blanco, Juan, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
Background
Initiation of kidney replacement therapy (KRT) in advanced chronic kidney disease is associated with high mortality, particularly in resource-limited settings. Data comparing outcomes according to initial KRT modality in patients treated at public hospitals in Mexico are limited.
Methods
Ambispective comparative cohort study including adults with chronic kidney disease initiating KRT between March 2024 and October 2025 at a Mexican public referral hospital. Survival was analyzed using Kaplan-Meier curves and log-rank tests. Multivariable Cox regression was performed to identify factors associated with mortality.
Results
A total of 279 patients were included: 171 (61.3%) initiated hemodialysis (HD) and 108 (38.7%) peritoneal dialysis (PD). During follow-up, 43 deaths occurred, including 32 in HD and 11 in PD (18.7% vs 10.2%). Kaplan-Meier analysis demonstrated higher survival among PD patients (log-rank p=0.009). In multivariable analysis, HD initiation was independently associated with higher mortality compared with PD (adjusted HR 2.57; 95% CI 1.18-5.63; p=0.017). Urgent-start HD represented the highest-risk subgroup. No significant differences were observed in infectious complications, access durability, or modality persistence.
Conclusion
Initial PD was associated with better survival compared with HD in this vulnerable population. Urgent-start HD showed the worst prognosis. These findings support strategies focused on earlier nephrology referral, expansion of urgent-start PD programs, and strengthening longitudinal care for HD patients.
Acknowledgment
No external funding was received for this study. These authors acknowledge the Nephrology Department at Hospital General de México "Dr. Eduardo Liceaga" for institutional support.