Starting on Peritoneal Dialysis May Offer Survival Edge

Highest survival rates found when initial dialysis modality was PD but then switched to HD.
Highest survival rates found when initial dialysis modality was PD but then switched to HD.

AMSTERDAM—Russian researchers who examined the impact of initial dialysis modality and modality switches on patient survival over 5 years found the highest survival among patients switched from peritoneal dialysis (PD) to hemodialysis (HD), according to a poster presentation at the 51st Congress of the European Renal Association-European Dialysis and Transplant Association.

Boris Bikbov, of A.I. Evdokimov Moscow State University of Medicine and Dentistry in Moscow, and colleagues studied 11,021 incident HD and PD patients who started treatment from January 1, 1995 to December 31, 2012. They classified subjects into four groups according to initial modality and long-term (duration more than 30 days) transfer to another modality: HD only, PD only, HD to PD, and PD to HD.

Among patients switched from PD to HD, the survival rates at 1, 2, 3, 4, and 5 years were 96%, 89.7%, 82%, 74.6%, and 67.5%, respectively. PD-only patients had a significant higher survival rate than HD-only patients at 1 year (82% vs. 76.1%), but a significantly lower rate at year 5 (33.7% vs. 54.5%). Survival rates did not differ significantly between the groups at years 2, 3, and 4.

“Our results suggest that PD was the preferable initial dialysis modality that could be later switched to HD,” the authors concluded.

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