Hospitalization Risk Less with PD

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SAN DIEGO—Patients initiating dialysis have a lower hospitalization risk in the first year if they start on peritoneal dialysis (PD) instead of hemodialysis (HD), according to findings presented at Kidney Week 2012.

Eduardo K. Lacson, MD, MPHD, of Fresenius Medical Care North America in Waltham, Mass., and colleagues found that 69% of 24,516 HD patients and 58% of 1,677 PD patients were hospitalized in the first year. Hospitalization rates were 0.92 per patient-year in the PD group compared with 1.48 per patient-year in the HD group. In adjusted analyses, PD patients had a 35% decreased risk of hospitalization in the first year.

Among the HD patients, those with catheter vascular access had a higher risk of hospitalization in the first year than those without a catheter (1.69 vs. 1.03 admissions per patient-year). Compared with PD patients, HD patients with and without a catheter had a 64% and 22% increased risk of hospitalization, respectively, in adjusted analyses.

PD patients were younger than HD patients (mean 57 vs. 64 years) and admitted later (mean admission vintage 22 vs. 11 days). The PD group had fewer black patients (21% vs. 31%) and a larger body mass index (mean 32 vs. 31 kg/m2). In addition, the PD group had fewer patients with diabetes, congestive heart failure, peripheral vascular disease, and amputations than the HD group. 

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