Home hemodialysis (HHD) is associated with better patient survival than peritoneal dialysis (PD), a new study suggests.

The study included 11,416 patients on incident home dialysis at 90 days after initiating renal replacement therapy (RRT). The group included 10,710 patients on PD (median age 62 years) and 706 on HHD (median age 50 years). The patients were enrolled in the Australian and New Zealand Dialysis and Transplantation Registry study.

The PD and HHD groups had 4,970 and 86 deaths, respectively. Results showed that 5-year survival rates were significantly higher among HHD than PD patients (85% vs. 44%). HHD was associated with a significant 53% decreased risk of death and a significant 66% decreased risk of technique failure, the researchers, led by David W. Johnson, MBBS, PhD, of Princess Alexandra Hospital in Brisbane, Australia, reported online ahead of print in the Clinical Journal of the American Society of Nephrology

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The investigators noted that few studies have directly compared clinical outcomes associated with HHD and PD, and none have specifically evaluated patients starting RRT with a home-based modality.

Whether the survival advantage conferred by HHD is related to the dialysis treatment itself or intrinsic patient differences is unclear, Dr. Johnson’s group noted.