A population-based approach indicates an overall higher patient mortality with peritoneal dialysis compared to hemodialysis in Korea

Hyunwook Kim, Kyoung Hoon Kim, Kisoo Park, Shin Wook Kang, Tae Hyun Yoo, Song Vogue Ahn, Hyeong Sik Ahn, Hoo Jae Hann, Shina Lee, Jung Hwa Ryu, Seung Jung Kim, Duk Hee Kang, Kyu Bok Choi, Dong Ryeol Ryu

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

To date, only a few large-scale studies have measured the effect of dialysis modality on mortality in Asian populations. Here, we sought to compare survival between incident hemodialysis (HD) and peritoneal dialysis (PD) patients using the Korean Health Insurance Review & Assessment Service database. This enabled us to perform a population-based complete survey that included 32,280 incident dialysis patients and followed them for a median of 26.5 months. To reduce biases due to nonrandomization, we first matched 7049 patient pairs with similar propensity scores. Using the log-rank test, we found the mortality rate in PD patients was significantly higher than that in HD patients. Subsequent subgroup analyses indicated that in older patients (55 years and older), with the exception of the subgroup of patients with no comorbidities and the subgroup of patients with malignancy, PD was consistently associated with a higher mortality rate. In younger patients (under 55 years), regardless of the covariates, the survival rate of PD patients was comparable to that of HD patients. Thus, while the overall mortality rate was higher in incident PD patients, mortality rates of some incident PD and HD patients were comparable in Korea.

Original languageEnglish
Pages (from-to)991-1000
Number of pages10
JournalKidney International
Volume86
Issue number5
DOIs
StatePublished - 5 Nov 2014

Bibliographical note

Publisher Copyright:
© 2014 International Society of Nephrology.

Keywords

  • hemodialysis
  • mortality
  • peritoneal dialysis

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