The researchers selected 2032 ESRD patients who were suitable for HD and PD for treatment from 7 dialysis centers, comparing the survival of HD (n = 1579) and PD (n = 453) patients. The median follow-up time was 520 days.
During follow-up, there was no significant difference in all-cause mortality between HD and PD in patients >65 years of age. In patients <65 years of age, the risk of death in PD patients was 40% lower than that in patients receiving HD in the first 3 years of dialysis.
Excluding patients who were not eligible for PD, further analysis showed no significant difference in mortality between HD and PD patients (0.47 vs 0.38) regardless of age.
"At present, there are many studies on the survival of HD or PD patients, although most studies have shown no significant differences in mortality between HD and PD patients, but the study was conducted in patients with appropriate HD and PD, the researchers said. The deviation is small. When the end-stage renal disease patients who are suitable for two dialysis treatments cannot make a choice, the results of the study can be used to guide the decision of the doctor and patient, which is of clinical significance."
Dr. Simonetta Carla Genovesi from Italy commented that “the study subjects were suitable for both HD and PD treatments, and the study bias was reduced as much as possible. The researchers corrected the confounding factors and found that HD and PD patients had no mortality. Significant differences are beneficial to patients (no PD contraindications) free choice for their own dialysis.
However, it should be noted that compared to other industrialized countries, the Canadian national PD treatment rate is 22%, about twice that of the United States and Italy (10%). In other words, the Canadian national PD promotion rate is higher than other countries, and for those countries that cannot promote PD, the results may not be meaningful. ”
