Why Early Survival on PD Matters

If survival between PD and standard in-center HD “evens out in the end,” does it matter? Yes, argues Mark Marshall, MD, from New Zealand. The early survival benefit increases patient life years—and persists even when accounting for use of central venous HD catheters. To support shared decision-making, patients have the right to know about survival on PD vs. standard HD.

Read the abstract » | (added 2020-03-16)

Tags: Survival, PD, In center HD, Early Survival, HD Catheter

Survival with PD vs. Home HD and When to Go Home

Using a national cohort of 1,993 patients transitioning to home HD and 16,514 to PD between 2007 to 2011, 1,195 home HD were matched to 1,195 using propensity scores and adjusting for demographics, comorbidities, dialysis duration, and BMI. Those on home HD had significantly better survival (9.6 vs. 12.9 deaths per 100 patient-years; p<0.001). However, when patients switched to PD within the first 12 months of starting dialysis, survival was comparable between PD and home HD: patients who transitioned after 12 months had an 83% higher risk of death.

Read the abstract » | (added 2020-02-19)

Tags: Home HD, PD, Comorbidities, Dialysis Duration, BMI, Survival

European Patients Live Longer with Extended HD Treatments

Compared to standard in-center HD, patients from eight European countries who dialyzed for 6+ hours thrice weekly lived longer. Of 142,460 patients, 1,338 did extended HD. Compared to in-center HD (13.5/100 person-years), crude mortality for extended HD (6.0/100 person-years) was significantly better. Overall, those treated with extended treatments were 73% more likely to have survived.

Read the abstract » | (added 2019-12-10)

Tags: Survival, Extended hours Hemodialysis, Haemodialysis, ERA EDTA Registry

Frequency vs. Time in HD Survival

Which matters more for HD--the number of treatments per week, or the length of each treatment? A retrospective registry study from the ANZDATA database looked at survival among 16,944 non-indigenous adult patients in Australia and New Zealand from 2001 to 2015. After controlling for frequency, patients with 5+ hour long treatments had significantly better survival than those whose treatments <5 hours. However, controlling for duration, increasing frequency did not boost survival.

Read the abstract » | (added 2019-06-13)

Tags: ANZDATA, Session Frequency, Session Duration, Survival, End stage Kidney Disease

BMI and Survival on PD

A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.

Read the abstract » | (added 2019-06-13)

Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality

Daily HD Practices in France and Australia/New Zealand

Registry data from both regions compared all incident patients who dialyzed 5-6 sessions per week—both daytime and nocturnal—with one-to-one matching of French to Australia/New Zealand patients based on age, sex, and dialysis start year. While survival and transplant access were comparable, other intriguing differences appeared.

Read the abstract » | (added 2019-05-15)

Tags: Registry Data, Dialysis Interval, Survival, Transplant Acces

Home HD - Significantly Better Survival and Transplant Rate

A Swedish matched cohort study compared the long-term survival of 152 home HD patients with those doing PD (n=456) or standard in-center HD (n=608). Median survival for home HD was significantly better (18.5 years) than PD (15.0) and in-center HD (11.9). Home HD patients were also significantly more likely to have received a transplant.

Read the abstract » | (added 2019-03-12)

Tags: Survival, Home Hemodialysis, Institutional Hemodialysis, Peritoneal Dialysis