Long-term mortality in patients with end-stage renal disease undergoing hemodialysis and peritoneal dialysis: a propensity score matching retrospective study
Pengjie Zhang, Liru Xun, Nan Bao, Ding Tong, Bin Duan, Peng Du
Abstract
Background: Hemodialysis (HD) and peritoneal dialysis (PD) are effective ways to treat end-stage renal disease (ERSD).This study aimed to investigate the differences in survival and the factors that influence it in patients with end-stage renal disease treated with HD or PD.Methods: We retrospectively analyzed factors related to all-cause death with renal replacement therapy and compared the long-term mortality between HD and PD strategies in patients with ESRD who started HD or PD treatment in our renal HD center between January 1, 2008, and December 1, 2021.Results: Overall, 1,319 patients were included, comprising 690 and 629 patients in the HD and PD groups, respectively, according to the inclusion criteria.After propensity matching, 922 patients remained, with 461 (50%) patients each in the two groups.There were no significant differences in the 1-, 2-, 3-, and 4-year mortality rates between the HD and PD groups (all p > .05).However, the 5-and 10-year mortality rates of the matched patients were 15.8%.17.6% in the HD group and 21.0%.27.3% in the PD group, respectively.The 5-and 10-year mortality rates were significantly lower in the HD group (all p < .05)as compared to the PD group.After matching, Kaplan-Meier curve analysis with log-rank test was performed, which showed a significant difference in the survival rates between the two groups (p = .001).Logistic multifactor regression analysis revealed that age, weight, hypertension, serum creatinine, and combined neoplasms influenced the survival rate of patients with ESRD (p < .05).In contrast, age, hypertension, parathyroid hormone (PTH), serum creatinine, and peripheral vascular diseases (PVD) influenced the survival rate of patients in the HD group (p < .05),and age and weight influenced the survival rate of patients in the PD group (p < .05).Conclusions: This study found that long-term mortality rates were higher in the PD group than that in the HD group, indicating that HD may be superior to PD.