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Comparative Study
. 2011 Nov;6(11):2657-61.
doi: 10.2215/CJN.02200311. Epub 2011 Sep 8.

Effect of dialysis modality on survival of hepatitis C-infected ESRF patients

Bhadran Bose  1 , Stephen P McDonald, Carmel M Hawley, Fiona G Brown, Sunil V Badve, Kathryn J Wiggins, Kym M Bannister, Neil Boudville, Philip Clayton, David W Johnson
Affiliations
Comparative Study

Effect of dialysis modality on survival of hepatitis C-infected ESRF patients

Bhadran Bose et al. Clin J Am Soc Nephrol. 2011 Nov.

Abstract

Background and objectives: Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in end-stage renal failure (ESRF) patients. Despite a lower incidence and risk of transmission of HCV infection with peritoneal dialysis (PD), the optimal dialysis modality for HCV-infected ESRF patients is not known. The aim of this study was to evaluate the impact of dialysis modality on the survival of HCV-infected ESRF patients.

Design, setting, participants, & measurements: The study included all adult incident ESRF patients in Australia and New Zealand who commenced dialysis between January 1, 1994, and December 31, 2008, and were HCV antibody-positive at the time of dialysis commencement. Time to all-cause mortality was compared between hemodialysis (HD) and PD according to modality assignment at day 90, using Cox proportional hazards model analysis.

Results: A total of 424 HCV-infected ESRF patients commenced dialysis during the study period and survived for at least 90 days (PD n = 134; HD n = 290). Mortality rates were comparable between PD and HD in the first year (10.7 versus 13.8 deaths per 100 patient-years, respectively; adjusted hazard ratio [HR] 0.65, 95% CI 0.34 to 1.26) and thereafter (20 versus 15.9 deaths per 100 patient-years, respectively; HR 1.27, 95% CI 0.86 to 1.88).

Conclusions: The survival of HCV-infected ESRF patients is comparable between PD and HD.

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Figures

Figure 1.
Figure 1.
Kaplan-Meier survival curve for 424 hepatitis C virus antibody-positive end-stage renal failure patients treated with hemodialysis (n = 290) or peritoneal dialysis (n = 134) in Australia and New Zealand during the period 1994 to 1998. HD, hemodialysis; PD, peritoneal dialysis.
See this image and copyright information in PMC

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