Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Jan;83(1):1-10.
doi: 10.5414/CN108382.

Peritoneal dialysis: update on patient survival

J Pedro Teixeira, Sara A Combs, Isaac Teitelbaum
Review

Peritoneal dialysis: update on patient survival

J Pedro Teixeira et al. Clin Nephrol. 2015 Jan.

Abstract

Due to ongoing limitations in the availability and timeliness of kidney transplantation, most patients with end-stage renal disease (ESRD) require some form of dialysis during their lifetime. Worldwide, ESRD patients most commonly receive hemodialysis (HD) or one of two forms of peritoneal dialysis (PD), continuous ambulatory PD (CAPD) or automated PD (APD). In this review, we analyze the data available from the last several decades on overall survival associated with HD as compared to PD as well as with CAPD compared to APD. Because of the inherent difficulty in randomly assigning patients to different dialysis modalities, the survival data available are virtually all observational and fraught with many confounding factors and limitations. However, over the last 10 - 15 years as overall survival of dialysis patients has steadily improved and statistical methods to analyze observational data have evolved, a pattern of virtual equivalence in survival among patients on HD vs. PD and on CAPD vs. APD has emerged. As such, impact upon lifestyle and upon quality of life likely should remain the predominant factors in guiding nephrologists and their patients in their choice of dialysis modality.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Patient survival by dialysis modality. Adjusted population survival curves comparing the outcome of PD and HD patients from a large US cohort with incident ESRD from 2002 to 2004. From reference [4] with permission. ESRD = end-stage renal disease; HD = hemodialysis; PD = peritoneal dialysis.
Figure 2.
Figure 2.. Kaplan-Meier curves of comparative survivals by univariate analysis of incident peritoneal dialysis patients on APD vs. CAPD in New Zealand and Australia. From reference [46] with permission. APD = automatic peritoneal dialysis; CAPD = continuous ambulatory peritoneal dialysis.
See this image and copyright information in PMC

References

    1. Korevaar JC Feith GW Dekker FW van Manen JG Boeschoten EW Bossuyt PM Krediet RT Effect of starting with hemodialysis compared with peritoneal dialysis in patients new on dialysis treatment: a randomized controlled trial. Kidney Int. 2003; 64: 2222–2228. - PubMed
    1. Choi JY Jang HM Park J Kim YS Kang SW Yang CW Kim NH Cho JH Park SH Kim CD Kim YL Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients: a nationwide prospective propensity-matched study in Korea. PLoS ONE. 2013; 8: c84257. - PMC - PubMed
    1. Lukowsky LR Mehrotra R Kheifets L Arah OA Nissenson AR Kalantar-Zadeh K Comparing mortality of peritoneal and hemodialysis patients in the first 2 years of dialysis therapy: a marginal structural model analysis. Clin J Am Soc Nephrol. 2013; 8: 619–628. - PMC - PubMed
    1. Mehrotra R Chiu YW Kalantar-Zadeh K Bargman J Vonesh E Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Arch Intern Med. 2011; 171: 110–118. - PubMed
    1. Serkes KD Blagg CR Nolph KD Vonesh EF Shapiro F Comparison of patient and technique survival in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis: a multicenter study. Perit Dial Int. 1990; 10: 15–19. - PubMed

MeSH terms