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. 2023 Jan-Mar;45(1):8-16.
doi: 10.1590/2175-8239-JBN-2021-0242en.

Comparative analysis of patients' survival on hemodialysis vs. peritoneal dialysis and identification of factors associated with death

[Article in English, Portuguese]
Carolina Aparecida de Almeida Vicentini  1 , Daniela Ponce  2
Affiliations

Comparative analysis of patients' survival on hemodialysis vs. peritoneal dialysis and identification of factors associated with death

[Article in English, Portuguese]
Carolina Aparecida de Almeida Vicentini et al. J Bras Nefrol. 2023 Jan-Mar.

Abstract
in English, Portuguese

Introduction: There are several studies comparing the outcomes of patients treated with peritoneal dialysis (PD) and hemodialysis (HD), and most are divergent.

Methods: This is a cohort study that followed patients with incident PD and HD in a planned and unplanned way, in a dialysis unit of the HCFMB from 01/2014 to 01/2019, until the outcome. We collected clinical and laboratory data. The PD and HD groups, death and non-death outcomes, were compared using the chi-square test for categorical variables and t-test, or Mann-Whitney test for continuous variables. Kaplan Meier curve and log-rank test were used for survival. Multivariate analysis was performed using the Cox regression. The significant difference was p < 0.05.

Results: We had 592 patients, 290 treated by HD and 302 by PD. The mean age was 59.9 ± 16.8, with a predominance of males (56.3%), the main underlying disease was diabetes (45%); 29% of the patients died. There was no difference in the survival of patients treated by HD and PD. The oldest age (1.018 (95% CI 1.000-1.037; p=0.046)) was identified as a risk factor for death, while the highest number of infection-free days (0.999 (95% CI 0.999-1.000; p=0.003 )) as a protective factor.

Conclusion: The analysis reinforced that the survival of patients on HD and PD was similar. Higher age and shorter infection-free time were associated with death.

Introdução:: Há vários estudos que comparam os desfechos de pacientes tratados por diálise peritoneal (DP) e hemodiálise (HD), e a maioria é divergente.

Métodos:: Estudo de coorte que acompanhou pacientes incidentes em DP e HD de modo planejado e não planejado em unidade de diálise do HCFMB de 01/2014 a 01/2019, até o desfecho. Foram coletados dados clínicos e laboratoriais. Comparou-se os grupos DP e HD, óbito e não óbito, por meio do teste qui-quadrado para variáveis categóricas e teste t ou Mann-Whitney para as contínuas. Curva de Kaplan Meier e log-rank test foram utilizados para a sobrevida. A análise multivariada foi realizada por Regressão de Cox. A diferença significante foi de p < 0,05.

Resultados:: Foram estudados 592 pacientes, 290 tratados por HD e 302 por DP. A média de idade foi de 59,9 ± 16,8, com predomínio de sexo masculino (56,3%), principal doença de base, diabetes (45%). Óbito ocorreu em 29% dos pacientes. Não houve diferença na sobrevida de pacientes tratados por HD e DP. A maior idade (1,018 (IC 95% 1,000-1,037; p=0,046)) foi identificada como fator de risco para o óbito, enquanto a maior quantidade de dias livres de infecção (0,999 (IC 95% 0,999-1,000; p=0,003)), como fator de proteção.

Conclusão:: A análise reforçou que a sobrevida dos pacientes em HD e DP é semelhante. Foram associados ao óbito a maior idade e o menor tempo livre de infecção.

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Conflict of interest statement

Conflict of Interest: There is no conflict of interest in this study.

Figures

Figure 1
Figure 1. Survival and infection-free time analysis of patients in HD and PD.
See this image and copyright information in PMC

Comment in

  • Peritoneal dialysis: why not?
    Andreoli MCC, Totoli C, Rocha DRD, Campagnaro LS. Andreoli MCC, et al. J Bras Nefrol. 2023 Jan-Mar;45(1):1-2. doi: 10.1590/2175-8239-JBN-2023-E001en. J Bras Nefrol. 2023. PMID: 37015051 Free PMC article. No abstract available.

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