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Multicenter Study
. 2023 Apr 13;13(1):6049.
doi: 10.1038/s41598-023-33216-w.

The benefit of planned dialysis to early survival on hemodialysis versus peritoneal dialysis: a nationwide prospective multicenter study in Korea

Jeong-Hoon Lim #  1   2 , Ji Hye Kim #  1   2 , Yena Jeon  2   3 , Yon Su Kim  2   4 , Shin-Wook Kang  2   5 , Chul Woo Yang  2   6 , Nam-Ho Kim  2   7 , Hee-Yeon Jung  1   2 , Ji-Young Choi  1   2 , Sun-Hee Park  1   2 , Chan-Duck Kim  1   2 , Yong-Lim Kim  8   9 , Jang-Hee Cho  10   11
Affiliations
Multicenter Study

The benefit of planned dialysis to early survival on hemodialysis versus peritoneal dialysis: a nationwide prospective multicenter study in Korea

Jeong-Hoon Lim et al. Sci Rep. .

Abstract

Optimal preparation is recommended for patients with advanced chronic kidney disease to minimize complications during dialysis initiation. This study evaluated the effects of planned dialysis initiation on survival in patients undergoing incident hemodialysis and peritoneal dialysis. Patients newly diagnosed with end-stage kidney disease who started dialysis were enrolled in a multicenter prospective cohort study in Korea. Planned dialysis was defined as dialysis therapy initiated with permanent access and maintenance of the initial dialysis modality. A total of 2892 patients were followed up for a mean duration of 71.9 ± 36.7 months and 1280 (44.3%) patients initiated planned dialysis. The planned dialysis group showed lower mortality than the unplanned dialysis group during the 1st and 2nd years after dialysis initiation (1st year: adjusted hazard ratio [aHR] 0.51; 95% confidence interval [CI] 0.37-0.72; P < 0.001; 2nd year: aHR 0.71; 95% CI 0.52-0.98, P = 0.037). However, 2 years after dialysis initiation, mortality did not differ between the groups. Planned dialysis showed a better early survival rate in hemodialysis patients, but not in peritoneal dialysis patients. Particularly, infection-related mortality was reduced only in patients undergoing hemodialysis with planned dialysis initiation. Planned dialysis has survival benefits over unplanned dialysis in the first 2 years after dialysis initiation, especially in patients undergoing hemodialysis. It improved infection-related mortality during the early dialysis period.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier curves for the cumulative risk of death according to planned dialysis. (A) All patients (B) Patients undergoing hemodialysis (C) Patients undergoing peritoneal dialysis. HD hemodialysis, PD peritoneal dialysis.
Figure 2
Figure 2
Kaplan–Meier curves for the cumulative risk of infection-related death according to planned dialysis (A) All patients (B) Patients undergoing hemodialysis (C) Patients undergoing peritoneal dialysis. HD hemodialysis, PD peritoneal dialysis.
Figure 3
Figure 3
Study population. ESKD end-stage kidney disease, HD hemodialysis, PD peritoneal dialysis.
See this image and copyright information in PMC

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