Survival Better on PD than HD in the First Year After Renal Graft Failure

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Survival Better on PD than HD in the First Year After Renal Graft Failure
John Schieszer
October 31, 2009
 
RELATED TOPICS

    * Hemodialysis
    * Peritoneal Dialysis
    * Transplantation

This article is part of our ongoing coverage of Renal Week 2009.

Key Points

    * Following renal transplant failure, patients starting peritoneal dialysis (PD) have better survival in the first year than patients starting on hemodialysis, but the survival advantage lessens with time.
    * This finding may reflect patient selection bias with younger and healthier patients opting for PD.
    * Previous studies comparing these two modalities in this patient population were much smaller and found no differences in survival.

Following renal transplant failure, patients starting peritoneal dialysis (PD) have better survival in the first year than patients starting on hemodialysis (HD), but the survival advantage lessens with time, according to British researchers in a report presented at ASN's Renal Week 2009.

However, this finding may reflect patient selection bias with younger and healthier patients opting for PD.

The study also showed that diabetic patients had significantly worse survival than non-diabetics regardless of dialysis modality, possibly because of their higher risk for ischemic heart disease and peripheral vascular disease, according to researchers led by Lynsey Webb, MD, a clinical nephrology research fellow at the Renal Association United Kingdom Renal Registry, Southmead Hospital, Bristol, United Kingdom.

Dr. Webb and colleagues examined 1,745 patients returning to dialysis between 2000 and 2006 after graft failure. A total of 1,361 patients returned to HD and 384 returned to PD.

The researchers found that the age-standardized death rates for HD at one year were 202.8 compared with 100.5 for PD. For most age groups, the survival advantage of PD reduced over time, with death rates becoming similar to HD around three years post-graft failure.
Dr. Webb said 600 patients a year in the United Kingdom start on dialysis after a failed transplant. Previous studies comparing these two modalities in this patient population were much smaller and found no differences in survival.

Posted Oct. 31, 2009 - 1:42 pm PT as an unedited blog

http://www.renalandurologynews.com/survival-better-on-pd-than-hd-in-the-first-year-after-renal-graft-failure/article/156780/