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Hemodialysis versus peritoneal dialysis: an observational study in two international centers

Abstract

Introduction

Given that it is difficult to randomize end-stage renal disease (ESRD) patients to either hemodialysis (HD) or peritoneal dialysis (PD), differences between these renal replacement therapy (RRT) modalities are of major interest and remain controversial.

Methods

All data on maintenance dialysis patients during 2009 to 2013 in the Renji Hospital in Shanghai, China and in the San Bortolo Hospital in Vicenza, Italy were selected. Patients who changed their therapy from HD to PD or PD to HD during this study were excluded.

Results

919 maintenance dialysis patients were included in the present study, including 509 patients on HD and 410 on PD. During the 5-year follow-up, mean arterial pressure (MAP) was higher in HD patients. The level of serum HCO3- was significantly better in PD patients than in HD patients. Phosphate was significantly higher in HD patients than in PD patients. With respect to lipid metabolism, triglyceride, total cholesterol and LDL were significantly higher in PD patients. Serum protein and albumin were higher in HD patients than in PD patients. Overall, 236 patients died (25.7%); 150 (16.3%) on HD and 86 (9.4%) on PD. The main cause of death in HD and PD patients was cerebral vascular disease and infection, respectively. After adjusting for dialysis vintage, the Kaplan-Meier patient survival was similar between HD and PD patients.

Conclusions

Based on 5 years of data, we demonstrate that lipid metabolism and nutritional status were better in HD patients. However, blood pressure control, acid-base balance, phosphate (P) control were better in PD patients. The main cause of death in HD and PD was cerebral vascular disease and infection, respectively. Considering the dialysis vintage, the Kaplan-Meier patient survival was similar between HD and PD patients.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ijao.5000656

Authors

Renhua Lu, Carla Estremadoyro, Xiaohuan Chen, Mingli Zhu, Leonardo C. Ribeiro, Yucheng Yan, Alessandra Brendolan, Wei Fang, Carlo Crepaldi, Zhaohui Ni, Leyi Gu, Claudio Ronco

Article History

Disclosures

Financial support: This study received the following grants: Natural Science Fund of the Xinjiang Uygur Autonomous Region (2016D01C094); Shanghai Science and Technology Commission (17695840500); Shanghai Science and Technology Commission (15ZR1425900); Natural Science Fund of the Xinjiang Uygur Autonomous Region (2015211C228).
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai - China
  • Nephrology, Dialysis and Transplantation of the San Bortolo Hospital, the International Renal Research Institute of Vicenza (IRRIV), Vicenza - Italy
  • Department of Nephrology, Kashgar Prefecture Second People’s Hospital, Kashgar, Sinkiang - China

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