Peritoneal dialysis has better mortality rate than haemodialysis
Peritoneal dialysis (PD) seems to be better than haemodialysis (HD) in terms of mortality, laboratory and echocardiography markers, according to a new study from Poland.
The study included 359 chronic dialysis patients, of which 301 were receiving HD thrice-weekly at a centre (mean age 64±15 years; 63 percent male) while 58 were receiving PD at home (mean age 56±17 years; 48 percent male).
Mean dialysis vintage was significantly longer for the HD than PD patients (264±216 vs 135±96 weeks; p<0.001). While there was no significant between-group difference in cardiovascular (CV) mortality, gross overall mortality was significantly higher in the HD group (p<0.001).
HD patients also showed significantly higher levels of cardiac markers including N-terminal pro-brain natriuretic peptide (p<0.001) and cardiac troponin T (p<0.05).
Additionally, the intraventricular septum (p<0.001) and left ventricle posterior wall (p<0.01) were significantly thicker in HD patients, according to echocardiography. Ejection fraction did not significantly differ between the groups.
While diabetes mellitus significantly shortened survival time in both HD and PD patients (p<0.05 for both), age >65 years was found to exert this negative effect only in HD patients (p<0.01); PD patients’ survival was unaffected by old age.
Multivariate logistic regression models for HD patients showed that all-cause and CV-related deaths were significantly correlated with troponin T (odds ratio [OR], 4.25; 95 percent CI, 2.30 to 7.85; p<0.001 and OR, 3.61; 1.75 to 7.44; p<0.001, respectively), HD vintage <104 weeks (OR, 0.45; 0.31 to 0.66; p<0.001 and OR, 0.49; 0.31 to 0.76; p<0.01, respectively) and age >65 years (OR, 2.18; 1.25 to 3.81; p<0.01 and OR, 2.80; 1.33 to 5.90; p<0.01, respectively).
Models could not be constructed for PD patients because of low mortality rates.