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Study shows survival advantage of home hemodialysis compared to peritoneal dialysis

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A study published in the American Journal of Kidney Diseases has demonstrated that frequent home hemodialysis patients have a lower risk of death, hospitalization, and therapy attrition than peritoneal dialysis patients.

The study, "Mortality, Hospitalization, and Technique Failure in Daily Home Hemodialysis and Matched Peritoneal Dialysis Patients: A Matched Cohort Study," was conducted by Eric Weinhandl, PhD, MS, et al, and affiliated with the Chronic Disease Research Group (CDRG). The intention-to-treat analysis showed that frequent home hemodialysis patients have a 20% lower risk of death, 8% lower risk of hospitalization and 37% lower risk of therapy attrition than PD patients.

A 38-factor algorithm matched 4,201 frequent HHD patients with 4,201 PD patients. Results showed lower risks of death due to cardiovascular disease, infection, and either cachexia or dialysis withdrawal with frequent HHD therapy. Results also showed 15% lower risk of hospitalization due to cardiovascular disease and 11% lower risk of hospitalization due to infection with frequent HHD therapy.

Related: Why choose peritoneal dialysis? 

Another study, published in the Clinical Journal of the American Society of Nephrology, showed that patient survival rates were significantly higher among home hemodialysis patients compared to peritoneal dialysis patients.

“Home dialysis is growing, but there are few studies that compare clinical outcomes with HHD and PD,” said Weinhandl. “This study suggests that frequent HHD may offer important advantages, especially with respect to reducing cardiovascular risk and keeping patients in their homes.”

The study also included detailed analysis of patients that began dialyzing in their homes within the first six months of being diagnosed with end-stage renal disease, during which time patients typically start PD. In this group, frequent HHD patients had similar risks of death and hospitalization as PD patients and 30% lower risk of therapy attrition. -by Rebecca Zumoff