Survival rate similar for patients on home hemodialysis vs peritoneal dialysis
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Survival rates were similar in patients who choose home hemodialysis vs. peritoneal dialysis, even with differences in age and number of comorbidities, according to a study published in Nephrology Dialysis Transplantation.
“Several studies have shown superior survival of patients on home hemodialysis (HD) compared to peritoneal dialysis (PD), but patients on automated PD (APD) and continuous ambulatory PD (CAPD) have not been considered separately,” Wisam Bitar, MD, of the Helsinki University Central Hospital, and colleagues wrote.
In a cohort study, researchers assessed patient data from 536 adults from Finland who had received kidney replacement therapy and were on home dialysis between 2004 and 2017. They calculated survival outcomes using a Kaplan-Meier curve and Cox regression.
Patients on home HD and patients on APD in the study had a mean age of 50 years, and more than 50% of patients in either group had three or more comorbidities. The survival rates between the groups were similar: Patients on home HD had a 5-year survival rate of 90% and patients on APD had a 5-year survival rate of 88%, according to the study.
Patients who received CAPD were older than the other two groups and 67% of them had three or more comorbidities. Initially, data suggested they had a lower 5-year survival rate of 56%, but “the difference compared to home HD diminished and was not statistically significant after accounting for confounders,” Bitar and colleagues wrote.
Researchers concluded that patients will not have a significant difference in their survival outcome whether they choose home HD or CAPD or APD. Also, because patients on HD and patients on APD were similar, statistical comparisons between the two groups may become more reliable, Bitar and colleagues wrote.
Study limitations include the possibility of residual confounding, the small sample size of patients and the inability to generalize the results. Researchers suggest future research efforts to examine home dialysis effects on other outcomes such as infections or cardiovascular events.
“The results of our study may help health care professionals when counseling patients about selection of dialysis modality,” Bitar and colleagues wrote.
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