Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients: A nationwide prospective propensity-matched study in Korea

Ji Young Choi, Hye Min Jang, Jongha Park, Yon Su Kim, Shin Wook Kang, Chul Woo Yang, Nam Ho Kim, Jang Hee Cho, Sun Hee Park, Chan Duck Kim, Yong Lim Kim, J. Y. Do, S. H. Song, S. E. Kim, S. H. Kim, Y. H. Kim, J. S. Lee, H. J. Jin, C. S. Lim, J. P. LeeJ. H. Chang, T. H. Yoo, J. T. Park, H. J. Oh, H. C. Park, T. I. Chang, D. R. Ryu, D. J. Oh, Y. S. Chang, Y. O. Kim, S. H. Kim, D. C. Jin, Y. K. Kim, H. Y. Kim, W. Kim, K. W. Lee, C. S. Lee

Research output: Contribution to journalArticle

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Abstract

Background: The impact of dialysis modality on survival is still somewhat controversial. Given possible differences in patients' characteristics and the cause and rate of death in different countries, the issue needs to be evaluated in Korean cohorts. Methods: A nationwide prospective observational cohort study (NCT00931970) was performed to compare survival between peritoneal dialysis (PD) and hemodialysis (HD). A total of 1,060 end-stage renal disease patients in Korea who began dialysis between September 1, 2008 and June 30, 2011 were followed through December 31, 2011. Results: The patients (PD, 30.6%; HD, 69.4%) were followed up for 16.3±7.9 months. PD patients were significantly younger, less likely to be diabetic, with lower body mass index, and larger urinary volume than HD patients. Infection was the most common cause of death. Multivariate Cox regression with the entire cohort revealed that PD tended to be associated with a lower risk of death compared to HD [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.36-1.08]. In propensity score matched pairs (n = 278 in each modality), cumulative survival probabilities for PD and HD patients were 96.9% and 94.1% at 12 months (P = 0.152) and 94.3% and 87.6% at 24 months (P = 0.022), respectively. Patients on PD had a 51% lower risk of death compared to those on HD (HR 0.49, 95% CI 0.25-0.97). Conclusions: PD exhibits superior survival to HD in the early period of dialysis, even after adjusting for differences in the patients' characteristics between the two modalities. Notably, the most common cause of death was infection in this Korean cohort.

Original languageEnglish
Article numbere84257
JournalPloS one
Volume8
Issue number12
DOIs
Publication statusPublished - 2013 Dec 30

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hemodialysis
Dialysis
Peritoneal Dialysis
Korea
dialysis
Korean Peninsula
Renal Dialysis
Survival
Cause of Death
death
Confidence Intervals
confidence interval
Hazards
Propensity Score
Infection
Chronic Kidney Failure
Observational Studies
kidney diseases
Body Mass Index
cohort studies

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Choi, Ji Young ; Jang, Hye Min ; Park, Jongha ; Kim, Yon Su ; Kang, Shin Wook ; Yang, Chul Woo ; Kim, Nam Ho ; Cho, Jang Hee ; Park, Sun Hee ; Kim, Chan Duck ; Kim, Yong Lim ; Do, J. Y. ; Song, S. H. ; Kim, S. E. ; Kim, S. H. ; Kim, Y. H. ; Lee, J. S. ; Jin, H. J. ; Lim, C. S. ; Lee, J. P. ; Chang, J. H. ; Yoo, T. H. ; Park, J. T. ; Oh, H. J. ; Park, H. C. ; Chang, T. I. ; Ryu, D. R. ; Oh, D. J. ; Chang, Y. S. ; Kim, Y. O. ; Kim, S. H. ; Jin, D. C. ; Kim, Y. K. ; Kim, H. Y. ; Kim, W. ; Lee, K. W. ; Lee, C. S. / Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients : A nationwide prospective propensity-matched study in Korea. In: PloS one. 2013 ; Vol. 8, No. 12.
@article{63798606221a4a708688a13b7034204f,
title = "Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients: A nationwide prospective propensity-matched study in Korea",
abstract = "Background: The impact of dialysis modality on survival is still somewhat controversial. Given possible differences in patients' characteristics and the cause and rate of death in different countries, the issue needs to be evaluated in Korean cohorts. Methods: A nationwide prospective observational cohort study (NCT00931970) was performed to compare survival between peritoneal dialysis (PD) and hemodialysis (HD). A total of 1,060 end-stage renal disease patients in Korea who began dialysis between September 1, 2008 and June 30, 2011 were followed through December 31, 2011. Results: The patients (PD, 30.6{\%}; HD, 69.4{\%}) were followed up for 16.3±7.9 months. PD patients were significantly younger, less likely to be diabetic, with lower body mass index, and larger urinary volume than HD patients. Infection was the most common cause of death. Multivariate Cox regression with the entire cohort revealed that PD tended to be associated with a lower risk of death compared to HD [hazard ratio (HR) 0.63, 95{\%} confidence interval (CI) 0.36-1.08]. In propensity score matched pairs (n = 278 in each modality), cumulative survival probabilities for PD and HD patients were 96.9{\%} and 94.1{\%} at 12 months (P = 0.152) and 94.3{\%} and 87.6{\%} at 24 months (P = 0.022), respectively. Patients on PD had a 51{\%} lower risk of death compared to those on HD (HR 0.49, 95{\%} CI 0.25-0.97). Conclusions: PD exhibits superior survival to HD in the early period of dialysis, even after adjusting for differences in the patients' characteristics between the two modalities. Notably, the most common cause of death was infection in this Korean cohort.",
author = "Choi, {Ji Young} and Jang, {Hye Min} and Jongha Park and Kim, {Yon Su} and Kang, {Shin Wook} and Yang, {Chul Woo} and Kim, {Nam Ho} and Cho, {Jang Hee} and Park, {Sun Hee} and Kim, {Chan Duck} and Kim, {Yong Lim} and Do, {J. Y.} and Song, {S. H.} and Kim, {S. E.} and Kim, {S. H.} and Kim, {Y. H.} and Lee, {J. S.} and Jin, {H. J.} and Lim, {C. S.} and Lee, {J. P.} and Chang, {J. H.} and Yoo, {T. H.} and Park, {J. T.} and Oh, {H. J.} and Park, {H. C.} and Chang, {T. I.} and Ryu, {D. R.} and Oh, {D. J.} and Chang, {Y. S.} and Kim, {Y. O.} and Kim, {S. H.} and Jin, {D. C.} and Kim, {Y. K.} and Kim, {H. Y.} and W. Kim and Lee, {K. W.} and Lee, {C. S.}",
year = "2013",
month = "12",
day = "30",
doi = "10.1371/journal.pone.0084257",
language = "English",
volume = "8",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

Choi, JY, Jang, HM, Park, J, Kim, YS, Kang, SW, Yang, CW, Kim, NH, Cho, JH, Park, SH, Kim, CD, Kim, YL, Do, JY, Song, SH, Kim, SE, Kim, SH, Kim, YH, Lee, JS, Jin, HJ, Lim, CS, Lee, JP, Chang, JH, Yoo, TH, Park, JT, Oh, HJ, Park, HC, Chang, TI, Ryu, DR, Oh, DJ, Chang, YS, Kim, YO, Kim, SH, Jin, DC, Kim, YK, Kim, HY, Kim, W, Lee, KW & Lee, CS 2013, 'Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients: A nationwide prospective propensity-matched study in Korea', PloS one, vol. 8, no. 12, e84257. https://doi.org/10.1371/journal.pone.0084257

Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients : A nationwide prospective propensity-matched study in Korea. / Choi, Ji Young; Jang, Hye Min; Park, Jongha; Kim, Yon Su; Kang, Shin Wook; Yang, Chul Woo; Kim, Nam Ho; Cho, Jang Hee; Park, Sun Hee; Kim, Chan Duck; Kim, Yong Lim; Do, J. Y.; Song, S. H.; Kim, S. E.; Kim, S. H.; Kim, Y. H.; Lee, J. S.; Jin, H. J.; Lim, C. S.; Lee, J. P.; Chang, J. H.; Yoo, T. H.; Park, J. T.; Oh, H. J.; Park, H. C.; Chang, T. I.; Ryu, D. R.; Oh, D. J.; Chang, Y. S.; Kim, Y. O.; Kim, S. H.; Jin, D. C.; Kim, Y. K.; Kim, H. Y.; Kim, W.; Lee, K. W.; Lee, C. S.

In: PloS one, Vol. 8, No. 12, e84257, 30.12.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Survival advantage of peritoneal dialysis relative to hemodialysis in the early period of incident dialysis patients

T2 - A nationwide prospective propensity-matched study in Korea

AU - Choi, Ji Young

AU - Jang, Hye Min

AU - Park, Jongha

AU - Kim, Yon Su

AU - Kang, Shin Wook

AU - Yang, Chul Woo

AU - Kim, Nam Ho

AU - Cho, Jang Hee

AU - Park, Sun Hee

AU - Kim, Chan Duck

AU - Kim, Yong Lim

AU - Do, J. Y.

AU - Song, S. H.

AU - Kim, S. E.

AU - Kim, S. H.

AU - Kim, Y. H.

AU - Lee, J. S.

AU - Jin, H. J.

AU - Lim, C. S.

AU - Lee, J. P.

AU - Chang, J. H.

AU - Yoo, T. H.

AU - Park, J. T.

AU - Oh, H. J.

AU - Park, H. C.

AU - Chang, T. I.

AU - Ryu, D. R.

AU - Oh, D. J.

AU - Chang, Y. S.

AU - Kim, Y. O.

AU - Kim, S. H.

AU - Jin, D. C.

AU - Kim, Y. K.

AU - Kim, H. Y.

AU - Kim, W.

AU - Lee, K. W.

AU - Lee, C. S.

PY - 2013/12/30

Y1 - 2013/12/30

N2 - Background: The impact of dialysis modality on survival is still somewhat controversial. Given possible differences in patients' characteristics and the cause and rate of death in different countries, the issue needs to be evaluated in Korean cohorts. Methods: A nationwide prospective observational cohort study (NCT00931970) was performed to compare survival between peritoneal dialysis (PD) and hemodialysis (HD). A total of 1,060 end-stage renal disease patients in Korea who began dialysis between September 1, 2008 and June 30, 2011 were followed through December 31, 2011. Results: The patients (PD, 30.6%; HD, 69.4%) were followed up for 16.3±7.9 months. PD patients were significantly younger, less likely to be diabetic, with lower body mass index, and larger urinary volume than HD patients. Infection was the most common cause of death. Multivariate Cox regression with the entire cohort revealed that PD tended to be associated with a lower risk of death compared to HD [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.36-1.08]. In propensity score matched pairs (n = 278 in each modality), cumulative survival probabilities for PD and HD patients were 96.9% and 94.1% at 12 months (P = 0.152) and 94.3% and 87.6% at 24 months (P = 0.022), respectively. Patients on PD had a 51% lower risk of death compared to those on HD (HR 0.49, 95% CI 0.25-0.97). Conclusions: PD exhibits superior survival to HD in the early period of dialysis, even after adjusting for differences in the patients' characteristics between the two modalities. Notably, the most common cause of death was infection in this Korean cohort.

AB - Background: The impact of dialysis modality on survival is still somewhat controversial. Given possible differences in patients' characteristics and the cause and rate of death in different countries, the issue needs to be evaluated in Korean cohorts. Methods: A nationwide prospective observational cohort study (NCT00931970) was performed to compare survival between peritoneal dialysis (PD) and hemodialysis (HD). A total of 1,060 end-stage renal disease patients in Korea who began dialysis between September 1, 2008 and June 30, 2011 were followed through December 31, 2011. Results: The patients (PD, 30.6%; HD, 69.4%) were followed up for 16.3±7.9 months. PD patients were significantly younger, less likely to be diabetic, with lower body mass index, and larger urinary volume than HD patients. Infection was the most common cause of death. Multivariate Cox regression with the entire cohort revealed that PD tended to be associated with a lower risk of death compared to HD [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.36-1.08]. In propensity score matched pairs (n = 278 in each modality), cumulative survival probabilities for PD and HD patients were 96.9% and 94.1% at 12 months (P = 0.152) and 94.3% and 87.6% at 24 months (P = 0.022), respectively. Patients on PD had a 51% lower risk of death compared to those on HD (HR 0.49, 95% CI 0.25-0.97). Conclusions: PD exhibits superior survival to HD in the early period of dialysis, even after adjusting for differences in the patients' characteristics between the two modalities. Notably, the most common cause of death was infection in this Korean cohort.

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U2 - 10.1371/journal.pone.0084257

DO - 10.1371/journal.pone.0084257

M3 - Article

C2 - 24386357

AN - SCOPUS:84893603797

VL - 8

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e84257

ER -