Comparison Of Survival Between Hemodialysis And Peritoneal Dialysis Among Elderly End-stage Renal Disease Patients In A Single Center

Objective: To explore the survival difference between hemodialysis(HD)and peritoneal dialysis(PD)modality in elderly end-stage renal disease patients.Materials and Methods: Elderly(age≥65)end-stage renal disease patients who had initially started HD or PD treatment and long-term followed in our department from 1 Jan 2010 to 31 Dec 2014 were enrolled.HD treatment was given three times per week and CAPD dosage was 8-10L/d.The end point was time to death.The sex,age,primary renal disease were documented.Survival between the dialysis modalities was compared by Kaplan–Meier plots and log-rank test.Survival was timed from the start of dialysis until the date of death and was censored for the date of end of the study period(31 December 2014).Multivariate analysis was by Cox regression model with survival of patients on dialysis modalities adjusted for sex,age at onset of RRT,primary renal disease.SPSS for Windows version 13.0 was used for the analysis.Results: A total of 185 elderly dialysis patients were enrolled among whom 123 patients accepted HD and others accepted PD.The average age at onset of RRT was 73.1±5.6.There were 78 cases of diabetic nephropathy,18 cases of chronic glomerulonephritis,78 cases of hypertensive and 11 cases of other cause of kidney injury.There were no significant differences in sex,age and primary renal disease between two groups.The median survival time of HD patients was 48.0 months and the 1-,2-,3-,4-year survival rate was 74%,62%,57%,57% respectively.The median survival time of PD patients was 29.6 months and the 1-,2-,3-,4-year survival rate was 60%,39%,21%,21% respectively.Log-rank test suggested that the mortality in PD patients was significantly higher than in HD patients(X2=7.423,P=0.006).After adjusted by sex,age at onset of RRT,primary renal disease and dialysis modality,Cox regression model showed that female,age at onset of RRT and PD were independent predictors for death.Conclusion:The survival rate was higher in HD group than in PD group among elderly end-stage renal disease patients in a our center.