Effects of dialysis modality choice on the survival of end-stage renal disease patients in southern China: a retrospecti

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RESEARCH ARTICLE

Open Access

Effects of dialysis modality choice on the survival of end-stage renal disease patients in southern China: a retrospective cohort study Zhiren He1,2†, Haijing Hou1,2†, Difei Zhang1,2*, Yenan Mo2, La Zhang1,2, Guobin Su1,2, Junjie Lin1,2, Liming Lu3, Jingyao Huang2, Yewen Gu2, Ying Zhang4, Jingxia Lin1,2, Fengling Yuan1,2, Yu Peng1,2, Hui Liang1,2, Daixin Zhao1,2, Fuhua Lu1,2, Xusheng Liu1,2 and Lixin Wang1,2*

Abstract Background: The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is still controversial. Only a few studies comparing HD and PD have been conducted in China, which has the largest number of dialysis patients in the world. Methods: A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics. Results: A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-yearold), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (> 70-year-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age at dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of allcause mortality in the younger subgroup, while PD was risk factor in the older subgroup. Conclusion: PD may be a better choice for younger ESRD patients, and HD for the older patients. Keywords: Peritoneal dialysis, Hemodialysis, Age, End-stage renal disease, All-cause mortality

* Correspondence: [email protected]; [email protected] † Zhiren He and Haijing Hou contributed equally to this work as first author. 1 Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No. 111 Dade Road, Guangzhou 510120, Guangdong, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included i

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