People who are suffering from kidney diseases may have increased risk of death if they choose the wrong dialysis option.
Researchers from Johns Hopkins University School of Medicine have found that in people// with end-stage kidney disease (ESRD), choosing peritoneal dialysis over hemodialysis increases their risk of dying by 50 percent.
The findings, to be published in the journal Annals of Internal Medicine online Aug. 1, are from one of the first comprehensive, large-scale, follow-up comparison studies in the debate about which kind of dialysis is better.
To find out, the study, called the Choices for Healthy Outcomes in Caring for ESRD, or CHOICE for short, followed 1,041 newly diagnosed patients from 81 dialysis clinics across the United States and monitored their health, mainly through reviews of patient charts and medical records, for eight years while they underwent dialysis treatment. The study participants, men and women between 18 and 96 years old, chose the method of dialysis: 274 selected peritoneal dialysis and 767 selected hemodialysis.
Initial results showed that during the first year of treatment, patients choosing peritoneal dialysis were doing as well as patients on hemodialysis. Death rates early in the study were 21 percent and 24 percent, respectively.
When these differences were taken into account, the researchers discovered that while healthy patients did well on either form of dialysis, hemodialysis was of greater benefit for those patients with coexisting illnesses, such as cardiovascular disease. The risk of death among 135 patients with cardiovascular disease who were using peritoneal dialysis was nearly twice that of 459 similar patients on hemodialysis. After one year of dialysis treatment, the risk of death for patients who started on peritoneal dialysis was greater than the risk of death for patients who started on hemodialysis.
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