| Comparison of long-term survival (beyond 12 years) in patients on peritoneal dialysis and on hemodialysis. | |
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MedLine Citation:
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PMID: 17986526 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We investigated the clinical condition and complications of patients on peritoneal dialysis (PD) and on hemodialysis (HD) for more than 12 years. DESIGN: This retrospective review was carried out in the renal unit of the Tung Wah Hospital, Hong Kong. Patients and METHODS: Of 103 HD and 341 PD patients who started dialysis before 1990, 14 HD and 22 PD patients were dialyzed for more than 12 years. We evaluated basic demography at the 12th year of dialysis and at the most recent follow-up, and assessed the prevalence of cardiovascular disease, bone disease, dialysis-related amyloidosis (DRA), and acquired cystic disease (ACD). Outcomes and mortality were recorded. RESULTS: The 36 patients in the study included 22 women and 14 men. The PD patients were older (p = 0.021) and had lower levels of serum phosphate and calcium x phosphate product. Only 3 patients were diabetic. Cardiovascular disease was present in 30 patients (83.3%), the most common types being ischemic heart disease (IHD, n = 11) and left ventricular hypertrophy (LVH, n = 22). Symptomatic DRA was found in 13 patients (36.1%), more commonly in the HD group (p = 0.014). Bone disease was present in 32 patients (88.9%), with parathyroidectomy being more frequently performed in the PD patients (p = 0.048). Symptomatic ACD occurred in 5 patients (13.9%). At the most recent follow-up, 26 patients were still on dialysis, 3 patients had undergone renal transplantation, and 7 patients had died, the causes of death being sudden death (n = 3), cerebrovascular accident (n = 1), chest infection (n = 2), and peritonitis (n = 1). Patient survival was similar in the PD and HD groups. Age at commencement of dialysis predicted mortality (p = 0.012), but mode of dialysis, sex, and presence of diabetes mellitus did not. CONCLUSIONS: Long-term survival is possible for both dialysis modalities (PD and HD), particularly for young, non diabetic patients. Symptomatic DRA is less common in PD patients, but the prevalence of other long-term complications is similar for both groups. Cardiovascular-related problems remain the leading cause of death. |
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Authors:
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Kai-Chung Tse; Sing-Leung Lui; Wai-Kei Lo |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis Volume: 23 Suppl 2 ISSN: 1718-4304 ISO Abbreviation: Perit Dial Int Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2007-11-07 Completed Date: 2010-05-19 Revised Date: 2012-08-08 |
Medline Journal Info:
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Nlm Unique ID: 8904033 Medline TA: Perit Dial Int Country: Canada |
Other Details:
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Languages: eng Pagination: S104-8 Citation Subset: IM |
Affiliation:
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Renal Unit, Department of Medicine, Tung Wah Hospital, Hong Kong SAR, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Humans Male Middle Aged Peritoneal Dialysis / adverse effects, mortality* Renal Dialysis / adverse effects, mortality Retrospective Studies Survival Rate Time Factors |
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