Dataset Information

Dialysis Modality and Mortality in the Elderly: A Meta-Analysis.

ABSTRACT:

Background and objectives

Identifying the appropriate choice between hemodialysis (HD) and peritoneal dialysis (PD) is an unresolved issue in elderly patients with ESRD, who are at high risk for death but have a low chance of receiving kidney transplantation.

Design, setting, participants, & measurements

Data on 13,065 incident dialysis Korean patients (age?65 years) receiving HD (n=10,675) or PD (n=2390) were obtained from the Korean Health Insurance dataset. Multiple statistical approaches, including the multivariate Cox model, were used to compare mortality between Korean patients receiving PD and those receiving HD. Subsequently, meta-analysis of previous comparison studies (published since the year 2000; population-based studies) and the Korean dataset was performed.

Results

During a mean duration of 1.8±1.3 years (maximum of 5 years), the Korean PD group had a higher mortality rate than the Korean HD group (hazard ratio [HR], 1.20 [95% confidence interval (95% CI), 1.13 to 1.28]; P<0.001 by multivariate Cox model). The discrepancy between the two modalities was greater in the presence of certain conditions, such as diabetes mellitus or longer dialysis duration. In the meta-analysis, 15 studies involving >631,421 elderly patients were reviewed. Compared with HD, the pooled HR with PD was 1.10 (95% CI, 1.01 to 1.20). When the meta-analysis was stratified by confounding factors, the survival benefit from HD was particularly strong in subgroups that had diabetes mellitus, had long dialysis duration (>1 year), or contained cohorts starting dialysis in the 1990s.

Conclusions

A meta-analysis that included results in Korean patients suggests a higher risk for death in elderly patients receiving PD than in those receiving HD.

SUBMITTER: Han SS

PROVIDER: S-EPMC4455206 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Dialysis Modality and Mortality in the Elderly: A Meta-Analysis.

Han Seung Seok SS Park Jae Yoon JY Kang Soohee S Kim Kyoung Hoon KH Ryu Dong-Ryeol DR Kim Hyunwook H Joo Kwon Wook KW Lim Chun Soo CS Kim Yon Su YS Kim Dong Ki DK

Clinical journal of the American Society of Nephrology : CJASN 20150504 6

<h4>Background and objectives</h4>Identifying the appropriate choice between hemodialysis (HD) and peritoneal dialysis (PD) is an unresolved issue in elderly patients with ESRD, who are at high risk for death but have a low chance of receiving kidney transplantation.<h4>Design, setting, participants, & measurements</h4>Data on 13,065 incident dialysis Korean patients (age≥65 years) receiving HD (n=10,675) or PD (n=2390) were obtained from the Korean Health Insurance dataset. Multiple statistical ...[more]

PMID: 25941194

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Dataset Information

Dialysis Modality and Mortality in the Elderly: A Meta-Analysis.

Background and objectives

Design, setting, participants, & measurements

Results

Conclusions

Publications

Dialysis Modality and Mortality in the Elderly: A Meta-Analysis.

Similar Datasets

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