Type of dialysis affects outcome in kidney disease

Reported by Susan Aldridge, PhD, medical journalist

A new study shows that peritoneal dialysis is linked with a worse outcome for patients who have end-stage kidney disease.
People with failing kidneys will often need to have dialysis - a treatment which removes waste products and excess water from the blood. In peritoneal dialysis, the membrane lining of the body cavity is used as a filter and a catheter is permanently implanted into the abdomen. An amount of waste-absorbing fluid is injected into the abdomen and then drained four to six times a day. In hemodialysis, blood is pumped outside the body though a vein into a machine called a dialyzer and then cleansed blood returned to the body. This is done three or four times a week.

Doctors at Johns Hopkins University have now compared the two kinds of dialysis. They looked at 274 patients on peritoneal dialysis and 767 on hemodialysis. During the first year, death rates were 21 per cent and 24 per cent respectively, for the group as a whole - not a significant difference. Those on peritoneal dialysis tended to be healthier, overall. Healthier patients, as you might expect, did better on either form of dialysis. But for those with coexisting disease, hemodialysis was a better choice. The death risk for this group, many of whom had heart disease, was twice as high on peritoneal dialysis than it was on hemodialysis in that first year.

Source
Annals of Internal Medicine online 1st August 2005

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