Peritoneal and hemodialysis: I. Differences in patient characteristics at initiation

Jay L. Xue, Shu Cheng Chen, James P. Ebben, Edward G. Constantini, Susan E. Everson, Eric T. Frazier, Lawrence Y. Agodoa, Allan J. Collins

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Background. Comparisons of mortality outcomes between peritoneal dialysis (PD) and hemodialysis (HD) patients have shown varying results, which may be caused by the unequally distributed clinical conditions of patients at initiation. To address this issue, we evaluated the clinical characteristics of 105,954 patients at the initiation of PD and HD, using the U.S. national incidence data on treated end-stage renal disease from the Medical Evidence Form, 1995 to 1997. Methods. A general linear model was used to analyze differences of age, albumin, creatinine, blood urea nitrogen (BUN), and hematocrit; categorical data analysis to evaluate body mass index (BMI), grouped into four categories: <19, 19-25 (<25), 25-30 (<30), and 30+; and logistic regression to assess the likelihood of initiating PD versus HD. Diabetics (DM) were analyzed separately from non-diabetics (NDM). Explanatory variables in the logistic regression included incidence year, race, gender, age, BMI, albumin, creatinine, BUN, and hematocrit. Race included white and black. Age was categorized into four groups: 20-44, 45-64, 65-74, and 75+. Results. At the initiation of dialysis PD patients were approximately 6 years younger (P < 0.0001) than HD patients. PD patients also had higher (P < 0.0001) albumin (+0.35 g/dL for DM and +0.23 g/dL for NDM) and hematocrit (+1.64% for DM and +1.71% for NDM) levels, and lower (P < 0.04) BUN (-8.75 mg/dL for DM and -5.24 mg/dL for NDM) and creatinine (-0.51 mg/dL for DM and -0.23 mg/dL for NDM) levels than HD patients. Whites had a higher (P < 0.0001) likelihood of starting PD than blacks, and patients with BMI <19 had a lower (P < 0.0001) chance of beginning on PD. Conclusion. PD patients had favorable clinical conditions at the initiation of dialysis, which should be taken into consideration when comparing dialysis outcomes between the two modalities.

Original languageEnglish (US)
Pages (from-to)734-740
Number of pages7
JournalKidney international
Volume61
Issue number2
DOIs
StatePublished - Jan 1 2002

Keywords

  • Data analysis
  • Dialysis modality
  • End-stage renal disease
  • Health Care Financing Administration
  • Medical Evidence Form
  • Mortality outcome

Fingerprint Dive into the research topics of 'Peritoneal and hemodialysis: I. Differences in patient characteristics at initiation'. Together they form a unique fingerprint.

Cite this