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A comparison of cause of death between patients treated with hemodialysis and peritoneal dialysis.

W E Bloembergen, F K Port, E A Mauger and R A Wolfe
JASN August 1995, 6 (2) 184-191;
W E Bloembergen
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F K Port
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E A Mauger
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R A Wolfe
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Abstract

Mortality rates associated with peritoneal dialysis (PD) have been found to be higher than those associated with hemodialysis (HD) among prevalent U.S. patients over the age of 55 in the preceding study. Given the substantial technical differences between PD and HD, causes of death might also be expected to differ between these dialytic modalities. In order to help elucidate the relative contributions of these technical differences and to further the understanding of the excess mortality observed among PD-treated dialysis patients, this epidemiologic study compared cause of death in prevalent HD- and PD-treated patients in a large national sample, adjusting for demographic characteristics. Data for patients prevalent on January 1 of the years 1987, 1988, and 1989, each with 1 yr of follow-up, were obtained from the U.S. Renal Data System. Patients were censored at transplantation. Death rates per 100 patient years for seven cause-of-death categories were compared between HD and PD, adjusting for age, race, gender, cause of ESRD (diabetes versus nondiabetes), and < 1 yr or > 1 yr of prior ESRD, by use of the Poisson regression. There were 42,372 deaths occurring over 170,700 patient years at risk. There was a significantly increased mortality risk for PD compared with HD for all cause-of-death categories, except malignancy, for which there was a higher mortality risk for HD. The excess all-cause mortality observed in PD-treated patients can be accounted for, in decreasing order, by infection (35%), acute myocardial infarction (24%), other cardiac causes (16%), cerebrovascular disease (8%), withdrawal (8%), and malignancy (-6%).(ABSTRACT TRUNCATED AT 250 WORDS)

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Journal of the American Society of Nephrology
Vol. 6, Issue 2
1 Aug 1995
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A comparison of cause of death between patients treated with hemodialysis and peritoneal dialysis.
W E Bloembergen, F K Port, E A Mauger, R A Wolfe
JASN Aug 1995, 6 (2) 184-191;

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A comparison of cause of death between patients treated with hemodialysis and peritoneal dialysis.
W E Bloembergen, F K Port, E A Mauger, R A Wolfe
JASN Aug 1995, 6 (2) 184-191;
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Cited By...

  • THE IMPACT OF TREATMENT MODALITY ON INFECTION-RELATED HOSPITALIZATION RATES IN PERITONEAL DIALYSIS AND HEMODIALYSIS PATIENTS
  • Association of Dialysis Modality and Cardiovascular Mortality in Incident Dialysis Patients
  • Predictors of Peritonitis in Patients on Peritoneal Dialysis: Results of a Large, Prospective Canadian Database
  • Changes in survival among elderly patients initiating dialysis from 1990 to 1999
  • Reducing dialysis associated bacteraemia, and recommendations for surveillance in the United Kingdom: prospective study
  • Determinants of Modality Selection among Incident US Dialysis Patients: Results from a National Study
  • An Evaluation of an Integrative Care Approach for End-Stage Renal Disease Patients
  • The Clinical Epidemiology of Cardiac Disease in Chronic Renal Failure
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