Patients with end-stage renal disease and diabetes had similar survival rates whether they received hemodialysis or peritoneal dialysis

Abstract

Background: The survival rate of patients with diabetes mellitus (DM) and end-stage renal disease (ESRD) undergoing maintenance dialysis, including hemodialysis (HD) and peritoneal dialysis (PD), is markedly lower than that observed in patients with ESRD without DM.

Methods: We used propensity score matching to balance the clinical characteristics of patients from the HD and PD groups. We compared the survival rate between HD or PD, followed by Cox regression analyses accounting for age, Charlson comorbidity index (CCI), body mass index (BMI), and serum albumin levels to examine the outcome influence of dialysis modalities.

Results: During follow-up, there were 19 (18.1%) and 18 (17.1%) deaths among patients who underwent HD and PD, respectively (P = 0.856). Kaplan-Meier survival analyses showed no significant difference in overall survival between patients in the HD and PD groups. Cox regression analyses stratified based on age, CCI, BMI, and serum albumin demonstrated that the choice of HD over PD did not influence survival.

Conclusions: Regardless of age, CCI, BMI, and albumin level, patients with DM and ESRD had similar survival rates whether they received HD or PD in China. The choice of dialysis modality should be individualized according to patients' physical status and local practices for patients with DM and ESRD.

Keywords: diabetes; end-stage renal disease; hemodialysis; outcomes; peritoneal dialysis.