Propensity-Matched Mortality Comparison of Incident Hemodialysis and Peritoneal Dialysis Patients
Propensity-Matched Mortality Comparison of Incident Hemodialysis and Peritoneal Dialysis Patients
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DOI：
10.1681/asn.2009060635
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发表时间：
2010-03-01
影响因子：
13.6
通讯作者：
Collins, Allan J.
中科院分区：
文献类型：
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作者：
Weinhandl, Eric D.;Foley, Robert N.;Collins, Allan J.
目前缺乏血液透析和腹膜透析患者死亡率的比较。我们的目的是通过意向治疗分析，在配对队列和按年龄、心血管疾病和糖尿病定义的亚组中比较血液透析和腹膜透析患者的生存率。我们匹配了2003年在美国开始透析的98，875名成年人的回顾性队列中的6337对患者。在第0天生存期的主要意向治疗分析中，腹膜透析患者的累积生存期高于血液透析患者（风险比0.92; 95% CI 0.86 - 1.00，P = 0.04）。在12、24、36和48个月时，腹膜透析与血液透析的累积生存概率分别为85.8%与80.7%（P <0.01）、71.1%与68.0%（P < 0.01）、58.1%与56.7%（P = 0.25）和48.4%与47.3%（P = 0.50）。在不同年龄的亚组中，腹膜透析与血液透析相比，
Contemporary comparisons of mortality in matched hemodialysis and peritoneal dialysis patients are lacking. We aimed to compare survival of incident hemodialysis and peritoneal dialysis patients by intention-to-treat analysis in a matched-pair cohort and in subsets defined by age, cardiovascular disease, and diabetes. We matched 6337 patient pairs from a retrospective cohort of 98,875 adults who initiated dialysis in 2003 in the United States. In the primary intention-to-treat analysis of survival from day 0, cumulative survival was higher for peritoneal dialysis patients than for hemodialysis patients (hazard ratio 0.92; 95% Cl 0.86 to 1.00, P = 0.04). Cumulative survival probabilities for peritoneal dialysis versus hemodialysis were 85.8% versus 80.7% (P < 0.01), 71.1% versus 68.0% (P < 0.01), 58.1% versus 56.7% (P = 0.25), and 48.4% versus 47.3% (P = 0.50) at 12, 24, 36, and 48 months, respectively. Peritoneal dialysis was associated with improved survival compared with hemodialysis among subgroups with age