Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 2, March-April, p. 251–258
Publication type: original article
Dialysis vintage and cardiovascular injury as factors influencing long-term survival in peritoneal dialysis and hemodialysis
1 Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poland
2 Department of Pathophysiology, Poznan University of Medical Sciences, Poland
3 Department of Philosophy and Bioethics, Poznan University of Medical Sciences, Poland
4 Department of Biostatistics, Poznan University of Medical Sciences, Poland
5 Karolinska Institutet, Clinical Science, Intervention and Technology, Stockholm, Sweden
Background. Cardiovascular (CV) incidents are the major cause of mortality in maintenance dialysis (MD) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD). CV injury indicators may be useful to investigate the dialysis modality influence on survival.
Objectives. The aim of this study was to compare selected laboratory and echocardiographic (ECHO) markers of CV injury in terms of dialysis vintage (DV), CV-related mortality and all-cause mortality.
Material and Methods. The study involved 301 patients on HD (n = 301) and PD (n = 58), who were divided into subgroups according to DV. The subjects’ medical histories included diabetes mellitus (DM), myocardial infarction (MI), stroke, CV deaths and deaths from non-CV causes. Their CV parameters were measured with ECHO for the left ventricle ejection fraction (EF), posterior wall (LVW) and interventricular septum (IVS). Serum analyses of cardiac troponin T (TnT) and N-terminal pro-brain natriuretic peptide (BNP) were also carried out.
Results. In the subgroup with a DV of 4 years, the PD and HD patients were of a similar age, and had similar mortality and morbidity rates and CV markers, except for thicker IVS in the HD patients.
Conclusion. Focusing on the data analysis based on mortality, and both laboratory and echocardiographic markers of cardiovascular injury, PD seems to be a more favorable method of dialysis. The advantage of PD was noted in subjects with a DV < 2 years. HD showed no outcome benefit over PD in longer DV.
hemodialysis, mortality, peritoneal dialysis, echocardiography, troponin T
- Oliver MJ, Garg AX, Blake PG, et al. Impact of contraindications, barriers to self-care and support on incident peritoneal dialysis utiliza-tion. Nephrol Dial Transplant. 2010;25:2737–2744.
- Blake PG, Quinn RR, Oliver MJ, et al. Peritoneal dialysis and the process of modality selection. Perit Dial Int. 2013;33:233–241.
- Stack AG. Determinants of modality selection among incident US dialysis patients: Results from a national study. J Am Soc Nephrol. 2002;13:1279–1287.
- Wankowicz Z. Peritoneal dialysis and its role in the demography and epidemiology of chronic kidney disease. Pol Arch Med Wewn. 2009;119:810–814.
- Bargman JM. Timing of initiation of RRT and modality selection. Clin J Am Soc Nephrol. 2015;10:1072–1077.
- Korevaar JC, Feith GW, Dekker FW, et al. Effect of starting with hemodialysis compared with peritoneal dialysis in patients new on dialysis treatment: A randomized controlled trial. Kidney Int. 2003; 64:2222–2228.
- Collins AJ, Foley RN, Chavers B, et al. 2013 USRDS Annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Am J Kidney Dis. 2014;59:e73–e82.
- Khan NA, Hemmelgarn BR, Tonelli M, et al. Prognostic value of troponin T and I among asymptomatic patients with end-stage renal disease: A meta-analysis. Circulation. 2005;112:3088–3096.
- McGill D, Talaulikar G, Potter JM, et al. Over time, high-sensitivity TnT replaces NT-proBNP as the most powerful predictor of death in pa-tients with dialysis-dependent chronic renal failure. Clin Chim Acta. 2010;411:936–939.
- Hickman PE, McGill DA, Potter JM, et al. Multiple biomarkers including cardiac troponins T and I measured by high-sensitivity assays, as pre-dictors of long-term mortality in patients with chronic renal failure who underwent dialysis. Am J Cardiol. 2015;115:1601–1606.
- Schwermer K, Hoppe K, Radziszewska D, et. al. N-terminal pro-B-type natriuretic peptide as a marker of hypervolemia and predictor of in-creased mortality in patients on hemodialysis. Pol Arch Med Wewn. 2015;125:560–569.
- Rebic DR, Rasic SR, Dervisevic MD, et al. Alteration of cardiovascular structure and function in patients undergoing peritoneal dialysis. Cardi-orenal Med. 2015;5:135–144.
- Koo HM, Doh FM, Kim CH, et al. Changes in echocardiographic parameters according to the rate of residual renal function decline in incident peritoneal dialysis patients. Medicine (Baltimore). 2015; 94(7):e427. doi:10.1097/MD.0000000000000427.
- Franczyk-Skora B, Gluba A, Olszewski R, et al. Heart function disturbances in chronic kidney disease: Echocardiographic indices. Arch Med Sci. 2014;10:1109–1116.
- Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7:79–108.
- Guo, A. and S. Mujais. Patient and technique survival on peritoneal dialysis in the United States: Evaluation in large incident cohorts. Kidney Int Suppl. 2003;88:3–12.
- Woodrow G, Turney JH, Brownjohn AM. Technique failure in peritoneal dialysis and its impact on patient survival. Perit Dial Int. 1997; 17:360–364.
- Ivarsen P, Povlsen JV. Can peritoneal dialysis be applied for unplanned initiation of chronic dialysis? Nephrol Dial Transplant. 2014;29:2201–2206.
- Winkelmayer WC, Glynn RJ, Levin R, et al. Late referral and modality choice in end-stage renal disease. Kidney Int. 2001;60:1547–1554.
- van de Luijtgaarden MW, Jager KJ, Segelmark M, et al. Trends in dialysis modality choice and related patient survival in the ERA-EDTA: Regis-try over a 20-year period. Nephrol Dial Transplant. 2016; 31:120–128.
- Liem YS, Wong JB, Hunink MG, et al. Propensity scores in the presence of effect modification: A case study using the comparison of mortality on hemodialysis versus peritoneal dialysis. Emerg Themes Epidemiol. 2010;7(1):1. doi: 10.1186/1742-7622-7-17:1.
- Jaar BG, Coresh J, Plantinga LC, et al. Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease. Ann Intern Med. 2005;143:174–183.
- Murphy SW, Foley RN, Barrett BJ. Comparative mortality of hemodialysis and peritoneal dialysis in Canada. Kidney Int. 2000;57:1720–1726.
- Termorshuizen F, Korevaar JC, Dekker FW, et al. Hemodialysis and peritoneal dialysis: Comparison of adjusted mortality rates according to the duration of dialysis: Analysis of the Netherlands cooperative study on the adequacy of dialysis 2. J Am Soc Nephrol. 2003; 14:2851–2860.
- Ganesh SK, Hulbert-Shearon T, Port FK, et al. Mortality differences by dialysis modality among incident ESRD patients with and without cor-onary artery disease. J Am Soc Nephrol. 2003;14:415–424.
- Stack AG, Molony DA, Rahman NS, et al. Impact of dialysis modality on survival of new ESRD patients with congestive heart failure in the United States. Kidney Int. 2003;64:1071–1079.
- Vonesh EF, Snyder JJ, Foley RN, Collins AJ. The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis. Kidney Int. 2004;66:2389–2401.
- Heaf JG, Lokkegaard H, Madsen M. Initial survival advantage of peritoneal dialysis relative to haemodialysis. Nephrol Dial Transplant. 2002;17:112–117.
- Perl J, Wald R, Bargman JM, et al. Changes in patient and technique survival over time among incident peritoneal dialysis patients in Canada. Clin J Am Soc Nephrol. 2012;7:1145–1154.
- Yeates K, Zhu N, Vonesh E, et al. Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transplant. 2012;27:3568–3575.
- Heaf JG, Wehberg S. Relative survival of peritoneal dialysis and haemodialysis patients: Effect of cohort and mode of dialysis initiation. PLoS One. 2014; 9(3):e90119. doi: 10.1371/journal.pone.0090119.
- Kumar VA, Sidell MA, Jones JP, Vonesh EF. Survival of propensity matched incident peritoneal and hemodialysis patients in a United States health care system. Kidney Int. 2014;86:1016–1022.
- McDonald SP, Marshall MR, Johnson DW, Polkinghorne KR. Relationship between dialysis modality and mortality. J Am Soc Nephrol. 2009;20:155–163.
- Weinhandl ED, Foley RN, Gilbertson DT, et al. Propensity-matched mortality comparison of incident hemodialysis and peritoneal dialysis patients. J Am Soc Nephrol. 2010;21:499–506.
- Mehrotra R, Chiu YW, Kalantar-Zadeh K, et al. Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Arch Intern Med. 2011;171:110–118.