Patient survival and causes of death on hemodialysis and peritoneal dialysis--single-center study.
Survival and causes of death in children dialyzed in a single center were analyzed. During the last 12 years a chronic dialysis program was introduced in 146 children in our center and 125 of them, eligible for observation, were included in this analysis; 58 patients were on hemodialysis (HD) and 67 on peritoneal dialysis [continuous ambulatory peritoneal dialysis/automated peritoneal dialysis (CAPD/APD)]. Mean age at the start of dialysis was 13.1 years in HD and 9.8 years in CAPD/APD patients. Overall, 16 patients died (12.5%); 6 (10.3%) on HD and 10 (14.9%) on CAPD/APD; 4 HD patients died of hemorrhagic stroke and 2 were killed in road traffic accidents. Of 10 CAPD/APD patients, 7 died of heart failure, ischemic stroke, and/or disseminated thromboembolic disease. Another was killed in a road traffic accident and 2 died during the course of severe infections. The 1-year patient survival rate was 96.6% in HD patients and 95% in CAPD/APD patients, 2-year survival 94% and 93% and 5-year survival 91% and 78%, respectively (P=0.2, NS). In conclusion, the survival rate for HD and CAPD patients is similar, although after 2 years of therapy, it is lower in CAPD patients. The main causes of death are cardiovascular. However, in CAPD/APD patients, heart failure with low cardiac output and thromboembolic complications are major causes of death, and in HD patients the main cause is hemorrhagic stroke.
Litwin
M
M
Department of Nephrology and Kidney Transplantation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-736 Warsaw, Poland. Mieczyk@zigzag.pl
Grenda
R
R
Prokurat
S
S
Abuauba
M
M
Latoszyñska
J
J
Jobs
K
K
Boguszewska-Baczkowska
A
A
Wawer
Z T
ZT
D000293:Adolescent; D000328:Adult; D001331:Automation; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods / Q000401:mortality*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000401:mortality; D006435:Renal Dialysis / Q000401:mortality*; D020521:Stroke / Q000401:mortality; D016019:Survival Analysis