Survival and morbidity of HIV patients on hemodialysis and peritoneal dialysis: one center's experience and review of the literature.
BACKGROUND
Controversy continues concerning the morbidity and mortality of HIV-infected ESRD patients on the two dialysis options. This article presents our experience with complications and survival rate among our HIV-infected ESRD patients on peritoneal dialysis and hemodialysis. We reviewed the literature on this subject.


METHODS
The charts of seven and eight HIV-infected ESRD patients on peritoneal dialysis and hemodialysis respectively, between January 1989 and November 2004, were reviewed retrospectively for specific clinical and demographic data. Their survival was calculated using the Kaplan-Meier method.


RESULTS
Total follow-up of HIV-infected PD and HD patients was 248.3 and 207 patient months, respectively. There was no significant difference in hospitalization rate between HIV-infected PD and HD patients (1.01 and 1.39 admission/year, respectively, P = NS). Survival of HIV-infected patients on PD at one, two and three years was 100, 83, and 50%, and for HD patients was 75, 33, and 33%, respectively. HIV-infected patients on HD had more prevalent advanced HIV disease. Two out of seven PD patients were on PD for more than five years and one of the HD patients was on that form of dialysis for more than nine years. Median survival of patients with advanced (Stage IV) AIDS (both HD and PD) was 15.1 months (range 1.6-17.3) while this value for non-advanced (Stage II, III) patients was 61.2 months (range 6.8-116.6).


CONCLUSIONS
Type of renal replacement therapy does not have a significant effect on the morbidity and mortality of HIV-infected ESRD patients. Survival is worse in patients with advanced HIV disease. Both dialysis options provide similar results in HIV patients; hence, the choice of dialysis modality should be based on patient's preference and social conditions.
Soleymanian
Tayebeh
T
Nephrology Ward, Shariati Hospital, North Kargar Street, Postal code: 14114, Tehran, Iran. t_soleymanian@tums.ac.ir
Raman
Suresh
S
Shannaq
Fouad Naser
FN
Richardson
Robert
R
Jassal
Sarbjit Vanita
SV
Bargman
Joanne
J
Oreopoulos
Dimitrios G
DG
D000328:Adult; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis