Life expectancy, expected years of life lost and survival of hemodialysis and peritoneal dialysis patients.
BACKGROUND
Expected years of life lost (EYLL) in dialysis patients are rarely discussed. This study compared life expectancy, EYLL and survival between hemodialysis (HD) and peritoneal dialysis (PD) patients.


METHODS
Adults who underwent maintenance dialysis at National Taiwan University Hospital from 1995 to 2006 were followed up until December 2007. Kaplan-Meier analysis and a constant excess hazard model were used to estimate and project long-term survival. EYLL was calculated by subtracting the life expectancy of patients from that of age- and sex-matched referents. HD patients were then matched with PD patients on age, sex and diabetes mellitus (DM). Life expectancy, EYLL and survival between the 2 groups were compared. Mortality risks were determined by the Cox model.


RESULTS
Before matching, the 305 HD patients were older than the 428 PD patients (62.4 ± 13.7 vs. 53.1 ± 16.7 years; p<0.0001). More HD patients had DM (HD vs. PD, 29.2% vs. 20.6%; p=0.0072). Life expectancy and EYLL of HD patients were 8.8 and 11.5 years, compared with those of PD patients (19.9 and 7.4 years). After matching, life expectancy (p=0.790) and EYLL (p=0.793) of both groups (236 patients each) were similar. Age (adjusted hazard ratio [AHR] = 1.07; 95% confidence interval [95% CI], 1.05-1.09) and DM (AHR=3.81; 95% CI, 2.28-6.36) were independent mortality predictors. For diabetic patients who underwent HD, a better survival rate was observed (AHR=0.24; 95% CI, 0.11-0.53).


CONCLUSIONS
After matching, HD and PD patients had similar life expectancy and EYLL. Survival was better for diabetic patients if they received HD.
Kao
Tze-Wah
TW
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Huang
Jenq-Wen
JW
Hung
Kuan-Yu
KY
Chang
Yu-Yin
YY
Chen
Pau-Chung
PC
Yen
Chung-Jen
CJ
Chen
Yung-Ming
YM
Chu
Tzong-Shinn
TS
Wu
Ming-Shiou
MS
Tsai
Tun-Jun
TJ
Wu
Kwan-Dun
KD
Wang
Jung-Der
JD
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality*; D006435:Renal Dialysis / Q000401:mortality*