title: Comparing cardiac surgery in peritoneal dialysis and hemodialysis patients: perioperative outcomes and two-year survival.
abstract: BACKGROUND
  We sought to compare perioperative outcomes and 2-year survival in a cohort of peritoneal dialysis (PD) patients compared with matched hemodialysis (HD) patients who underwent cardiothoracic surgery at our institution.
  
  
  METHODS
  We obtained a list of all dialysis-dependent patients who underwent cardiac surgery (coronary artery bypass grafting, valve replacement, or both) at our center between 1994 and 2008. All patients undergoing PD at the time of surgery were included in our analysis. Two HD patients matched for age, diabetes status, and Charleston comorbidity score were obtained for each PD patient.
  
  
  RESULTS
  The analysis included 36 PD patients and 72 HD patients. Mean age, sex, diabetes status, cardiac unit stay, hospital stay, and operative mortality did not differ by dialysis modality. The incidence of 1 or more postoperative complications (infection, prolonged intubation, death) was higher for HD patients (50% vs. 28% for PD patients, p = 0.046). After surgery, 2 PD patients required conversion to HD. The 2-year survival was 69% for PD patients and 66% for HD patients (p = 0.73).
  
  
  CONCLUSIONS
  Our findings suggest that, compared with HD patients, PD patients who require cardiac surgery do not experience more early complications or a lesser 2-year survival and that 2-year survival for dialysis patients after cardiac surgery is acceptable.
authors.affiliation: Southern California Permanente Medical Group, Los Angeles, California, USA. victoria.a.kumar@kp.org
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Kumar
authors.forename: Shubha
authors.initials: S
authors.lastname: Ananthakrishnan
authors.forename: Scott A
authors.initials: SA
authors.lastname: Rasgon
authors.forename: Eric
authors.initials: E
authors.lastname: Yan
authors.forename: Raoul
authors.initials: R
authors.lastname: Burchette
authors.forename: Karen
authors.initials: K
authors.lastname: Dewar
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D016019:Survival Analysis; D016896:Treatment Outcome