title: A population-based approach indicates an overall higher patient mortality with peritoneal dialysis compared to hemodialysis in Korea.
abstract: To date, only a few large-scale studies have measured the effect of dialysis modality on mortality in Asian populations. Here, we sought to compare survival between incident hemodialysis (HD) and peritoneal dialysis (PD) patients using the Korean Health Insurance Review & Assessment Service database. This enabled us to perform a population-based complete survey that included 32,280 incident dialysis patients and followed them for a median of 26.5 months. To reduce biases due to nonrandomization, we first matched 7049 patient pairs with similar propensity scores. Using the log-rank test, we found the mortality rate in PD patients was significantly higher than that in HD patients. Subsequent subgroup analyses indicated that in older patients (55 years and older), with the exception of the subgroup of patients with no comorbidities and the subgroup of patients with malignancy, PD was consistently associated with a higher mortality rate. In younger patients (under 55 years), regardless of the covariates, the survival rate of PD patients was comparable to that of HD patients. Thus, while the overall mortality rate was higher in incident PD patients, mortality rates of some incident PD and HD patients were comparable in Korea.
authors.affiliation: Department of Internal Medicine, Wonkwang University College of Medicine Sanbon Hospital, Gunpo, Korea.
authors.forename: Hyunwook
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Public Health, Graduate School, Korea University, Seoul, Korea.
authors.forename: Kyoung Hoon
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, School of Medicine and Health Science Institute, Gyeongsang National University, Jinju, Korea.
authors.forename: Kisoo
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
authors.affiliation: Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
authors.forename: Song Vogue
authors.initials: SV
authors.lastname: Ahn
authors.affiliation: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hyeong Sik
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Hoo Jae
authors.initials: HJ
authors.lastname: Hann
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Shina
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Jung-Hwa
authors.initials: JH
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Kyu Bok
authors.initials: KB
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Dong-Ryeol
authors.initials: DR
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality*; D015995:Prevalence; D057216:Propensity Score; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome