First initiative peritoneal dialysis versus hemodialysis for the treatment of renal failure

The aim of this review is to summarize available evidence in order to establish whether the choice of the first dialysis modality may impact on the clinical outcomes in patients with renal failure in who dialysis is being initiated for the first time, with a focus on “crash start” dialysis. [...] The study did not report BMI and eGFR data.11 Interventions and Comparators In the studies that applied the propensity-matched model2,9 PD patients were matched in a 1:1 fashion with HD patients, creating 692 pairs of patients with comparable baseline variables in one study,2 and 1003 matched pair in the other study.9 In one study,2 the median follow-up time was 13.0 months in the PD group and 10. [...] In the as-treated analysis, survival was analyzed on the basis of the modality a patient was on at the time of death, regardless of whether the patient began on a different modality. [...] The ITT analysis attributed death to the initial dialysis modality of the patient regardless of whether the patient switched modalities over the course of the study. [...] In one study,9 both the as-treated analyses and ITT analyses at one year resulted in more than twice survival advantage in the PD group compared with HD with the cumulative hazard ratio (CHR) for death (HD versus PD) of 2.38 (95% CI: 1.68 to 3.40; P<0.0001) for the as-treated analysis and 2.10 (95% CI: 1.50 to 2.94; P<0.0001) for the ITT analysis.