August 2, 2005 - Researchers from Johns Hopkins have published a paper from the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study in the Annals of Internal Medicine showing that long-term peritoneal dialysis is riskier than hemodialysis.

While there is little difference between the two forms of dialysis for the first year, by the second year the risk of death for those on peritoneal dialysis is about twice that of those on hemodialysis, especially for people who have cardiovascular disease.

The risk of death among 135 patients with cardiovascular disease who were using peritoneal dialysis was nearly twice that of 459 similar patients on hemodialysis.

"Our results show that there is clearly a benefit in choosing hemodialysis over peritoneal dialysis, particularly for patients suffering from cardiovascular disease," says the study�s principal and senior investigator, Neil R. Powe, M.D., M.P.H., M.B.A., a professor and director of the Welch Center for Prevention, Epidemiology and Clinical Research at Hopkins. "Patients who initially select peritoneal dialysis should be monitored carefully for a timely switch to hemodialysis, when peritoneal dialysis does not work as well anymore." Press release from Johns Hopkins via Newswise.

"Comparing the Risk for Death with Peritoneal Dialysis and Hemodialysis in a National Cohort of Patients with Chronic Kidney Disease" - abstract from the Annals of Internal Medicine (AOIM)

"Effects of Dialysis Type on Survival in Patients with End-Stage Kidney Disease" - summary for patients from AOIM

In the same issue, there is an accompanying editorial (pay for viewing) by Dr. Gerald Schulman who points out that study's conclusion can't be stated as definitive.

New technologies make these comparisons a constantly moving target. This prospective study of incident dialysis was also not a randomized trial.


March 2, 2004 - Recent articles by Johns Hopkins researchers on educating patients on their choice between hemodialysis and peritoneal dialysis continues to receive widespread attention in the press. News item from Johns Hopkins Bloomberg School of Public Health.

Last month, the British Medical Journal (BMJ) raised the idea that denying patients choices in their medical care may be a form of abuse.

"Abusing patients by denying them choice" - editorial from BMJ

February 23, 2004 - The March issue of the Journal of the American Society of Nephrology (JASN) contains a study on differences in health-related quality of life (HRQOL) between hemodialysis (HD) and peritoneal dialysis (PD) patients. The main outcome measured was change in qualify-of-life scores from start of dialysis to 1 year on dialysis and overall health status. The study found that for ESRD-specific HRQOL, results were not consistent; some domains were better for PD patients whereas others were better for HD patients.

"Changes in Quality of Life during Hemodialysis and Peritoneal Dialysis Treatment: Generic and Disease Specific Measures" - abstract from JASN

February 11, 2004 - This week's issue of the Journal of the American Medical Association (JAMA) contains a free, full-text article on a study of patient satisfaction with hemodialysis vs. peritoneal dialysis treatment modalities. A survey of nearly 700 dialysis patients after seven weeks of treatment found 85 percent of peritoneal dialysis patients rated their care as excellent, compared to 56 percent of hemodialysis patients. Overview from Reuters/Yahoo. (link is no longer available)

"Patient Ratings of Dialysis Care with Peritoneal Dialysis vs. Hemodialysis" - abstract from JAMA

[Page reviewed on 10/23/2005.]