Dialysis treatment choice affects risk of death in patients with end-stage kidney disease

Researchers at Johns Hopkins have found that in people with end-stage kidney disease (ESRD), choosing peritoneal dialysis over hemodialysis increases their risk of dying by 50 percent.

The Hopkins findings, to be published in the journal Annals of Internal Medicine online Aug. 1, are from one of the first comprehensive, large-scale, follow-up comparison studies in the debate about which kind of dialysis is better.

Currently, more than 400,000 Americans require one of the two kinds of dialysis to remove waste products and excess water from the blood because their failing kidneys have less than 15 percent of their normal function remaining. On average, a healthy kidney filters approximately 200 quarts of blood per day. By 2030, the number of Americans needing dialysis is expected to jump to 2 million, due in part to rising rates of diabetes, the leading cause of kidney failure.

"Lifelong dialysis is often the only option when a patient's kidneys fail because there are not enough kidneys available for transplantation," says the study's primary author, kidney specialist Bernard G. Jaar, M.D., M.P.H., an assistant professor at the Welch Center for Prevention, Epidemiology and Clinical Research at The Johns Hopkins University School of Medicine. More than 55,000 people are on the national waiting list for a kidney, he says.

"Until now, people with kidney disease have picked the kind of dialysis that best suits their lifestyle, sometimes switching from one method to the other, but we have always wondered if one of the two methods helped people live longer," Jaar adds.

To find out, the study, called the Choices for Healthy Outcomes in Caring for ESRD, or CHOICE for short, followed 1,041 newly diagnosed patients from 81 dialysis clinics across the United States and monitored their health, mainly through reviews of patient charts and medical records, for eight years while they underwent dialysis treatment. The study particip

Contact: David March
Johns Hopkins Medical Institutions

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