COMPARING SURVIVAL BETWEEN PERITONEAL DIALYSIS AND HEMODIALYSIS TREATMENT IN ESRD PATIENTS WITH CHRONIC HEPATITIS C INFECTION

[Guest guest]

http://www.pdiconnect.com/cgi/content/abstract/30/1/86

Perit Dial Int 30(1): 86-90

2010

© 2010 International Society for Peritoneal Dialysis

Clinical

COMPARING SURVIVAL BETWEEN PERITONEAL DIALYSIS AND HEMODIALYSIS TREATMENT IN

ESRD PATIENTS WITH CHRONIC HEPATITIS C INFECTION

Che-Yi Chou, I-Kuan Wang, Jiung-Hsiun Liu, Hsin-Hung Lin, Shu-Ming Wang and

Chiu-Ching Huang

Division of Nephrology, Department of Internal Medicine, China Medical

University Hospital, Taichung, Taiwan

Correspondence to: C.C. Huang, Division of Nephrology, Department of Internal

Medicine, China Medical University Hospital, No. 2, Yude Road, North District,

Taichung City 40461, Taiwan. cch@...

Objective: End-stage renal disease (ESRD) patients with hepatitis C virus (HCV)

infection are associated with an increasing mortality risk on hemodialysis (HD)

and peritoneal dialysis (PD). The aim of this study was to compare patient

survival between HCV-positive patients undergoing PD versus HD.

Methods: We reviewed 78 PD and 78 HD patients with chronic hepatitis C

infection in China Medical University Hospital from 1996 to 2006. The HD

patients were selected using the propensity score matching method. Kaplan–Meier

analysis with log-rank test was used to compare patient survival between

patients treated with PD and those treated with HD. Possible prognostic factors

were analyzed using multivariate proportional hazard regression with

adjustments for age, sex, and propensity score.

Results: Mortality rate was 50% (39/78) for PD and 41% (32/78) for HD

(chi-square test p = 0.26). Diabetes, hypertension, and cardiovascular disease

were present in 43.6%, 25.6%, and 14.1% of patients, respectively. Kaplan–Meier

estimate and univariate regression with adjustments for age and propensity

score showed that HCV patients treated with PD had a similar survival to those

treated with HD (p = 0.381 and p = 0.363). In forward stepwise regression,

positivity for hepatitis B virus surface antigen (p < 0.001), diabetes (p =

0.009), and serum albumin (p = 0.032) were independently associated with higher

mortality.

Conclusion: Patient survival is not different between ESRD patients with

chronic hepatitis C treated with PD and those treated with HD. In ESRD patients

positive for HCV, being positive for hepatitis B virus is an important

prognostic factor.

KEY WORDS: Cardiovascular disease; mortality; hemodialysis; hepatitis C;

hepatitis B.

Received 24 May 2008; accepted 12 January 2009.