Keshaviah P, Ma J, Thope K, Churchill D, Collins A
Comparison of 2 year survival on hemodialysis and peritoneal
dialysis with dose of dialysis matched using the peak concentration
hypothesis
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:540 1995
This work is based on a combination of the CANUSA PD database
and the RKDP HD database in Minneapolis. These contain 680 and 1051
patients, respectively. When the Peak Concentration Hypothesis is
applied, and when patients are broken down by age and by diabetic
status, 2-year survival for #equivalent# dialysis dose are very similar
between HD and PD. The authors suggest that this validates the peak
concentration hypothesis.
A valid criticism might be that these findings are consistent with
the hypothesis but do not validate it. They are equally consistent with
other hypotheses such as that recently put forward by Depner. What
the authors have essentially done is confirmed the long-standing
observation that PD patients achieve comparable outcomes to HD
patients with significantly lower levels of KT/V. Exactly why this is so
remains open to debate.
(Blake)
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Am Soc Nephrol
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling
CRF: Problem Areas :
Outcomes (Morbidity, Mortality)