PMID- 21511830
OWN - NLM
STAT- MEDLINE
DCOM- 20110825
LR  - 20211020
IS  - 1533-3450 (Electronic)
IS  - 1046-6673 (Print)
IS  - 1046-6673 (Linking)
VI  - 22
IP  - 6
DP  - 2011 Jun
TI  - Hemodialysis vascular access modifies the association between dialysis modality 
      and survival.
PG  - 1113-21
LID - 10.1681/ASN.2010111155 [doi]
AB  - Several comparisons of peritoneal dialysis (PD) and hemodialysis (HD) in incident 
      patients with ESRD demonstrate superior survival in PD-treated patients within 
      the first 1 to 2 years. These survival differences may be due to higher 
      HD-related mortality as a result of high rates of incident central venous 
      catheter (CVC) use or due to an initial survival advantage conferred by PD. We 
      compared the survival of incident PD patients with those who initiated HD with a 
      CVC (HD-CVC) or with a functional arteriovenous fistula or arteriovenous graft 
      (HD-AVF/AVG). We used multivariable piece-wise exponential nonproportional and 
      proportional hazards models to evaluate early (1 year) mortality as well as 
      overall mortality during the period of observation using an intention-to-treat 
      approach. We identified 40,526 incident adult dialysis patients from the Canadian 
      Organ Replacement Register (2001 to 2008). Compared with the 7412 PD patients, 
      1-year mortality was similar for the 6663 HD-AVF/AVG patients but was 80% higher 
      for the 24,437 HD-CVC patients (adjusted HR, 1.8; 95% confidence intervals [CI], 
      1.6 to 1.9). During the entire period of follow-up, HD-AVF/AVG patients had a 
      lower risk for death, and HD-CVC patients had a higher risk for death compared 
      with patients on PD. In conclusion, the use of CVCs in incident HD patients 
      largely accounts for the early survival benefit seen with PD.
FAU - Perl, Jeffrey
AU  - Perl J
AD  - Division of Nephrology, St. Michael's Hospital and the Keenan Research Centre in 
      the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, 
      Canada. Jeff.perl@utoronto.ca
FAU - Wald, Ron
AU  - Wald R
FAU - McFarlane, Philip
AU  - McFarlane P
FAU - Bargman, Joanne M
AU  - Bargman JM
FAU - Vonesh, Edward
AU  - Vonesh E
FAU - Na, Yingbo
AU  - Na Y
FAU - Jassal, S Vanita
AU  - Jassal SV
FAU - Moist, Louise
AU  - Moist L
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110421
PL  - United States
TA  - J Am Soc Nephrol
JT  - Journal of the American Society of Nephrology : JASN
JID - 9013836
SB  - IM
CIN - J Am Soc Nephrol. 2011 Jun;22(6):989-90. PMID: 21628624
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arteriovenous Shunt, Surgical
MH  - Canada
MH  - Catheters, Indwelling
MH  - Female
MH  - Humans
MH  - Kidney Failure, Chronic/*mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Peritoneal Dialysis/*methods
MH  - Proportional Hazards Models
MH  - Registries
MH  - Renal Dialysis/*methods
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC3103730
EDAT- 2011/04/23 06:00
MHDA- 2011/08/27 06:00
PMCR- 2012/06/01
CRDT- 2011/04/23 06:00
PHST- 2011/04/23 06:00 [entrez]
PHST- 2011/04/23 06:00 [pubmed]
PHST- 2011/08/27 06:00 [medline]
PHST- 2012/06/01 00:00 [pmc-release]
AID - ASN.2010111155 [pii]
AID - 2010111155 [pii]
AID - 10.1681/ASN.2010111155 [doi]
PST - ppublish
SO  - J Am Soc Nephrol. 2011 Jun;22(6):1113-21. doi: 10.1681/ASN.2010111155. Epub 2011 
      Apr 21.