Survival on hemodialysis and peritoneal dialysis over 12 years with emphasis on nutritional parameters

We analyzed the prognostic importance of nutritional markers and mortality data in 537 hemodialysis (HD) and 422 peritoneal dialysis (PD) patients fol lowed for up to 12 years. Patients on HD had a 44% lower risk of mortality than did those treated with PD (P < 0.0001), The difference in mortality be tween the modalities was even more striking among diabetics but less striki ng among younger patients. Over a 12-year period, survival of dialysis pati ents with lower enrollment levels of albumin, creatinine, and parathyroid h ormone (PTH) were significantly lower. In multivariate Cox's proportional h azards models, serum prealbumin and enrollment PTH level of <65 pg/mL were independent predictors of mortality both in HD and PD patients. In conclusi on, HD patients had higher cumulative survival than PD patients over a 12-y ear period. Nutritional markers at enrollment continue to be strong predict ors of mortality for up to 12 years, (C) 2001 by the National Kidney Founda tion, Inc.