Patient survival and causes of death on hemodialysis and peritoneal dialysis - single-center study

• DOI: 10.1007/s004670100012
• Publication Date: 2002-10-15T14:43:57Z
• Authors: M. Litwin; R. Grenda; S. Prokurat; M. Abuauba; J. Latoszy�ska; K. Jobs; A. Boguszewska-Ba...; Z. T. Wawer
• Keywords: Adult; Male; Adolescent; Infant; Survival Analysis; 3. Good health; Stroke; Automation; 03 medical and health sciences; 0302 clinical medicine; Peritoneal Dialysis, Continuous Ambulatory; Cardiovascular Diseases; Renal Dialysis; Cause of Death; Child, Preschool; Humans; Female; Child; Peritoneal Dialysis

Survival and causes of death in children dialyzed in a single center were analyzed. During the last 12 years a chronic dialysis program was introduced in 146 children in our center and 125 of them, eligible for observation, were included in this analysis; 58 patients were on hemodialysis (HD) and 67 on peritoneal dialysis [continuous ambulatory peritoneal dialysis/automated peritoneal dialysis (CAPD/APD)]. Mean age at the start of dialysis was 13.1 years in HD and 9.8 years in CAPD/APD patients. Overall, 16 patients died (12.5%); 6 (10.3%) on HD and 10 (14.9%) on CAPD/APD; 4 HD patients died of hemorrhagic stroke and 2 were killed in road traffic accidents. Of 10 CAPD/APD patients, 7 died of heart failure, ischemic stroke, and/or disseminated thromboembolic disease. Another was killed in a road traffic accident and 2 died during the course of severe infections. The 1-year patient survival rate was 96.6% in HD patients and 95% in CAPD/APD patients, 2-year survival 94% and 93% and 5-year survival 91% and 78%, respectively (P=0.2, NS). In conclusion, the survival rate for HD and CAPD patients is similar, although after 2 years of therapy, it is lower in CAPD patients. The main causes of death are cardiovascular. However, in CAPD/APD patients, heart failure with low cardiac output and thromboembolic complications are major causes of death, and in HD patients the main cause is hemorrhagic stroke.