Dialysis Modality and Patient Survival: An Epidemiology Perspective

The comparison of outcomes between PD and HD has been debated for more than a decade. After reviewing 16 large-scale studies conducted from 1994 to 2009, we identified several analytical concerns regarding dialysis modality comparisons in a perspective of epidemiology. These studies suggest that it is preferable to recruit only incident patients because the inclusion of prevalent patients may bias the analysis. Both retrospective and prospective studies have their strengths and weaknesses. When building a survival model comparing PD and HD, case-mix adjustment, time-varying risks, as well as comparability must be taken into account. Furthermore, researchers must test the sensitivity of different analytical approaches to deal with issues posed by modality switching. Owing to the scarcity of studies comparing survival of PD and HD patients in Asia, it is, thus, important to conduct further large-scale investigations of Asian ethnic groups. This is especially true for Taiwan, which has the highest prevalence and incidence of ESRD in the world.

並列關鍵字

end-stage renal disease ； dialysis ； survival ； propensity score

國際替代計量

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