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All Dialysis Treatments Not Equal

Hemodialysis safer for kidney failure patients, study reveals

TUESDAY, Aug. 2, 2005 (HealthDay News) -- Patients with end-stage kidney disease who choose peritoneal dialysis over hemodialysis increase their risk of death by 50 percent, according to new research.

The eight-year study by researchers at Johns Hopkins University School of Medicine tracked 1,041 newly diagnosed patients at 81 dialysis clinics in the United States -- 274 of the patients selected peritoneal dialysis and 767 chose hemodialysis. The results were published in the Aug. 1 online issue of the Annals of Internal Medicine.

"Until now, people with kidney disease have picked the kind of dialysis that best suits their lifestyle -- sometimes switching from one method to the other -- but we have always wondered if one of the two methods helped people live longer," study author Dr. Bernard G. Jaar, an assistant professor at the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins, said in a prepared statement.

Peritoneal dialysis uses the membrane lining the patient's body cavity as a substitute filter to do the work of the kidneys. Waste-absorbing fluid is pumped through an implanted catheter into the cavity and remains there for two to six hours before it's pumped out. This process has to be done four to six times a day. Patients can do the treatments on their own at home, work or while traveling.

Patients on hemodialysis have their blood circulated through a machine that filters out waste. Treatment lasts three to four hours and is done about three times a week. Patients have to go to a dialysis center or approved clinic in order to have hemodialysis.

"Our results show that there is clearly a benefit in choosing hemodialysis over peritoneal dialysis, particularly for patients suffering from cardiovascular disease," said senior investigator Dr. Neil R. Powe, a professor and director of the Welch Center.

"Patients who initially select peritoneal dialysis should be monitored carefully for a timely switch to hemodialysis, when peritoneal dialysis does not work as well anymore," Powe said.

More information

The U.S. National Kidney and Urologic Diseases Information Clearinghouse has more about treatments for kidney failure.

SOURCE: Johns Hopkins University School of Medicine, news release, Aug. 1, 2005
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