Department of Nephrology, , Internal Medicine, Nowon Eulji Medical center, Eulji University, Seoul, Korea.
National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
Sci Rep. 2019 Apr 11;9(1):5905. doi: 10.1038/s41598-019-42508-z.
There has been paucity of data regarding the secular trend of adverse outcomes in peritoneal dialysis (PD) as compared with hemodialysis (HD) in Korea. 96,596 patients who started dialysis between 2004-2015 in Korea were identified using the National Health Insurance Service database. The adjusted hazard ratio (HR) (95% confidence interval, CI) of PD over HD for mortality was 1.31 (1.27-1.36; P < 0.001) in the period of 2004-2007 and 1.21 (1.16-1.27; P < 0.001) in the period of 2008-2011. However, the hazard of PD over HD for mortality turned out to be insignificant in the period of 2012-2015. Similar trend was noted for nonfatal cardiovascular events (CVEs). In subgroup analysis, the hazard of PD over HD for mortality was evident, regardless of the status of age, diabetes, and comorbidity burden in 2004-2011. In 2012-2015, however, the hazard of PD over HD for mortality was insignificant when follow up was censored at one year, which became significant when follow up follow up was censored at three or five year. In conclusion, the mortality of PD over HD in Korea has been significantly improved, a finding that was paralleled by the improved nonfatal CVEs.
与血液透析（HD）相比，韩国腹膜透析（PD）不良结局的长期趋势数据较少。使用国家健康保险服务数据库，确定了 2004-2015 年期间在韩国开始透析的 96596 名患者。在 2004-2007 年期间，PD 相对于 HD 的死亡率调整后的危险比（HR）（95%置信区间，CI）为 1.31（1.27-1.36；P < 0.001），在 2008-2011 年期间为 1.21（1.16-1.27；P < 0.001）。然而，2012-2015 年期间，PD 相对于 HD 的死亡率风险并不显著。非致命性心血管事件（CVE）也出现了类似的趋势。在亚组分析中，2004-2011 年期间，无论年龄、糖尿病和合并症负担状况如何，PD 相对于 HD 的死亡率风险均明显升高。然而，2012-2015 年期间，当随访截止为一年时，PD 相对于 HD 的死亡率风险不显著，当随访截止为三年或五年时，该风险变得显著。总之，韩国 PD 相对于 HD 的死亡率得到了显著改善，这一发现与非致命性 CVE 的改善相吻合。
