A Comparison of Hospitalization Outcomes Between Peritoneal Dialysis and Home Hemodialysis Patients by Sex and Race.
In a nationally representative cohort of 14,643 incident peritoneal dialysis and 875 home haemodialysis patients (2005 to 2018), home haemodialysis was associated with fewer hospitalisations (incidence rate ratio 0.78) and fewer days in hospital (0.68), with a stronger effect in men and in Black patients and for infection-related admissions.
Study design
Nationally representative cohort of incident home dialysis patients starting between January 2005 and December 2018 (last follow-up July 2020): 14,643 on peritoneal dialysis and 875 on home haemodialysis. All-cause hospitalisation rates and days in hospital were compared by modality, sex and race.
Key findings
The overall hospitalisation rate was 0.82 events per patient-year. Home haemodialysis patients had a lower hospitalisation rate (IRR 0.78, 95% CI 0.71 to 0.85) and fewer days in hospital (IRR 0.68, 95% CI 0.59 to 0.78) than peritoneal dialysis patients. The difference was more pronounced in more contemporary cohorts and in men, was stronger for Black patients, and was largest for infection-related admissions.
Clinical implications
When counselling patients choosing between home modalities, home haemodialysis may carry a lower hospitalisation burden, but the analysis is observational and exploratory; modality choice should remain shared decision-making informed by patient preference, eligibility and local programme strength.
Category
Research
Source
Kidney International Reports
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