Characteristics and 1-year survival of incident patients on chronic peritoneal dialysis compared with hemodialysis: a large 11-year cohort study

Purpose: Few studies have evaluated patients’ characteristics and survival by dialysis modality in Brazil. We evaluated changes in dialysis modality and its survival in the country. Methods: This is a retrospective database of a cohort with incident chronic dialysis patients from Brazil. Patients’ characteristics and one-year multivariate survival risk were assessed considering dialysis modality from 2011 to 2016 and 2017 to 2021. Survival analysis was also performed on a reduced sample after adjustment using propensity score matching. Results: Of the 8295 dialysis patients, 5.3% were on peritoneal dialysis (PD) and 94.7% on hemodialysis (HD). PD patients had higher BMI, schooling and the prevalence of elective dialysis starting in the first period than those on HD. In the second period, PD patients were predominantly women, non-white, from the Southeast region, and funded by the public health system, having more frequent elective dialysis starting and predialysis nephrologist follow-ups than those on HD. There was no difference in mortality comparing PD and HD (HR 0.67, 95% CI 0.39–2.42; and HR 1.17, 95% CI 0.63–2.16; first and second period, respectively). This non-significantly different survival between both dialysis methods was also found in the reduced matched sample. Higher age and non-elective dialysis initiation were associated with higher mortality. In the second period, the lack of predialysis nephrologist follow-up and living in the Southeast region increased the mortality risk. Conclusion: Some sociodemographic factors have changed according to dialysis modality over the last decade in Brazil. The one-year survival of the two dialysis methods was comparable.