Survival for haemodialysis vs. peritoneal dialysis and technique transference. Experience in Ourense, Spain, from 1976 to 2012.

Objective: To assess SV in our RRT population in the period 1976-2012 as well as the influence of technique transference (TT).
Material and Methods: The study included a retrospective cohort of 993 patients. Data were classified as transplant (Tx), change in technique, exitus or lost to follow-up. SV for TT was determined in patients with over 12 weeks of permanence.
Results: The mortality risk adjusted for age, sex, dialysis technique or diabetes mellitus (DM) showed that the estimated risk of death increased by 4.8% per year increase (HR=1.048; 95% CI: 1.04-1.06; P<.001) and was 44% higher in diabetics compared to non-diabetics (HR=1.44; 95% CI 1.16-1.76; P<.01). Regarding SV for TT, patients who initiated HD had a shorter survival than those who initiated PD and transferred to HD (P=.00563).
Conclusion: In our experience, SV in RRT is dependent on age and coexistence of DM. It would be beneficial to reinstate the concept of "comprehensive care", in which RRT would start with PD and later transfer to HD.
(Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)