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Getting the latest healthcare news for you
Getting the latest healthcare news for you
For octogenarians on dialysis, the starting modality doesn't matter much — but switching does. A new study found that transitioning from peritoneal dialysis (PD) to hemodialysis (HD) was linked to a 46% higher mortality risk in adults aged 80+. Researchers say the increased risk likely reflects underlying clinical decline rather than the switch itself.
For older adults on dialysis, the choice between peritoneal dialysis (PD) and hemodialysis (HD) at the outset may matter less than what happens down the road. A large retrospective cohort study spanning over two decades found that initial dialysis modality did not significantly affect long-term survival in adults aged 80 and older — but switching from PD to HD told a different story.
Among the 63 patients who transitioned from PD to HD during the study, the switch was independently associated with a 46% increased risk of death. The most common reasons for switching included loss of peritoneal membrane function, severe illness, PD-related infections, and patient preference. Researchers note the elevated mortality likely reflects the patient's deteriorating clinical condition rather than any direct harm from changing modalities.
By the Numbers
Why it matters: With a growing population of frail, elderly patients requiring dialysis, clinicians need nuanced guidance on modality decisions. This study reinforces that stability in dialysis modality may be as important as the initial choice — and that transitions in this vulnerable population warrant careful clinical scrutiny.
