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For octogenarians on dialysis, the switch matters. A new study finds that patients aged 80+ who transitioned from peritoneal dialysis (PD) to hemodialysis faced a 46% higher mortality risk — though researchers say this likely reflects underlying health decline rather than the switch itself. Importantly, the initial choice of dialysis modality didn't significantly affect 5-year survival rates.
For octogenarians on dialysis, the switch matters. A new study published in Clinical Kidney Journal found that patients aged 80 and older who transitioned from peritoneal dialysis (PD) to hemodialysis faced significantly higher mortality risks compared to those who stayed on one modality. Researchers analyzed data from over 4,200 patients in Catalonia, Spain, spanning more than two decades.
Crucially, the initial choice of dialysis modality — PD vs. hemodialysis — did not significantly affect 5-year survival rates. The elevated mortality risk tied to switching is thought to reflect underlying clinical deterioration rather than the transition itself, with common reasons for switching including loss of peritoneal membrane function, severe comorbidities, and PD-related infections.
By the Numbers:
Why it matters: As more older adults live with end-stage kidney disease, clinicians need to think beyond initial modality selection. Experts emphasize that dialysis planning for octogenarians should be a dynamic, ongoing conversation — factoring in independence, caregiver support, and patients' personal health priorities, not just survival odds.
