Liver cirrhosis leads to poorer survival in patients with end-stage renal disease

Abstract

Background/Aims: Liver cirrhosis (LC) is an important problem in patients with end-stage renal disease (ESRD). Few studies have investigated the influence of LC on mortality in patients with ESRD. This study investigated the association between LC and mortality among patients with ESRD and compare mortality between two dialysis modalities. Methods: Adult patients (>= 18 years of age) starting dialysis for ESRD were enrolled in the present study from 2000 to 2011. We analyzed 1,069 patients with ESRD; of these, 742 patients were undergoing hemodialysis (HD) and 327 patients were undergoing peritoneal dialysis (PD). Results: The prevalence of LC was 44 of 1,069 patients (4.1%). The cumulative 1-, 3-, and 5-year survival rates of noncirrhotic patients were 93%, 83%, and 73%, respectively, whereas the equivalent survival rates of cirrhotic patients were 90%, 68%, and 48%, respectively (p = 0.011). After adjustment, LC was an independent risk factor for death in patients with ESRD. No difference in mortality associated with LC was found between the HD and PD subgroups. Conclusions: Of the patients with ESRD, cirrhotic patients had poorer survival than noncirrhotic patients. Among patients with ESRD and LC, survival of patients undergoing PD may be comparable with that of patients undergoing HD.