---
title: "Dialysis Modality Outcomes in Patients with Liver Cirrhosis and ESKD: Propensity-Matched Cohort"
id: "pubmed-42623151"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42623151"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42623151/"
doi: "10.34067/KID.0000001325"
published_at: "2026-08-20T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Dialysis Modality Outcomes in Patients with Liver Cirrhosis and ESKD: Propensity-Matched Cohort
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42623151
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42623151/)
- **DOI:** [10.34067/KID.0000001325](https://doi.org/10.34067%2FKID.0000001325)
- **Published At:** 2026-08-20T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort study used the TriNetX electronic health record network to compare outcomes for adults with **liver cirrhosis** and end-stage kidney disease (ESKD) initiating **peritoneal dialysis** (PD) versus **hemodialysis** (HD). - Patients were matched 1:1 on 43 covariates and follow-up began at a 30-day landmark after dialysis initiation. - The primary endpoint was **all-cause mortality**; secondary endpoints included **peritonitis**, **sepsis**, gastrointestinal bleeding requiring endoscopic hemostasis, and hospitalization. - Exploratory cardiovascular outcomes included a composite of **major adverse cardiovascular events** (MACE), non-fatal myocardial infarction, and non-fatal stroke. - Among 1,534 matched pairs, 3-year survival was lower with PD (39.5%) than HD (46.6%); PD had higher mortality (HR 1.23; 95% CI, 1.10–1.38; P < 0.001). - PD was associated with substantially higher risk of **peritonitis** (HR 3.85; 95% CI, 2.86–5.19; P < 0.001) and higher risk of **sepsis** (HR 1.51; 95% CI, 1.23–1.84; P < 0.001). - Patients on PD had more hospital admissions on average (mean 4.94 vs 4.32; P = 0.02). - Rates of gastrointestinal bleeding requiring endoscopic hemostasis did not differ significantly between PD and HD (HR 1.20; P = 0.38). - In exploratory analyses PD was associated with higher composite **MACE** (HR 1.36; 95% CI, 1.08–1.72; P = 0.01) and a borderline higher risk of non-fatal myocardial infarction (HR 1.30; 95% CI, 1.00–1.69; P = 0.05); non-fatal stroke did not differ significantly. - The study concludes that in patients with cirrhosis and ESKD, PD was linked to higher mortality, greater infectious complications, and more hospitalizations compared with HD, without a reduction in severe gastrointestinal bleeding. - The abstract does not report detailed baseline characteristics, causes of death, center-level practices, or sensitivity analyses; those details were not reported in the source abstract.
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Online ahead of print. # Dialysis Modalities in Liver Cirrhosis with ESKD: A Propensity-Matched Cohort [Ting-Yu Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+TY&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan."), [Ming-Tsang Chuang](https://pubmed.ncbi.nlm.nih.gov/?term=Chuang+MT&cauthor_id=42623151)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-2 "Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan."), [Wei-Yu Kao](https://pubmed.ncbi.nlm.nih.gov/?term=Kao+WY&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-3 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-4 "TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-5 "Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan."), [Hsing-Jung Yeh](https://pubmed.ncbi.nlm.nih.gov/?term=Yeh+HJ&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-4 "TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-6 "Division of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan."), [Raymond K Hsu](https://pubmed.ncbi.nlm.nih.gov/?term=Hsu+RK&cauthor_id=42623151)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-7 "Division of Nephrology, Department of Medicine, University of California, San Francisco."), [Jui-Ting Chang](https://pubmed.ncbi.nlm.nih.gov/?term=Chang+JT&cauthor_id=42623151)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-8 "School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-9 "Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-10 "Nutrition Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Yen-Chung Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+YC&cauthor_id=42623151)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-11 "Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#full-view-affiliation-12 "Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.") Affiliations Expand ### Affiliations * 1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. * 2 Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan. * 3 Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 4 TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan. * 5 Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan. * 6 Division of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 7 Division of Nephrology, Department of Medicine, University of California, San Francisco. * 8 School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. * 9 Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * 10 Nutrition Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * 11 Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. * 12 Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * PMID: **42623151** * DOI: [ 10.34067/KID.0000001325 ](https://doi.org/10.34067/kid.0000001325) Item in Clipboard # Dialysis Modalities in Liver Cirrhosis with ESKD: A Propensity-Matched Cohort Ting-Yu Lin et al. Kidney360. 2026. Show details Display options Display options Format Abstract PubMed PMID Kidney360 Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Kidney360%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Kidney360%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42623151/) . 2026 Aug 20. doi: 10.34067/KID.0000001325. Online ahead of print. ### Authors [Ting-Yu Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+TY&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan."), [Ming-Tsang Chuang](https://pubmed.ncbi.nlm.nih.gov/?term=Chuang+MT&cauthor_id=42623151)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-2 "Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan."), [Wei-Yu Kao](https://pubmed.ncbi.nlm.nih.gov/?term=Kao+WY&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-3 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-4 "TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-5 "Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan."), [Hsing-Jung Yeh](https://pubmed.ncbi.nlm.nih.gov/?term=Yeh+HJ&cauthor_id=42623151)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-1 "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-4 "TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-6 "Division of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan."), [Raymond K Hsu](https://pubmed.ncbi.nlm.nih.gov/?term=Hsu+RK&cauthor_id=42623151)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-7 "Division of Nephrology, Department of Medicine, University of California, San Francisco."), [Jui-Ting Chang](https://pubmed.ncbi.nlm.nih.gov/?term=Chang+JT&cauthor_id=42623151)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-8 "School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-9 "Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-10 "Nutrition Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan."), [Yen-Chung Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+YC&cauthor_id=42623151)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-11 "Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42623151/#short-view-affiliation-12 "Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.") ### Affiliations * 1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. * 2 Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan. * 3 Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 4 TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan. * 5 Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan. * 6 Division of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * 7 Division of Nephrology, Department of Medicine, University of California, San Francisco. * 8 School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. * 9 Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * 10 Nutrition Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. * 11 Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. * 12 Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. * PMID: **42623151** * DOI: [ 10.34067/KID.0000001325 ](https://doi.org/10.34067/kid.0000001325) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** In patients with liver cirrhosis and end-stage kidney disease, the optimal dialysis modality remains uncertain because liver cirrhosis amplifies competing risks of infection, bleeding, and cardiovascular events. **Methods:** Using the TriNetX electronic health record network, we conducted a retrospective cohort study of adults with liver cirrhosis and end-stage kidney disease initiating peritoneal dialysis or hemodialysis, matched 1:1 on 43 covariates. Follow-up began at a 30-day landmark. The primary endpoint was all-cause mortality. Secondary endpoints included peritonitis, sepsis, gastrointestinal bleeding requiring endoscopic hemostasis, and hospitalization. Composite major adverse cardiovascular events, non-fatal myocardial infarction, and non-fatal stroke were exploratory outcomes. **Results:** Among 1,534 matched pairs, peritoneal dialysis was associated with lower 3-year survival (39.5% versus 46.6%; hazard ratio (HR), 1.23; 95% confidence interval (CI), 1.10 to 1.38; P < 0.001), higher risk of peritonitis (HR, 3.85; 95% CI, 2.86 to 5.19; P < 0.001) and sepsis (HR, 1.51; 95% CI, 1.23 to 1.84; P < 0.001), and more hospital admissions (mean, 4.94 versus 4.32; P = 0.02). Gastrointestinal bleeding requiring endoscopic hemostasis did not differ significantly (HR, 1.20; P = 0.38). Among exploratory cardiovascular outcomes, peritoneal dialysis was associated with higher composite major adverse cardiovascular events (HR, 1.36; 95% CI, 1.08 to 1.72; P = 0.01) and borderline higher non-fatal myocardial infarction risk (HR, 1.30; 95% CI, 1.00 to 1.69; P = 0.05), whereas non-fatal stroke did not differ significantly (HR, 1.32; P = 0.10). **Conclusions:** In patients with liver cirrhosis and end-stage kidney disease, peritoneal dialysis was associated with higher mortality, greater infectious and hospitalization burden compared with hemodialysis, without a reduction in severe gastrointestinal bleeding; in exploratory analyses, peritoneal dialysis was also associated with higher composite major adverse cardiovascular events. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the American Society of Nephrology. 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