{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:27:21Z","timestamp":1787243241731,"version":"build-2736575974"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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 &lt; 0.001), higher risk of peritonitis (HR, 3.85; 95% CI, 2.86 to 5.19; P &lt; 0.001) and sepsis (HR, 1.51; 95% CI, 1.23 to 1.84; P &lt; 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001325","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:03:13Z","timestamp":1787241793000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Dialysis Modalities in Liver Cirrhosis with ESKD"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3846-3139","authenticated-orcid":false,"given":"Ting-Yu","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8945-3513","authenticated-orcid":false,"given":"Ming-Tsang","family":"Chuang","sequence":"additional","affiliation":[{"name":"Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5506-4293","authenticated-orcid":false,"given":"Wei-Yu","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3415-836X","authenticated-orcid":false,"given":"Hsing-Jung","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"},{"name":"TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Division of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-8984","authenticated-orcid":false,"given":"Raymond K.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7399-5438","authenticated-orcid":false,"given":"Jui-Ting","family":"Chang","sequence":"additional","affiliation":[{"name":"School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan"},{"name":"Nutrition Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8981-8671","authenticated-orcid":false,"given":"Yen-Chung","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,20]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:03:13Z","timestamp":1787241793000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001325"}},"subtitle":["A Propensity-Matched Cohort"],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001325","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"assertion":[{"value":"2026-03-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}