Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Dr Goel points out that patients
with peritoneal dialysis differed from those receiving hemodialysis in a variety
of ways, thus raising the possibility of selection bias. We used a number
of techniques to adjust for the measured differences between patients, including
propensity score analysis. Nonetheless, we acknowledge that patients receiving
peritoneal dialysis may differ with regard to unmeasured factors. The only
way to resolve this question would be to conduct a randomized study of dialysis
modality, but such studies have proved unfeasible because of very low enrollment
rates.1 Thus, we believe that carefully
performed observational studies with comparison groups may yield the best
evidence on patient satisfaction with dialysis modality.
Rubin HR, Powe NR. Differences Between Patients Receiving Peritoneal Dialysis vs Hemodialysis—Reply. JAMA. 2004;291(20):2429. doi:10.1001/jama.291.20.2429-b