Dialysis Dynamics: Insights into ESKD Parameters in Hemodialysis vs. Peritoneal Dialysis: A Comparative Study

Background: End-stage kidney disease (ESKD) is a rising global health burden requiring renal replacement therapy, primarily via hemodialysis (HD) or peritoneal dialysis (PD). While both modalities are established treatments, their differential impacts on clinical and biochemical parameters remain underexplored in Gulf region populations. This study aims to provide a comparative evaluation of HD and PD patients after one year of therapy, focusing on anemia management, bone mineral metabolism, and biochemical outcomes. Methods: This descriptive, observational study included 89 adult ESKD patients un-dergoing either HD or PD for at least one year. Patients with confounding comorbidities or treatment inconsistencies were excluded. Clinical and biochemical data were col-lected at initiation and after one year of dialysis, and subgroup analyses by gender and age were performed. Statistical comparisons included t-tests, Mann-Whitney U, and Pearson correlation. Results: HD patients had significantly higher hemoglobin levels (10.7 ± 1.7 g/dL vs 9.9 ± 1.8 g/dL, p = 0.038) and bicarbonate levels (p = 0.021), indicating superior anemia and acidosis control. PD patients showed more stable phosphorus levels (p < 0.001), despite higher baseline values in HD patients (p = 0.026). Male and female HD subgroups demonstrated better blood urea nitrogen (BUN) and phosphorus control compared to PD. A significant inverse correlation between age and phosphorus levels was noted in PD patients (r = -0.388, p = 0.023), suggesting age-dependent phosphate metabolism. Conclusions: This study reveals clinically relevant differences between HD and PD outcomes in a Gulf-region cohort. HD offers advantages in hemoglobin and BUN con-trol, while PD provides better phosphorus regulation. Age and gender influence treatment efficacy, underscoring the importance of individualized dialysis modality selection in ESKD management.