Early Start of Dialysis Has No Survival Benefit in End-Stage Renal Disease Patients
Journal of Korean Medical Science
; : 1177-1181, 2012.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-164997
Responsible library:
WPRO
ABSTRACT
The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m2 in the early-start group compared with 6.1 mL/min/1.73 m2 in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged > or = 70 yr (hazard ratio [HR] 3.29; P = 0.048) and/or who had albumin levels > or = 3.5 g/dL (HR 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR.
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Chronic Kidney Disease
/
Kidney, Renal Pelvis and Ureter Cancer
Database:
WPRIM (Western Pacific)
Main subject:
Time Factors
/
Serum Albumin
/
Proportional Hazards Models
/
Risk Factors
/
Age Factors
/
Renal Dialysis
/
Kaplan-Meier Estimate
/
Propensity Score
/
Glomerular Filtration Rate
/
Kidney Failure, Chronic
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2012
Document type:
Article