Dataset Information

Preexisting comorbidities are associated with the mortality rate as well as the predialysis adverse events in incident dialysis patients.

ABSTRACT:

Background

Optimal estimated glomerular filtration rate (eGFR) to start maintenance dialysis is controversial. Observational studies have reported that initiation of dialysis at high eGFRs is associated with worse postdialysis survival.

Methods

We retrospectively investigated 1,038 incident dialysis patients who started maintenance dialysis during 2010-2015. Patients were assessed for comorbidities and adverse events during the transitional period of dialysis initiation. Patients were classified as planned dialysis (PD) vs. unplanned dialysis (UD) according to indications for dialysis initiation.

Results

UD group comprised 352 patients (33.9%). Mean eGFR at dialysis initiation was higher in UD patients than PD patients (7.9 ± 5.1 vs. 5.9 ± 3.4 mL/min/1.73 m2, p < 0.001). Mean Davies comorbidity index in the UD group was higher (vs. PD group, 1.3 ± 1.0 vs. 0.9 ± 1.0, p < 0.001). Patients with more comorbidities experienced more ischemic heart disease (hazard ratio [HR], 4.36; 95% confidence interval [CI], 1.71-11.14) in the medium-risk group and HR of 8.84 (95% CI, 3.06-25.55) in the high-risk group (vs. low-risk group, p < 0.001)) during the predialysis period. High-risk group had increased postdialysis mortality (HR, 2.48; 95% CI, 1.46-4.20; p = 0.001). Adjusted HR of mortality was higher in the medium-risk group of UD patients (HR, 1.72; 95% CI, 1.16-2.56; p = 0.007).

Conclusion

Patients with more comorbidities were at increased risk of predialysis ischemic heart disease and postdialysis mortality. UD patients in the medium-risk population had increased risk of postdialysis mortality. Dialysis start should be individualized by considering comorbidities.

SUBMITTER: Lee MJ

PROVIDER: S-EPMC8476300 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Publications

Preexisting comorbidities are associated with the mortality rate as well as the predialysis adverse events in incident dialysis patients.

Lee Min-Jeong MJ Park Inwhee I Kim Heungsoo H Shin Gyu-Tae GT Jeong Jong Cheol JC

Kidney research and clinical practice 20210813 3

<h4>Background</h4>Optimal estimated glomerular filtration rate (eGFR) to start maintenance dialysis is controversial. Observational studies have reported that initiation of dialysis at high eGFRs is associated with worse postdialysis survival.<h4>Methods</h4>We retrospectively investigated 1,038 incident dialysis patients who started maintenance dialysis during 2010-2015. Patients were assessed for comorbidities and adverse events during the transitional period of dialysis initiation. Patients ...[more]

PMID: 34510861

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Dataset Information

Preexisting comorbidities are associated with the mortality rate as well as the predialysis adverse events in incident dialysis patients.

Background

Methods

Results

Conclusion

Publications

Preexisting comorbidities are associated with the mortality rate as well as the predialysis adverse events in incident dialysis patients.

Similar Datasets

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