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Early start of dialysis has no survival benefit in end-stage renal disease patients
- Source :
- Journal of Korean Medical Science
- Publication Year :
- 2012
-
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 m(2) in the early-start group compared with 6.1 mL/min/1.73 m(2) 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 ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Urology
Renal function
Kaplan-Meier Estimate
Peritoneal dialysis
End stage renal disease
Renal Dialysis
Risk Factors
Medicine
Humans
Mortality
Propensity Score
Dialysis
Serum Albumin
Aged
Proportional Hazards Models
business.industry
Proportional hazards model
Mortality rate
Hazard ratio
Age Factors
General Medicine
Middle Aged
Surgery
Log-rank test
Nephrology
Kidney Failure, Chronic
Female
Original Article
End Stage Renal Disease
business
Peritoneal Dialysis
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 15986357
- Volume :
- 27
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Korean medical science
- Accession number :
- edsair.doi.dedup.....5917513f8d4a1a816e89e38327474572