TY - JOUR
T1 - First-year mortality in incident dialysis patients
T2 - results of the Peridialysis study
AU - Heaf, James
AU - Heiro, Maija
AU - Petersons, Aivars
AU - Vernere, Baiba
AU - Povlsen, Johan V
AU - Sørensen, Anette Bagger
AU - Clyne, Naomi
AU - Bumblyte, Inga
AU - Zilinskiene, Alanta
AU - Randers, Else
AU - Løkkegaard, Niels
AU - Rosenberg, Mai
AU - Kjellevold, Stig
AU - Kampmann, Jan Dominik
AU - Rogland, Björn
AU - Lagreid, Inger
AU - Heimburger, Olof
AU - Qureshi, Abdul Rashid
AU - Lindholm, Bengt
N1 - Funding Information:
We thank all physicians and other staff members who participated in this study. Baxter Novum is the result of a grant from Baxter Healthcare to Karolinska Institutet. Thanks to Sara Denguir for data collection assistance.
Funding Information:
The project was supported by an unrestricted grant from Baxter Healthcare, Deerfield, Illinois, USA, grant number 05253284. The funder had no role in study design; collection, analysis and interpretation of data; writing the report; or the decision to submit the report for publication.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - BACKGROUND: Controversy surrounds which factors are important for predicting early mortality after dialysis initiation (DI). We investigated associations of predialysis course and circumstances affecting planning and execution of DI with mortality following DI.METHODS: Among 1580 patients participating in the Peridialysis study, a study of causes and timing of DI, we registered features of predialysis course, clinical and biochemical data at DI, incidence of unplanned suboptimal DI, contraindications to peritoneal dialysis (PD) or hemodialysis (HD), and modality preference, actual choice, and cause of modality choice. Patients were followed for 12 months or until transplantation. A flexible parametric model was used to identify independent factors associated with all-cause mortality.RESULTS: First-year mortality was 19.33%. Independent factors predicting death were high age, comorbidity, clinical contraindications to PD or HD, suboptimal DI, high eGFR, low serum albumin, hyperphosphatemia, high C-reactive protein, signs of overhydration and cerebral symptoms at DI. Among 1061 (67.2%) patients who could select dialysis modality based on personal choice, 654 (61.6%) chose PD, 368 (34.7%) center HD and 39 (3.7%) home HD. The 12-months survival did not differ significantly between patients receiving PD and in-center HD.CONCLUSIONS: First-year mortality in incident dialysis patients was in addition to high age and comorbidity, associated with clinical contraindications to PD or HD, clinical symptoms, hyperphosphatemia, inflammation, and suboptimal DI. In patients with a "free" choice of dialysis modality based on their personal preferences, PD and in-center HD led to broadly similar short-term outcomes.
AB - BACKGROUND: Controversy surrounds which factors are important for predicting early mortality after dialysis initiation (DI). We investigated associations of predialysis course and circumstances affecting planning and execution of DI with mortality following DI.METHODS: Among 1580 patients participating in the Peridialysis study, a study of causes and timing of DI, we registered features of predialysis course, clinical and biochemical data at DI, incidence of unplanned suboptimal DI, contraindications to peritoneal dialysis (PD) or hemodialysis (HD), and modality preference, actual choice, and cause of modality choice. Patients were followed for 12 months or until transplantation. A flexible parametric model was used to identify independent factors associated with all-cause mortality.RESULTS: First-year mortality was 19.33%. Independent factors predicting death were high age, comorbidity, clinical contraindications to PD or HD, suboptimal DI, high eGFR, low serum albumin, hyperphosphatemia, high C-reactive protein, signs of overhydration and cerebral symptoms at DI. Among 1061 (67.2%) patients who could select dialysis modality based on personal choice, 654 (61.6%) chose PD, 368 (34.7%) center HD and 39 (3.7%) home HD. The 12-months survival did not differ significantly between patients receiving PD and in-center HD.CONCLUSIONS: First-year mortality in incident dialysis patients was in addition to high age and comorbidity, associated with clinical contraindications to PD or HD, clinical symptoms, hyperphosphatemia, inflammation, and suboptimal DI. In patients with a "free" choice of dialysis modality based on their personal preferences, PD and in-center HD led to broadly similar short-term outcomes.
KW - Humans
KW - Hyperphosphatemia/etiology
KW - Incidence
KW - Kidney Failure, Chronic
KW - Peritoneal Dialysis/adverse effects
KW - Renal Dialysis/methods
UR - https://www.mendeley.com/catalogue/1641fe77-c5fc-3dd6-a651-a7bd602d6a18/
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/WOS:000817291500001
U2 - 10.1186/s12882-022-02852-1
DO - 10.1186/s12882-022-02852-1
M3 - Article
C2 - 35761193
SN - 1471-2369
VL - 23
JO - BMC Nephrology
JF - BMC Nephrology
IS - 1
M1 - 229
ER -