First-year mortality in incident dialysis patients: results of the Peridialysis study

James Heaf (Coresponding Author), Maija Heiro, Aivars Petersons, Baiba Vernere, Johan V Povlsen, Anette Bagger Sørensen, Naomi Clyne, Inga Bumblyte, Alanta Zilinskiene, Else Randers, Niels Løkkegaard, Mai Rosenberg, Stig Kjellevold, Jan Dominik Kampmann, Björn Rogland, Inger Lagreid, Olof Heimburger, Abdul Rashid Qureshi, Bengt Lindholm

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number229
Number of pages12
JournalBMC Nephrology
Volume23
Issue number1
DOIs
Publication statusPublished - Jun 2022
Externally publishedYes

Keywords*

  • Humans
  • Hyperphosphatemia/etiology
  • Incidence
  • Kidney Failure, Chronic
  • Peritoneal Dialysis/adverse effects
  • Renal Dialysis/methods

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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