Optimal Start in Dialysis Shows Increased Survival in Patients with Chronic Kidney Disease

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Jul 31

PMID 31361758

Citations 4

Authors

Araceli Caro Martinez

Antonio Olry de Labry Lima

Jose Manuel Munoz Terol

Oscar Javier Mendoza Garcia

Cesar Remon Rodriguez

Leticia Garcia Mochon

Pablo Castro de la Nuez

Nuria Areste Fosalba

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the survival among patients with chronic kidney disease who had optimal starts of renal replacement therapy, dialysis or hemodialysis, with patients who had suboptimal starts.

Methods: A retrospective cohort consisting of >18 year-old patients who started renal replacement therapy, using peritoneal dialysis or hemodialysis, in any public hospital or associated center of the Andalusian Public Health System, between the 1st of January of 2006 and the 15th of March of 2017. The optimal start was defined when all the following criteria were met: a planned dialysis start, a minimum of six-month follow-up by a nephrologist, and a first dialysis method coinciding with the one registered at 90 days. The information was obtained from the registry of the Information System of the Transplant Autonomic Coordination of Andalusia.

Results: A total of 10,692 patients were studied. 4,377 (40.9%) of these patients died. A total of 4,937 patients (46.17%) achieved optimal starts of renal replacement therapy and showed higher survival rates (HR 0.669; 95% CI 0.628-0.712) in the multivariate analysis of Cox regression model.

Conclusions: Patients with an optimal start of renal replacement therapy have a greater survival than those who had a non-optimal start. Therefore, the necessary measures should be encouraged to increase the optimal start of the patient in dialysis.

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References

Mendelssohn D, Curtis B, Yeates K, Langlois S, MacRae J, Semeniuk L . Suboptimal initiation of dialysis with and without early referral to a nephrologist. Nephrol Dial Transplant. 2011; 26(9):2959-65. DOI: 10.1093/ndt/gfq843. View

Brown P, Akbari A, Molnar A, Taran S, Bissonnette J, Sood M . Factors Associated with Unplanned Dialysis Starts in Patients followed by Nephrologists: A Retropective Cohort Study. PLoS One. 2015; 10(6):e0130080. PMC: 4457723. DOI: 10.1371/journal.pone.0130080. View

Couchoud C, Moranne O, Frimat L, Labeeuw M, Allot V, Stengel B . Associations between comorbidities, treatment choice and outcome in the elderly with end-stage renal disease. Nephrol Dial Transplant. 2007; 22(11):3246-54. DOI: 10.1093/ndt/gfm400. View

Mendelssohn D, Malmberg C, Hamandi B . An integrated review of "unplanned" dialysis initiation: reframing the terminology to "suboptimal" initiation. BMC Nephrol. 2009; 10:22. PMC: 2735745. DOI: 10.1186/1471-2369-10-22. View

Prieto-Velasco M, Quiros P, Remon C . The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?. PLoS One. 2015; 10(10):e0138811. PMC: 4605797. DOI: 10.1371/journal.pone.0138811. View

Martin Escobar E . The Spanish Renal Registry: 2013 report and evolution from 2007-2013. Nefrologia. 2016; 36(2):97-120. DOI: 10.1016/j.nefro.2015.10.020. View

Machowska A, Alscher M, Vanga S, Koch M, Aarup M, Qureshi A . Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients. Patient Prefer Adherence. 2016; 10:2229-2237. PMC: 5098564. DOI: 10.2147/PPA.S119243. View

Henry S, Munoz-Plaza C, Garcia Delgadillo J, Mihara N, Rutkowski M . Patient perspectives on the optimal start of renal replacement therapy. J Ren Care. 2017; 43(3):143-155. DOI: 10.1111/jorc.12202. View

Lorenzo-Sellares V, Pedrosa M, Santana-Exposito B, Garcia-Gonzalez Z, Barroso-Montesinos M . Cost analysis and sociocultural profile of kidney patients. Impact of the treatment method. Nefrologia. 2014; 34(4):458-68. DOI: 10.3265/Nefrologia.pre2014.Apr.12501. View

10.

Kessler M, Frimat L, Panescu V, Briancon S . Impact of nephrology referral on early and midterm outcomes in ESRD: EPidémiologie de l'Insuffisance REnale chronique terminale en Lorraine (EPIREL): results of a 2-year, prospective, community-based study. Am J Kidney Dis. 2003; 42(3):474-85. DOI: 10.1016/s0272-6386(03)00805-9. View

11.

Gorriz J, Sancho A, Pallardo L, Amoedo M, Martin M, Sanz P . [Prognostic significance of programmed dialysis in patients who initiate renal substitutive treatment. Multicenter study in Spain]. Nefrologia. 2002; 22(1):49-59. View

12.

Roca-Tey R, Arcos E, Comas J, Cao H, Tort J . Starting hemodialysis with catheter and mortality risk: persistent association in a competing risk analysis. J Vasc Access. 2015; 17(1):20-8. DOI: 10.5301/jva.5000468. View

13.

Lopez-Vargas P, Tong A, Howell M, Craig J . Educational Interventions for Patients With CKD: A Systematic Review. Am J Kidney Dis. 2016; 68(3):353-70. DOI: 10.1053/j.ajkd.2016.01.022. View

14.

Metcalfe W, Khan I, Prescott G, Simpson K, MacLeod A . Hospitalization in the first year of renal replacement therapy for end-stage renal disease. QJM. 2003; 96(12):899-909. DOI: 10.1093/qjmed/hcg155. View

15.

Mendelssohn D, Pierratos A . Reformulating the integrated care concept for the new millennium. Perit Dial Int. 2002; 22(1):5-8. View

16.

Buck J, Baker R, Cannaby A, Nicholson S, Peters J, Warwick G . Why do patients known to renal services still undergo urgent dialysis initiation? A cross-sectional survey. Nephrol Dial Transplant. 2007; 22(11):3240-5. DOI: 10.1093/ndt/gfm387. View

17.

Coentrao L, Santos-Araujo C, Dias C, Neto R, Pestana M . Effects of starting hemodialysis with an arteriovenous fistula or central venous catheter compared with peritoneal dialysis: a retrospective cohort study. BMC Nephrol. 2012; 13:88. PMC: 3476986. DOI: 10.1186/1471-2369-13-88. View

18.

Liu F, Ghaffari A, Dhatt H, Kumar V, Balsera C, Wallace E . Economic evaluation of urgent-start peritoneal dialysis versus urgent-start hemodialysis in the United States. Medicine (Baltimore). 2014; 93(28):e293. PMC: 4603112. DOI: 10.1097/MD.0000000000000293. View

19.

Marron B, Ostrowski J, Torok M, Timofte D, Orosz A, Kosicki A . Type of Referral, Dialysis Start and Choice of Renal Replacement Therapy Modality in an International Integrated Care Setting. PLoS One. 2016; 11(5):e0155987. PMC: 4882011. DOI: 10.1371/journal.pone.0155987. View

20.

Marron B, Ortiz A, de Sequera P, Martin-Reyes G, de Arriba G, Lamas J . Impact of end-stage renal disease care in planned dialysis start and type of renal replacement therapy--a Spanish multicentre experience. Nephrol Dial Transplant. 2006; 21 Suppl 2:ii51-5. DOI: 10.1093/ndt/gfl191. View