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Modifiable Risk Factors for Early Mortality on Hemodialysis
Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determ...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409533/ https://www.ncbi.nlm.nih.gov/pubmed/22888426 http://dx.doi.org/10.1155/2012/435736 |
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author | McQuillan, Rory Trpeski, Lilyanna Fenton, Stanley Lok, Charmaine E. |
author_facet | McQuillan, Rory Trpeski, Lilyanna Fenton, Stanley Lok, Charmaine E. |
author_sort | McQuillan, Rory |
collection | PubMed |
description | Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determined by a Cox model. In total, 876 of 4807 incident patients died during their first year on dialysis; 304 (34.7%) deaths occurred within the first 90 days of dialysis initiation. The majority of deaths were attributed to a cardiovascular event or infection and more likely occurred in older patients and those with cardiovascular co-morbidities. Of potentially modifiable risk factors, low body mass index (<18.5), a surrogate for malnutrition, was a strong predictor of early mortality [adjusted hazard ratio (HR) 4.22 (CI: 3.12–5.17)]. Also, central venous catheter use was associated with a 2.40 fold increase risk of death (CI: 1.4–3.90). Patients who attended a multidisciplinary pre-dialysis clinic were less likely to die (HR: 0.60, CI: 0.47–0.78). The first 90 days after initiation of dialysis is a period of especially high risk of death. We have identified potentially modifiable risk factors in vascular access type, pre-dialysis care and nutritional status. |
format | Online Article Text |
id | pubmed-3409533 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-34095332012-08-10 Modifiable Risk Factors for Early Mortality on Hemodialysis McQuillan, Rory Trpeski, Lilyanna Fenton, Stanley Lok, Charmaine E. Int J Nephrol Clinical Study Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determined by a Cox model. In total, 876 of 4807 incident patients died during their first year on dialysis; 304 (34.7%) deaths occurred within the first 90 days of dialysis initiation. The majority of deaths were attributed to a cardiovascular event or infection and more likely occurred in older patients and those with cardiovascular co-morbidities. Of potentially modifiable risk factors, low body mass index (<18.5), a surrogate for malnutrition, was a strong predictor of early mortality [adjusted hazard ratio (HR) 4.22 (CI: 3.12–5.17)]. Also, central venous catheter use was associated with a 2.40 fold increase risk of death (CI: 1.4–3.90). Patients who attended a multidisciplinary pre-dialysis clinic were less likely to die (HR: 0.60, CI: 0.47–0.78). The first 90 days after initiation of dialysis is a period of especially high risk of death. We have identified potentially modifiable risk factors in vascular access type, pre-dialysis care and nutritional status. Hindawi Publishing Corporation 2012-07-24 /pmc/articles/PMC3409533/ /pubmed/22888426 http://dx.doi.org/10.1155/2012/435736 Text en Copyright © 2012 Rory McQuillan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study McQuillan, Rory Trpeski, Lilyanna Fenton, Stanley Lok, Charmaine E. Modifiable Risk Factors for Early Mortality on Hemodialysis |
title | Modifiable Risk Factors for Early Mortality on Hemodialysis |
title_full | Modifiable Risk Factors for Early Mortality on Hemodialysis |
title_fullStr | Modifiable Risk Factors for Early Mortality on Hemodialysis |
title_full_unstemmed | Modifiable Risk Factors for Early Mortality on Hemodialysis |
title_short | Modifiable Risk Factors for Early Mortality on Hemodialysis |
title_sort | modifiable risk factors for early mortality on hemodialysis |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409533/ https://www.ncbi.nlm.nih.gov/pubmed/22888426 http://dx.doi.org/10.1155/2012/435736 |
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