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Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model
BACKGROUND: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortali...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Japan Epidemiological Association
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310874/ https://www.ncbi.nlm.nih.gov/pubmed/25721069 http://dx.doi.org/10.2188/jea.JE20130193 |
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author | Beuscart, Jean-Baptiste Pagniez, Dominique Boulanger, Eric Duhamel, Alain |
author_facet | Beuscart, Jean-Baptiste Pagniez, Dominique Boulanger, Eric Duhamel, Alain |
author_sort | Beuscart, Jean-Baptiste |
collection | PubMed |
description | BACKGROUND: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration. METHODS: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states (‘HD, not wait-listed’, ‘HD, wait-listed’, ‘death’, and ‘RT’) was used to estimate the effect of being wait-listed on the probability of death. RESULTS: During the study, 1392 (19.5%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9%) were observed in the not wait-listed group compared with only 33 (1.1%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95% CI, 1.70–7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age. CONCLUSIONS: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis. |
format | Online Article Text |
id | pubmed-4310874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Japan Epidemiological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-43108742015-02-09 Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model Beuscart, Jean-Baptiste Pagniez, Dominique Boulanger, Eric Duhamel, Alain J Epidemiol Original Article BACKGROUND: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration. METHODS: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states (‘HD, not wait-listed’, ‘HD, wait-listed’, ‘death’, and ‘RT’) was used to estimate the effect of being wait-listed on the probability of death. RESULTS: During the study, 1392 (19.5%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9%) were observed in the not wait-listed group compared with only 33 (1.1%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95% CI, 1.70–7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age. CONCLUSIONS: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis. Japan Epidemiological Association 2015-02-05 /pmc/articles/PMC4310874/ /pubmed/25721069 http://dx.doi.org/10.2188/jea.JE20130193 Text en © 2014 Jean-Baptiste Beuscart et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Beuscart, Jean-Baptiste Pagniez, Dominique Boulanger, Eric Duhamel, Alain Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title | Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title_full | Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title_fullStr | Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title_full_unstemmed | Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title_short | Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model |
title_sort | registration on the renal transplantation waiting list and mortality on dialysis: an analysis of the french rein registry using a multi-state model |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310874/ https://www.ncbi.nlm.nih.gov/pubmed/25721069 http://dx.doi.org/10.2188/jea.JE20130193 |
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