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Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study

INTRODUCTION: In China, a quarter of patients are undergoing 2-times weekly hemodialysis. Using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS), we tested the hypothesis that whereas survival and hospitalizations would be similar in the presence of residual kidney function...

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Autores principales: Yan, Yucheng, Wang, Mia, Zee, Jarcy, Schaubel, Doug, Tu, Charlotte, Qian, JiaQi, Bieber, Brian, Wang, Mei, Chen, Nan, Li, Zuo, Port, Friedrich K., Robinson, Bruce M., Anand, Shuchi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035134/
https://www.ncbi.nlm.nih.gov/pubmed/29988994
http://dx.doi.org/10.1016/j.ekir.2018.03.008
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author Yan, Yucheng
Wang, Mia
Zee, Jarcy
Schaubel, Doug
Tu, Charlotte
Qian, JiaQi
Bieber, Brian
Wang, Mei
Chen, Nan
Li, Zuo
Port, Friedrich K.
Robinson, Bruce M.
Anand, Shuchi
author_facet Yan, Yucheng
Wang, Mia
Zee, Jarcy
Schaubel, Doug
Tu, Charlotte
Qian, JiaQi
Bieber, Brian
Wang, Mei
Chen, Nan
Li, Zuo
Port, Friedrich K.
Robinson, Bruce M.
Anand, Shuchi
author_sort Yan, Yucheng
collection PubMed
description INTRODUCTION: In China, a quarter of patients are undergoing 2-times weekly hemodialysis. Using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS), we tested the hypothesis that whereas survival and hospitalizations would be similar in the presence of residual kidney function (RKF), patients without RKF would fare worse on 2-times weekly hemodialysis. METHODS: In our cohort derived from 15 units randomly selected from each of 3 major cities (total N = 45), we generated a propensity score for the probability of dialysis frequency assignment, estimated a survival function by propensity score quintiles, and averaged stratum-specific survival functions to generate mean survival time. We used the proportional rates model to assess hospitalizations. We stratified all analyses by RKF, as reported by patients (urine output <1 vs. ≥1 cup/day). RESULTS: Among 1265 patients, 123 and 133 were undergoing 2-times weekly hemodialysis with and without evidence of RKF. Over 2.5 years, adjusted mean survival times were similar for 2- versus 3-times weekly dialysis groups: 2.20 versus 2.23 and 2.20 versus 2.15 for patients with and without RKF (P = 0.65). Hazard ratios for hospitalization rates were similar for 2- versus 3-times weekly groups, with (1.15, 95% confidence interval = 0.66−2.00) and without (1.10, 95% confidence interval 0.68−1.79]) RKF. The normalized protein catabolic rate was lower and intradialytic weight gain was not substantially higher in the 2- versus 3-times weekly dialysis group, suggesting greater restriction of dietary sodium and protein. CONCLUSION: In our study of patients in China’s major cities, we could not detect differences in survival and hospitalization for those undergoing 2- versus 3-times weekly dialysis, regardless of RKF. Our findings indicate the need for pragmatic studies regarding less frequent dialysis with associated nutritional management.
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spelling pubmed-60351342018-07-09 Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study Yan, Yucheng Wang, Mia Zee, Jarcy Schaubel, Doug Tu, Charlotte Qian, JiaQi Bieber, Brian Wang, Mei Chen, Nan Li, Zuo Port, Friedrich K. Robinson, Bruce M. Anand, Shuchi Kidney Int Rep Clinical Research INTRODUCTION: In China, a quarter of patients are undergoing 2-times weekly hemodialysis. Using data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS), we tested the hypothesis that whereas survival and hospitalizations would be similar in the presence of residual kidney function (RKF), patients without RKF would fare worse on 2-times weekly hemodialysis. METHODS: In our cohort derived from 15 units randomly selected from each of 3 major cities (total N = 45), we generated a propensity score for the probability of dialysis frequency assignment, estimated a survival function by propensity score quintiles, and averaged stratum-specific survival functions to generate mean survival time. We used the proportional rates model to assess hospitalizations. We stratified all analyses by RKF, as reported by patients (urine output <1 vs. ≥1 cup/day). RESULTS: Among 1265 patients, 123 and 133 were undergoing 2-times weekly hemodialysis with and without evidence of RKF. Over 2.5 years, adjusted mean survival times were similar for 2- versus 3-times weekly dialysis groups: 2.20 versus 2.23 and 2.20 versus 2.15 for patients with and without RKF (P = 0.65). Hazard ratios for hospitalization rates were similar for 2- versus 3-times weekly groups, with (1.15, 95% confidence interval = 0.66−2.00) and without (1.10, 95% confidence interval 0.68−1.79]) RKF. The normalized protein catabolic rate was lower and intradialytic weight gain was not substantially higher in the 2- versus 3-times weekly dialysis group, suggesting greater restriction of dietary sodium and protein. CONCLUSION: In our study of patients in China’s major cities, we could not detect differences in survival and hospitalization for those undergoing 2- versus 3-times weekly dialysis, regardless of RKF. Our findings indicate the need for pragmatic studies regarding less frequent dialysis with associated nutritional management. Elsevier 2018-03-17 /pmc/articles/PMC6035134/ /pubmed/29988994 http://dx.doi.org/10.1016/j.ekir.2018.03.008 Text en © 2018 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Yan, Yucheng
Wang, Mia
Zee, Jarcy
Schaubel, Doug
Tu, Charlotte
Qian, JiaQi
Bieber, Brian
Wang, Mei
Chen, Nan
Li, Zuo
Port, Friedrich K.
Robinson, Bruce M.
Anand, Shuchi
Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title_full Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title_fullStr Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title_full_unstemmed Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title_short Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study
title_sort twice-weekly hemodialysis and clinical outcomes in the china dialysis outcomes and practice patterns study
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035134/
https://www.ncbi.nlm.nih.gov/pubmed/29988994
http://dx.doi.org/10.1016/j.ekir.2018.03.008
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