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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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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. |
format | Online Article Text |
id | pubmed-6035134 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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