Cargando…
Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort
INTRODUCTION: Although residual urine output (UOP) is associated with better survival and quality of life in dialysis patients, frequent measurement by 24-hour urine collection is burdensome. We thus sought to examine the association of patients’ self-reported residual UOP, as an alternative proxy o...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210610/ https://www.ncbi.nlm.nih.gov/pubmed/32405586 http://dx.doi.org/10.1016/j.ekir.2020.02.002 |
_version_ | 1783531309643071488 |
---|---|
author | You, Amy S. Kalantar-Zadeh, Kamyar Obi, Yoshitsugu Novoa, Alejandra Peralta, Rene Amel Streja, Elani Nakata, Tracy Kovesdy, Csaba P. Nguyen, Danh V. Rhee, Connie M. |
author_facet | You, Amy S. Kalantar-Zadeh, Kamyar Obi, Yoshitsugu Novoa, Alejandra Peralta, Rene Amel Streja, Elani Nakata, Tracy Kovesdy, Csaba P. Nguyen, Danh V. Rhee, Connie M. |
author_sort | You, Amy S. |
collection | PubMed |
description | INTRODUCTION: Although residual urine output (UOP) is associated with better survival and quality of life in dialysis patients, frequent measurement by 24-hour urine collection is burdensome. We thus sought to examine the association of patients’ self-reported residual UOP, as an alternative proxy of measured residual UOP, with mortality risk in a prospective hemodialysis cohort study. METHODS: Among 670 hemodialysis patients from the prospective multicenter Malnutrition, Diet, and Racial Disparities in Kidney Disease study, we examined associations of residual UOP, ascertained by patient self-report, with all-cause mortality. Patients underwent protocolized surveys assessing presence and frequency of UOP (absent, every 1–3 days, >1 time per day) every 6 months from 2011 to 2015. We examined associations of baseline and time-varying UOP with mortality using Cox regression. RESULTS: In analyses of baseline UOP, absence of UOP was associated with higher mortality in expanded case-mix adjusted Cox models (ref: presence of UOP): hazard ratio (HR), 1.78 (95% confidence interval [CI], 1.16–2.72). In analyses examining baseline frequency of UOP, point estimates suggested a graded association between lower frequency of UOP and higher mortality, although estimates for UOP every 1 to 3 days did not reach statistical significance (reference: UOP >1 time per day): HR, 1.29 (95% CI, 0.82–2.05) and HR, 1.97 (95% CI, 1.24–3.12) for UOP every 1 to 3 days and absence of UOP, respectively. Similar findings were observed in analyses of time-varying UOP. CONCLUSION: In hemodialysis patients, there is a graded association between lower frequency of self-reported UOP and higher mortality. Further studies are needed to determine the clinical impact of more frequent assessment of residual UOP using self-reported methods. |
format | Online Article Text |
id | pubmed-7210610 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-72106102020-05-13 Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort You, Amy S. Kalantar-Zadeh, Kamyar Obi, Yoshitsugu Novoa, Alejandra Peralta, Rene Amel Streja, Elani Nakata, Tracy Kovesdy, Csaba P. Nguyen, Danh V. Rhee, Connie M. Kidney Int Rep Clinical Research INTRODUCTION: Although residual urine output (UOP) is associated with better survival and quality of life in dialysis patients, frequent measurement by 24-hour urine collection is burdensome. We thus sought to examine the association of patients’ self-reported residual UOP, as an alternative proxy of measured residual UOP, with mortality risk in a prospective hemodialysis cohort study. METHODS: Among 670 hemodialysis patients from the prospective multicenter Malnutrition, Diet, and Racial Disparities in Kidney Disease study, we examined associations of residual UOP, ascertained by patient self-report, with all-cause mortality. Patients underwent protocolized surveys assessing presence and frequency of UOP (absent, every 1–3 days, >1 time per day) every 6 months from 2011 to 2015. We examined associations of baseline and time-varying UOP with mortality using Cox regression. RESULTS: In analyses of baseline UOP, absence of UOP was associated with higher mortality in expanded case-mix adjusted Cox models (ref: presence of UOP): hazard ratio (HR), 1.78 (95% confidence interval [CI], 1.16–2.72). In analyses examining baseline frequency of UOP, point estimates suggested a graded association between lower frequency of UOP and higher mortality, although estimates for UOP every 1 to 3 days did not reach statistical significance (reference: UOP >1 time per day): HR, 1.29 (95% CI, 0.82–2.05) and HR, 1.97 (95% CI, 1.24–3.12) for UOP every 1 to 3 days and absence of UOP, respectively. Similar findings were observed in analyses of time-varying UOP. CONCLUSION: In hemodialysis patients, there is a graded association between lower frequency of self-reported UOP and higher mortality. Further studies are needed to determine the clinical impact of more frequent assessment of residual UOP using self-reported methods. Elsevier 2020-02-12 /pmc/articles/PMC7210610/ /pubmed/32405586 http://dx.doi.org/10.1016/j.ekir.2020.02.002 Text en © 2020 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 You, Amy S. Kalantar-Zadeh, Kamyar Obi, Yoshitsugu Novoa, Alejandra Peralta, Rene Amel Streja, Elani Nakata, Tracy Kovesdy, Csaba P. Nguyen, Danh V. Rhee, Connie M. Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title | Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title_full | Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title_fullStr | Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title_full_unstemmed | Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title_short | Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort |
title_sort | residual urine output and mortality in a prospective hemodialysis cohort |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210610/ https://www.ncbi.nlm.nih.gov/pubmed/32405586 http://dx.doi.org/10.1016/j.ekir.2020.02.002 |
work_keys_str_mv | AT youamys residualurineoutputandmortalityinaprospectivehemodialysiscohort AT kalantarzadehkamyar residualurineoutputandmortalityinaprospectivehemodialysiscohort AT obiyoshitsugu residualurineoutputandmortalityinaprospectivehemodialysiscohort AT novoaalejandra residualurineoutputandmortalityinaprospectivehemodialysiscohort AT peraltareneamel residualurineoutputandmortalityinaprospectivehemodialysiscohort AT strejaelani residualurineoutputandmortalityinaprospectivehemodialysiscohort AT nakatatracy residualurineoutputandmortalityinaprospectivehemodialysiscohort AT kovesdycsabap residualurineoutputandmortalityinaprospectivehemodialysiscohort AT nguyendanhv residualurineoutputandmortalityinaprospectivehemodialysiscohort AT rheeconniem residualurineoutputandmortalityinaprospectivehemodialysiscohort |