| Nightly home hemodialysis: Outcome and factors associated with survival. | |
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MedLine Citation:
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PMID: 21435157 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Nightly home hemodialysis (NHHD) has been reported to have a much better survival than the excessive mortality of thrice-weekly in-center dialysis, but the factors influencing survival of NHHD have not been investigated in detail. We studied the association of survival in a 12-year study of 87 NHHD patients from a single center evaluating demographic, sociologic, and anthropomorphic factors, diagnosis, comorbidity, vintage, and dialysis performance and efficiency. Secondly, we compared the survival of the 87 NHHD patients with that reported by the United States Renal Data System (USRDS) using standardized mortality rate (SMR). The average patient age was 52 ± 15 years, and 59% were males, 51% African Americans, and 25% had diabetes. The patients dialyzed 40 ± 6 hours weekly with a stdKt/V of 5.25 ± 0.84. Thirteen patients died. The cumulative survival was 79% at 5 years and 64% at 10 years. Using Cox proportional hazards univariate analysis, 7 of 26 factors studied were associated with mortality: less than high school education, hour of each dialysis, comorbidities, secondary renal disease, congestive heart failure, Leypoldt's eKt/V, and Daugirdas Kt/V. In backward stepwise Cox analysis, education and hour of dialysis were the only factors independently associated with survival. The standardized mortality rate was only 0.30 of that reported by the United States Renal Data System for patients on thrice-weekly hemodialysis adjusted for age, gender, race, and diagnosis. The influence of education was the most significantly associated with survival, and the duration of each dialysis treatment was important. The survival rate of NHHD patients appeared to be superior to intermittent hemodialysis. |
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Authors:
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Robert S Lockridge; Carl M Kjellstrand |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-21 |
Journal Detail:
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Title: Hemodialysis international. International Symposium on Home Hemodialysis Volume: - ISSN: 1542-4758 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101093910 Medline TA: Hemodial Int Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors. Hemodialysis International © 2011 International Society for Hemodialysis. |
Affiliation:
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Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA Lynchburg Nephrology, Lynchburg Virginia, USA Department of Medicine, Loyola University Chicago, Chicago, Illinois, USA Department of Medicine, SUNY, Brooklyn, New York, New York, USA Docent, Karolinska Institute, Stockholm, Sweden. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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