Document Detail


Prescription of twice-weekly hemodialysis in the USA.
MedLine Citation:
PMID:  10592355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The purpose of this study was to investigate the frequency and characteristics of two hemodialysis sessions/week, to identify factors which influence or predict this prescription, and to examine the outcomes of patients receiving hemodialysis two times/week as compared to the more common treatment of three times/week. METHODS: Data from a national sample of 15,067 adult hemodialysis patients were utilized to compare twice-weekly with thrice-weekly therapy by logistic regression. RESULTS: Patients treated less than one year were more likely to be treated twice-weekly (6.1%) than patients on dialysis for one year or more (2.7%) (AOR = 1.49, p = 0.002). Treatment schedules also varied significantly by geographic region. Factors predictive of twice-weekly hemodialysis (p < 0.05) were older age, Caucasian race, female gender, higher serum albumin, lower serum creatinine levels, and lower body mass index. A higher estimated renal function at the start of ESRD was also predictive of a twice-weekly schedule among incident patients (AOR = 1.05, p = 0.05). In addition, Cox-adjusted survival analysis indicated a lower mortality risk (RR = 0.76, p = 0. 02) for twice-weekly hemodialysis compared to thrice-weekly among prevalent patients. For incident patients, however, the results were not significant when adjusted for GFR at ESRD onset (RR = 0.85, p = 0.31). CONCLUSION: Geographic differences in prescribed treatment remained unexplained by measured characteristics. The survival advantage associated with twice-weekly hemodialysis is likely to be related to patient selection and greater residual renal function.
Authors:
J A Hanson; T E Hulbert-Shearon; A O Ojo; F K Port; R A Wolfe; L Y Agodoa; J T Daugirdas
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of nephrology     Volume:  19     ISSN:  0250-8095     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  1999  
Date Detail:
Created Date:  2000-01-20     Completed Date:  2000-01-20     Revised Date:  2009-12-30    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  625-33     Citation Subset:  IM    
Copyright Information:
Copyright 1999 S. Karger AG, Basel
Affiliation:
University of Michigan, Ann Arbor 48103, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Kidney Failure, Chronic / mortality,  therapy*
Male
Middle Aged
Prescriptions / statistics & numerical data*
Prospective Studies
Renal Dialysis / mortality,  utilization*
Risk Factors
Survival Rate
Treatment Outcome
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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