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Survival withThree-Times WeeklyIn-Center NocturnalVersus ConventionalHemodialysis Eduardo LacsonJianglin XuRita S. Suri2012 год

Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis
статья из журнала

Страница публикацииПубликация в OpenAlex
Аннотация: Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score-matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61-0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score-matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials.
Год издания: 2012
Авторы: Eduardo Lacson, Jianglin Xu, Rita S. Suri, Gihad Nesrallah, Robert M. Lindsay, Amit X. Garg, Keith S. Lester, Norma J. Ofsthun, Michael Lazarus, Raymond M. Hakim
Издательство: American Society of Nephrology
Источник: Journal of the American Society of Nephrology
Ключевые слова: Dialysis and Renal Disease Management, Central Venous Catheters and Hemodialysis, Chronic Kidney Disease and Diabetes
Другие ссылки: Journal of the American Society of Nephrology (HTML)
Europe PMC (PubMed Central) (HTML)
PubMed Central (HTML)
PubMed (HTML)