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Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis: a propensity-matched study of a prospective cohort in Korea

Authors
 Ji In Park  ;  Jung Tak Park  ;  Yong-Lim Kim  ;  Shin-Wook Kang  ;  Chul Woo Yang  ;  Nam-Ho Kim  ;  Yun Kyu Oh  ;  Chun Soo Lim  ;  Yon Su Kim  ;  Jung Pyo Lee 
Citation
 NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol.32(2) : 355-363, 2017 
Journal Title
 NEPHROLOGY DIALYSIS TRANSPLANTATION 
ISSN
 0931-0509 
Issue Date
2017
MeSH
Female ; Humans ; Kidney Failure, Chronic/mortality* ; Kidney Failure, Chronic/therapy* ; Male ; Middle Aged ; Propensity Score ; Prospective Studies ; Quality of Life ; Renal Dialysis/methods* ; Renal Dialysis/mortality* ; Republic of Korea ; Time Factors ; Treatment Outcome
Keywords
chronic kidney failure ; depression ; dialysis ; propensity score ; quality of life
Abstract
BACKGROUND: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. METHODS: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline. We compared health-related quality of life (HRQOL), daily urine volume at 12 months and all-cause mortality between the groups. We matched the thrice-weekly and incremental groups at a 1:2 ratio using propensity score matching. RESULTS: A total of 312 patients (207 in the thrice-weekly group and 105 in the incremental group) were selected. All-cause mortality was comparable between the two groups before and after propensity score matching. The HRQOL tended to be better in the incremental group for the majority of domains of the Kidney Disease Quality of Life Short Form and Beck's Depression Inventory; however, only the symptoms and problems domain was significantly better in the incremental group at 3 months after HD. At 12 months after HD, there were no differences between the groups. The daily urine volume at 12 months after HD was similar between the two groups. CONCLUSIONS: Incremental HD initiation showed comparable results to thrice-weekly initiation for HRQOL, residual renal function and all-cause mortality. Incremental HD may be considered an additional option for HD initiation in selected patients.
Full Text
https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfw332
DOI
10.1093/ndt/gfw332
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154222
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