지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.9
- 수록면
- 419 - 431 (13page)
- DOI
- 10.23876/j.krcp.20.231
이용수
초록· 키워드
오류제보하기
Background: Optimal estimated glomerular filtration rate (eGFR) to start maintenance dialysis is controversial. Observational studies have reported that initiation of dialysis at high eGFRs is associated with worse postdialysis survival.
Methods: We retrospectively investigated 1,038 incident dialysis patients who started maintenance dialysis during 2010-2015. Pa- tients were assessed for comorbidities and adverse events during the transitional period of dialysis initiation. Patients were classified as planned dialysis (PD) vs. unplanned dialysis (UD) according to indications for dialysis initiation.
Results: UD group comprised 352 patients (33.9%). Mean eGFR at dialysis initiation was higher in UD patients than PD patients (7.9 ± 5.1 vs. 5.9 ± 3.4 mL/min/1.73 m2, p < 0.001). Mean Davies comorbidity index in the UD group was higher (vs. PD group, 1.3 ± 1.0 vs. 0.9 ± 1.0, p < 0.001). Patients with more comorbidities experienced more ischemic heart disease (hazard ratio [HR], 4.36; 95% confidence interval [CI], 1.71?11.14) in the medium-risk group and HR of 8.84 (95% CI, 3.06?25.55) in the high-risk group (vs. low-risk group, p < 0.001)) during the predialysis period. High-risk group had increased postdialysis mortality (HR, 2.48; 95% CI, 1.46?4.20; p = 0.001). Adjusted HR of mortality was higher in the medium-risk group of UD patients (HR, 1.72; 95% CI, 1.16?2.56; p = 0.007).
Conclusion: Patients with more comorbidities were at increased risk of predialysis ischemic heart disease and postdialysis mortality. UD patients in the medium-risk population had increased risk of postdialysis mortality. Dialysis start should be individualized by con- sidering comorbidities.
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참고문헌 (36)
참고문헌 신청
Liyanage T / 2015 / Worldwide access to treatment for end-stage kidney disease : a systematic review / Lancet 385:1975~1982
McCullough KP / 2019 / Projecting ESRD incidence and prevalence in the United States through 2030 / J Am Soc Nephrol 30:127~135
진동찬 / 2015 / Lessons from 30 years’ data of Korean end-stage renal disease registry, 1985–2015 / Kidney Research and Clinical Practice 34(3):132~139
진동찬 / 2018 / Current characteristics of dialysis therapy in Korea: 2016 registry data focusing on diabetic patients / Kidney Research and Clinical Practice 37(1):20~29
Tattersall J / 1995 / Urea kinetics and when to commence dialysis / Am J Nephrol 15:283~289
McCullough KP / 2019 / Projecting ESRD incidence and prevalence in the United States through 2030 / J Am Soc Nephrol 30:127~135
진동찬 / 2015 / Lessons from 30 years’ data of Korean end-stage renal disease registry, 1985–2015 / Kidney Research and Clinical Practice 34(3):132~139
진동찬 / 2018 / Current characteristics of dialysis therapy in Korea: 2016 registry data focusing on diabetic patients / Kidney Research and Clinical Practice 37(1):20~29
Tattersall J / 1995 / Urea kinetics and when to commence dialysis / Am J Nephrol 15:283~289
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