Details

Autor(en) / Beteiligte

• Okazaki, Masaki
• Inaguma, Daijo
• Imaizumi, Takahiro
• Hishida, Manabu
• Kurasawa, Shimon
• Kubo, Yoko
• Kato, Sawako
• Yasuda, Yoshinari
• Katsuno, Takayuki
• Kaneda, Fumika
• Maruyama, Shoichi
• Wu, Ping-Hsun

Titel

Impact of old age on the association between in-center extended-hours hemodialysis and mortality in patients on incident hemodialysis

Ist Teil von

• PloS one, 2020-07, Vol.15 (7), p.e0235900-e0235900

Ort / Verlag

San Francisco: Public Library of Science

Erscheinungsjahr

2020

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• With the global problem of aging, it has become more difficult to improve the prognosis of older dialysis patients. Extended-hours hemodialysis offers longer treatment time compared to conventional hemodialysis regimen and provides favorable metabolic status, hemodynamic stability, and increased dietary intake. Despite prior studies reporting that in-center extended-hours hemodialysis can reduce the mortality rate, the treatment impact on elderly patients remains unclear. Therefore, we examined the association between extended-hours hemodialysis compared to conventional hemodialysis and all-cause mortality. Survival analyses using Cox proportional hazard model with multivariable adjustments and propensity-score based method were performed to compare mortality risk between 198 consecutive patients who started in-center extended-hours hemodialysis (Extended-HD) and 1407 consecutive patients who initiated conventional hemodialysis. The median age was 67.1 years in the Extended-HD group and 70.7 years in the conventional hemodialysis group. Extended-HD was associated with lower all-cause mortality in overall patients and the subgroup >70 years (adjusted hazard ratios of 0.60 [95% CI, 0.39–0.91] and 0.35 [95% CI, 0.18–0.69], respectively). There was a significant interaction between age >70 years and Extended-HD. In conclusion, extended-hours hemodialysis was associated with a lower mortality rate, especially in elderly patients.