Residual Urine Output and Mortality in a Prospective Hemodialysis Cohort.
Kidney Int Rep
; 5(5): 643-653, 2020 May.
Article
em En
| MEDLINE
| ID: mdl-32405586
ABSTRACT
INTRODUCTION:
Although residual urine output (UOP) is associated with better survival and quality of life in dialysis patients, frequent measurement by 24-hour urine collection is burdensome. We thus sought to examine the association of patients' self-reported residual UOP, as an alternative proxy of measured residual UOP, with mortality risk in a prospective hemodialysis cohort study.METHODS:
Among 670 hemodialysis patients from the prospective multicenter Malnutrition, Diet, and Racial Disparities in Kidney Disease study, we examined associations of residual UOP, ascertained by patient self-report, with all-cause mortality. Patients underwent protocolized surveys assessing presence and frequency of UOP (absent, every 1-3 days, >1 time per day) every 6 months from 2011 to 2015. We examined associations of baseline and time-varying UOP with mortality using Cox regression.RESULTS:
In analyses of baseline UOP, absence of UOP was associated with higher mortality in expanded case-mix adjusted Cox models (ref presence of UOP) hazard ratio (HR), 1.78 (95% confidence interval [CI], 1.16-2.72). In analyses examining baseline frequency of UOP, point estimates suggested a graded association between lower frequency of UOP and higher mortality, although estimates for UOP every 1 to 3 days did not reach statistical significance (reference UOP >1 time per day) HR, 1.29 (95% CI, 0.82-2.05) and HR, 1.97 (95% CI, 1.24-3.12) for UOP every 1 to 3 days and absence of UOP, respectively. Similar findings were observed in analyses of time-varying UOP.CONCLUSION:
In hemodialysis patients, there is a graded association between lower frequency of self-reported UOP and higher mortality. Further studies are needed to determine the clinical impact of more frequent assessment of residual UOP using self-reported methods.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Kidney Int Rep
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos