Greater first-year survival on hemodialysis in facilities in which patients are provided earlier and more frequent pre-nephrology visits.
Clin J Am Soc Nephrol
; 4(3): 595-602, 2009 Mar.
Article
in En
| MEDLINE
| ID: mdl-19261827
ABSTRACT
BACKGROUND AND OBJECTIVES:
The aim of this study was to evaluate the relation between pre-nephrology visit (PNV) and 1-yr patient survival after hemodialysis (HD) induction. DESIGN, SETTING PARTICIPANTS, & MEASUREMENTS Data were analyzed from 8500 incident HD patients (on HDRESULTS:
In patient-level analysis, PNV was associated with significantly lower risk for death (AHR 0.57; P < 0.0001). Facility-level analysis also showed a significant lower risk for death in facilities with greater prevalence of PNV in both continuous models (AHR 0.92 per 10% greater facility mean %PNV; P < 0.0004) and in categorical models (AHR 0.71 for facilities with >90% of patients receiving PNV [first quartile] compared with facilities with <71% of patients receiving PNV [fourth quartile]; P = 0.001).CONCLUSIONS:
These results provide not only patient-level but also facility practice evidence that PNV is related to improved patient survival during the first year after initiation of HD, indicating the possible mortality benefits with more increased attention to PNV.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Referral and Consultation
/
Renal Dialysis
/
Health Services Accessibility
/
Hemodialysis Units, Hospital
/
Kidney Failure, Chronic
Type of study:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
/
Asia
/
Europa
Language:
En
Journal:
Clin J Am Soc Nephrol
Journal subject:
NEFROLOGIA
Year:
2009
Document type:
Article
Affiliation country:
Japan