Different impact of hemodialysis vintage on cause-specific mortality in long-term hemodialysis patients.
Nephrol Dial Transplant
; 31(2): 298-305, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26666499
ABSTRACT
BACKGROUND:
Although dialysis vintage is associated with increased mortality risk in patients receiving hemodialysis (HD), the association of dialysis vintage with cause-specific mortality is unclear.METHODS:
We conducted a nationwide registry-based retrospective cohort study of 216 246 patients receiving maintenance HD for > 1 year at the end of 2009. The associations of dialysis vintage categories (1 -< 2, 2 -< 5, 5 -< 10, 10 -< 15, 15 -< 20, 20 -< 25, 25 -< 30 and ≥ 30 years) with 1-year all-cause and cause-specific mortality, including cardiovascular diseases (CVDs) and infection-related mortality, were examined using logistic regression models.RESULTS:
During the 1-year study period, 18 614 deaths occurred from all causes, including 7263 and 3504 deaths from CVD and infection-related causes. From multivariate analysis, the dialysis vintage was incrementally associated with a higher risk for all-cause mortality, with worse outcome observed in the ≥ 30 years category {odds ratio [OR] = 2.43 (95% confidence interval (CI) 2.13-2.77}. A similar association was apparent between the dialysis vintage and infection-related mortality, with a higher risk than that of all-cause mortality in each vintage category [≥ 30 years, OR = 3.55 (95% CI 2.72-4.66)], while the dialysis vintage was associated with only a modest increase in risk of CVD mortality [≥ 30 years, OR = 1.64 (95% CI 1.30-2.08)].CONCLUSIONS:
Dialysis vintage has a different impact on cause-specific mortality, with a higher risk for infection-related mortality than CVD mortality. This impact is most pronounced in long-term HD survivors, to whom much attention should be devoted to prevent infectious complications.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
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Sistema de Registros
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Diálise Renal
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Falência Renal Crônica
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article