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Home- or Institutional Hemodialysis? - a Matched Pair-Cohort Study Comparing Survival and Some Modifiable Factors Related to Survival

Rydell, Helena LU ; Clyne, Naomi LU and Segelmark, Mårten LU (2016) In Kidney & Blood Pressure Research 41(4). p.392-401
Abstract

Background/Aims: Survival for dialysis patients is poor. Earlier studies have shown better survival in home-hemodialysis (HHD). The aims of this study are to compare survival for matched patients with HHD and institutional hemodialysis (IHD) and to elucidate the effect on factors related to survival such as hyperphosphatemia, fluid overload and anemia. Methods: In this retrospective, observational study, incident patients starting HHD and IHD were matched according to sex, age, comorbidity and date of start. Survival analysis was performed both as ”intention to treat” including renal transplantation and ”on treatment” with censoring at the date of transplantation. Dialysis doses, laboratory parameters and prescriptions of medications... (More)

Background/Aims: Survival for dialysis patients is poor. Earlier studies have shown better survival in home-hemodialysis (HHD). The aims of this study are to compare survival for matched patients with HHD and institutional hemodialysis (IHD) and to elucidate the effect on factors related to survival such as hyperphosphatemia, fluid overload and anemia. Methods: In this retrospective, observational study, incident patients starting HHD and IHD were matched according to sex, age, comorbidity and date of start. Survival analysis was performed both as ”intention to treat” including renal transplantation and ”on treatment” with censoring at the date of transplantation. Dialysis doses, laboratory parameters and prescriptions of medications were compared. Results: After matching, 41 pairs of patients, with HHD and IHD, were included. Survival among HHD patients was longer compared with IHD, median survival being 17.3 and 13.0 years (p=0.016), respectively. The “on treatment” analysis, also favoured HHD (p=0.015). HHD patients had lower phosphate, 1.5 mmol/L compared with 2.1 mmol/L (p

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Calcium and phosphate metabolism, Home hemodialysis, Hypertension, Survival, Volume control
in
Kidney & Blood Pressure Research
volume
41
issue
4
pages
392 - 401
publisher
Karger
external identifiers
  • scopus:84976524134
  • wos:000382740300005
ISSN
1420-4096
DOI
10.1159/000443441
language
English
LU publication?
yes
id
b7a5fb28-92dd-4c98-aed0-86f2e8b8fc88
date added to LUP
2016-07-21 11:44:32
date last changed
2017-09-18 11:30:51
@article{b7a5fb28-92dd-4c98-aed0-86f2e8b8fc88,
  abstract     = {<p>Background/Aims: Survival for dialysis patients is poor. Earlier studies have shown better survival in home-hemodialysis (HHD). The aims of this study are to compare survival for matched patients with HHD and institutional hemodialysis (IHD) and to elucidate the effect on factors related to survival such as hyperphosphatemia, fluid overload and anemia. Methods: In this retrospective, observational study, incident patients starting HHD and IHD were matched according to sex, age, comorbidity and date of start. Survival analysis was performed both as ”intention to treat” including renal transplantation and ”on treatment” with censoring at the date of transplantation. Dialysis doses, laboratory parameters and prescriptions of medications were compared. Results: After matching, 41 pairs of patients, with HHD and IHD, were included. Survival among HHD patients was longer compared with IHD, median survival being 17.3 and 13.0 years (p=0.016), respectively. The “on treatment” analysis, also favoured HHD (p=0.015). HHD patients had lower phosphate, 1.5 mmol/L compared with 2.1 mmol/L (p</p>},
  author       = {Rydell, Helena and Clyne, Naomi and Segelmark, Mårten},
  issn         = {1420-4096},
  keyword      = {Calcium and phosphate metabolism,Home hemodialysis,Hypertension,Survival,Volume control},
  language     = {eng},
  number       = {4},
  pages        = {392--401},
  publisher    = {Karger},
  series       = {Kidney & Blood Pressure Research},
  title        = {Home- or Institutional Hemodialysis? - a Matched Pair-Cohort Study Comparing Survival and Some Modifiable Factors Related to Survival},
  url          = {http://dx.doi.org/10.1159/000443441},
  volume       = {41},
  year         = {2016},
}