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Early start of dialysis has no survival benefit in end-stage renal disease patients.
J Korean Med Sci. 2012 Oct; 27(10):1177-81.JK

Abstract

The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m(2) in the early-start group compared with 6.1 mL/min/1.73 m(2) in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 3.5 g/dL (HR: 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR.

Authors+Show Affiliations

Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23091314

Citation

Chang, Jae Hyun, et al. "Early Start of Dialysis Has No Survival Benefit in End-stage Renal Disease Patients." Journal of Korean Medical Science, vol. 27, no. 10, 2012, pp. 1177-81.
Chang JH, Rim MY, Sung J, et al. Early start of dialysis has no survival benefit in end-stage renal disease patients. J Korean Med Sci. 2012;27(10):1177-81.
Chang, J. H., Rim, M. Y., Sung, J., Ko, K. P., Kim, D. K., Jung, J. Y., Lee, H. H., Chung, W., & Kim, S. (2012). Early start of dialysis has no survival benefit in end-stage renal disease patients. Journal of Korean Medical Science, 27(10), 1177-81. https://doi.org/10.3346/jkms.2012.27.10.1177
Chang JH, et al. Early Start of Dialysis Has No Survival Benefit in End-stage Renal Disease Patients. J Korean Med Sci. 2012;27(10):1177-81. PubMed PMID: 23091314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early start of dialysis has no survival benefit in end-stage renal disease patients. AU - Chang,Jae Hyun, AU - Rim,Min Young, AU - Sung,Jiyoon, AU - Ko,Kwang-Pil, AU - Kim,Dong Ki, AU - Jung,Ji Yong, AU - Lee,Hyun Hee, AU - Chung,Wookyung, AU - Kim,Sejoong, Y1 - 2012/10/02/ PY - 2012/03/23/received PY - 2012/07/30/accepted PY - 2012/10/24/entrez PY - 2012/10/24/pubmed PY - 2013/5/10/medline KW - End Stage Renal Disease KW - Glomerular Filtration Rate KW - Mortality KW - Peritoneal Dialysis KW - Renal Dialysis SP - 1177 EP - 81 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 27 IS - 10 N2 - The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m(2) in the early-start group compared with 6.1 mL/min/1.73 m(2) in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 3.5 g/dL (HR: 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/23091314/Early_start_of_dialysis_has_no_survival_benefit_in_end_stage_renal_disease_patients_ L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2012.27.10.1177 DB - PRIME DP - Unbound Medicine ER -