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Increased mortality early after dialysis initiation: a universal phenomenon.
Marlies Noordzij1, Kitty J Jager1
1European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Kidney International
|January 2, 2014
Summary
Mortality is higher for hemodialysis patients within the first 120 days of treatment compared to later periods across 11 countries. This early mortality highlights critical factors influencing patient outcomes in dialysis initiation and withdrawal.
Area of Science:
- Nephrology
- Public Health
- Clinical Epidemiology
Background:
- Hemodialysis is a life-sustaining treatment for end-stage renal disease.
- Patient outcomes can vary significantly based on geographical location and healthcare practices.
- Early mortality in dialysis patients is a critical concern for clinical management and public health.
Purpose of the Study:
- To analyze mortality patterns in hemodialysis patients globally.
- To identify if mortality risk differs in the initial period after starting dialysis compared to later stages.
- To explore potential factors contributing to international variations in early hemodialysis mortality.
Main Methods:
- Utilized data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) census database.
- Included a large cohort of 86,886 hemodialysis patients.
- Analyzed data from 11 diverse countries to assess international differences.
Main Results:
- A consistent finding across all 11 countries was higher mortality within the first 120 days of initiating hemodialysis.
- Mortality rates decreased after this initial 120-day period.
- International variations in early mortality were observed, suggesting the influence of local practices.
Conclusions:
- The initial 120 days post-hemodialysis initiation represent a period of heightened mortality risk.
- Dialysis initiation practices and patient withdrawal from treatment are potential factors influencing these early mortality differences.
- Further research into these factors is warranted to improve patient survival in the early stages of dialysis therapy.
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