Optimal start in dialysis shows increased survival in patients with chronic kidney disease

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URI: http://hdl.handle.net/10498/21752
DOI: 10.1371/journal.pone.0219037
ISSN: 1932-6203
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2019-07Department
Medicina; MedicinaSource
PLoSONE14(7):e0219037Abstract
Objective
To compare the survival among patients with chronic kidney disease who had optimal starts
of renal replacement therapy, dialysis or hemodialysis, with patients who had suboptimal
starts.
Methods
A retrospective cohort consisting of >18 year-old patients who started renal replacement
therapy, using peritoneal dialysis or hemodialysis, in any public hospital or associated center
of the Andalusian Public Health System, between the 1st of January of 2006 and the 15th of
March of 2017. The optimal start was defined when all the following criteria were met: a
planned dialysis start, a minimum of six-month follow-up by a nephrologist, and a first dialysis
method coinciding with the one registered at 90 days. The information was obtained from
the registry of the Information System of the Transplant Autonomic Coordination of
Andalusia.
Results
A total of 10,692 patients were studied. 4,377 (40.9%) of these patients died. A total of
4,937 patients (46.17%) achieved optimal starts of renal replacement therapy and showed
higher survival rates (HR 0.669; 95% CI 0.628–0.712) in the multivariate analysis of Cox
regression model.
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