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BMC Nephrology
Published in: BMC Nephrology 1/2022

Open Access 01-12-2022 | Peritoneal Dialysis | Research

First-year mortality in incident dialysis patients: results of the Peridialysis study

Authors: James Heaf, Maija Heiro, Aivars Petersons, Baiba Vernere, Johan V. Povlsen, Anette Bagger Sørensen, Naomi Clyne, Inga Bumblyte, Alanta Zilinskiene, Else Randers, Niels Løkkegaard, Mai Rosenberg, Stig Kjellevold, Jan Dominik Kampmann, Björn Rogland, Inger Lagreid, Olof Heimburger, Abdul Rashid Qureshi, Bengt Lindholm

Published in: BMC Nephrology | Issue 1/2022

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Abstract

Background

Controversy surrounds which factors are important for predicting early mortality after dialysis initiation (DI). We investigated associations of predialysis course and circumstances affecting planning and execution of DI with mortality following DI.

Methods

Among 1580 patients participating in the Peridialysis study, a study of causes and timing of DI, we registered features of predialysis course, clinical and biochemical data at DI, incidence of unplanned suboptimal DI, contraindications to peritoneal dialysis (PD) or hemodialysis (HD), and modality preference, actual choice, and cause of modality choice. Patients were followed for 12 months or until transplantation. A flexible parametric model was used to identify independent factors associated with all-cause mortality.

Results

First-year mortality was 19.33%. Independent factors predicting death were high age, comorbidity, clinical contraindications to PD or HD, suboptimal DI, high eGFR, low serum albumin, hyperphosphatemia, high C-reactive protein, signs of overhydration and cerebral symptoms at DI. Among 1061 (67.2%) patients who could select dialysis modality based on personal choice, 654 (61.6%) chose PD, 368 (34.7%) center HD and 39 (3.7%) home HD. The 12-months survival did not differ significantly between patients receiving PD and in-center HD.

Conclusions

First-year mortality in incident dialysis patients was in addition to high age and comorbidity, associated with clinical contraindications to PD or HD, clinical symptoms, hyperphosphatemia, inflammation, and suboptimal DI. In patients with a “free” choice of dialysis modality based on their personal preferences, PD and in-center HD led to broadly similar short-term outcomes.
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Metadata
Title
First-year mortality in incident dialysis patients: results of the Peridialysis study
Authors
James Heaf
Maija Heiro
Aivars Petersons
Baiba Vernere
Johan V. Povlsen
Anette Bagger Sørensen
Naomi Clyne
Inga Bumblyte
Alanta Zilinskiene
Else Randers
Niels Løkkegaard
Mai Rosenberg
Stig Kjellevold
Jan Dominik Kampmann
Björn Rogland
Inger Lagreid
Olof Heimburger
Abdul Rashid Qureshi
Bengt Lindholm
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2022
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-022-02852-1

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