Dialysis dose and risk factors for death among ESRD patients treated with twice-weekly hemodialysis: a prospective cohort study

Blood Purif. 2014;38(3-4):253-62. doi: 10.1159/000368885. Epub 2015 Jan 6.

Abstract

Background/aims: We aimed to define the dosing and risk factors for death in patients undergoing twice-weekly hemodialysis.

Methods: A prospective multi-center cohort study was conducted with one-year observation. Patients treated with twice- or thrice-weekly hemodialysis were identified. Death and first admission were the outcomes. spKt/V was a factor of interest.

Results: We enrolled 504 twice-weekly and 169 thrice-weekly hemodialysis patients. The mean weekly values of spKt/V in the two groups were 3.4 and 5.1. The one-year survival rate and times to hospitalization were similar in both groups. The hazard ratios for death in higher spKt/V quartile was not associated with lower mortality, p = 0.70. The four significant predictors for death were serum albumin, HR = 2.6, current smoking, HR = 19.3, age, HR = 1.1, and the Index of Coexistent Disease [ICED], HR = 1.9.

Conclusion: The effect of spKt/V on short-term mortality was not obvious in twice-weekly dialysis patients. Attention should be paid to patients who smoke, have hypoalbuminemia, are elderly, or have a high ICED.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Female
  • Hepatitis, Viral, Human / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypoalbuminemia / epidemiology
  • Hypoalbuminemia / etiology
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis / adverse effects
  • Renal Dialysis / methods*
  • Risk Factors
  • Serum Albumin / analysis
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Thailand / epidemiology
  • Young Adult

Substances

  • Serum Albumin