Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis

A propensity-matched study of a prospective cohort in Korea

Ji In Park, Jung Tak Park, Yong Lim Kim, Shin-Wook Kang, Chul Woo Yang, Nam Ho Kim, Yun Kyu Oh, Chun Soo Lim, Yon Su Kim, Jung Pyo Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. Methods: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline. We compared health-related quality of life (HRQOL), daily urine volume at 12 months and all-causemortality between the groups. We matched the thrice-weekly and incremental groups at a 1:2 ratio using propensity score matching. Results: A total of 312 patients (207 in the thrice-weekly group and 105 in the incremental group) were selected. All-cause mortality was comparable between the two groups before and after propensity score matching. The HRQOL tended to be better in the incremental group for the majority of domains of the Kidney Disease Quality of Life Short Form and Beck's Depression Inventory; however, only the symptoms and problems domain was significantly better in the incremental group at 3 months after HD. At 12 months after HD, there were no differences between the groups. The daily urine volume at 12 months after HD was similar between the two groups. Conclusions: Incremental HD initiation showed comparable results to thrice-weekly initiation for HRQOL, residual renal function and all-cause mortality. Incremental HDmay be considered an additional option for HD initiation in selected patients.

Original languageEnglish
Pages (from-to)355-363
Number of pages9
JournalNephrology Dialysis Transplantation
Volume32
Issue number2
DOIs
Publication statusPublished - 2017 Feb 1

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Korea
Renal Dialysis
Prospective Studies
Quality of Life
Propensity Score
Urine
Mortality
Kidney Diseases
Chronic Kidney Failure
Dialysis
Kidney
Safety
Equipment and Supplies
Research

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Park, Ji In ; Park, Jung Tak ; Kim, Yong Lim ; Kang, Shin-Wook ; Yang, Chul Woo ; Kim, Nam Ho ; Oh, Yun Kyu ; Lim, Chun Soo ; Kim, Yon Su ; Lee, Jung Pyo. / Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis : A propensity-matched study of a prospective cohort in Korea. In: Nephrology Dialysis Transplantation. 2017 ; Vol. 32, No. 2. pp. 355-363.
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abstract = "Background: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. Methods: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline. We compared health-related quality of life (HRQOL), daily urine volume at 12 months and all-causemortality between the groups. We matched the thrice-weekly and incremental groups at a 1:2 ratio using propensity score matching. Results: A total of 312 patients (207 in the thrice-weekly group and 105 in the incremental group) were selected. All-cause mortality was comparable between the two groups before and after propensity score matching. The HRQOL tended to be better in the incremental group for the majority of domains of the Kidney Disease Quality of Life Short Form and Beck's Depression Inventory; however, only the symptoms and problems domain was significantly better in the incremental group at 3 months after HD. At 12 months after HD, there were no differences between the groups. The daily urine volume at 12 months after HD was similar between the two groups. Conclusions: Incremental HD initiation showed comparable results to thrice-weekly initiation for HRQOL, residual renal function and all-cause mortality. Incremental HDmay be considered an additional option for HD initiation in selected patients.",
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Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis : A propensity-matched study of a prospective cohort in Korea. / Park, Ji In; Park, Jung Tak; Kim, Yong Lim; Kang, Shin-Wook; Yang, Chul Woo; Kim, Nam Ho; Oh, Yun Kyu; Lim, Chun Soo; Kim, Yon Su; Lee, Jung Pyo.

In: Nephrology Dialysis Transplantation, Vol. 32, No. 2, 01.02.2017, p. 355-363.

Research output: Contribution to journalArticle

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T1 - Comparison of outcomes between the incremental and thrice-weekly initiation of hemodialysis

T2 - A propensity-matched study of a prospective cohort in Korea

AU - Park, Ji In

AU - Park, Jung Tak

AU - Kim, Yong Lim

AU - Kang, Shin-Wook

AU - Yang, Chul Woo

AU - Kim, Nam Ho

AU - Oh, Yun Kyu

AU - Lim, Chun Soo

AU - Kim, Yon Su

AU - Lee, Jung Pyo

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N2 - Background: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. Methods: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline. We compared health-related quality of life (HRQOL), daily urine volume at 12 months and all-causemortality between the groups. We matched the thrice-weekly and incremental groups at a 1:2 ratio using propensity score matching. Results: A total of 312 patients (207 in the thrice-weekly group and 105 in the incremental group) were selected. All-cause mortality was comparable between the two groups before and after propensity score matching. The HRQOL tended to be better in the incremental group for the majority of domains of the Kidney Disease Quality of Life Short Form and Beck's Depression Inventory; however, only the symptoms and problems domain was significantly better in the incremental group at 3 months after HD. At 12 months after HD, there were no differences between the groups. The daily urine volume at 12 months after HD was similar between the two groups. Conclusions: Incremental HD initiation showed comparable results to thrice-weekly initiation for HRQOL, residual renal function and all-cause mortality. Incremental HDmay be considered an additional option for HD initiation in selected patients.

AB - Background: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. Methods: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline. We compared health-related quality of life (HRQOL), daily urine volume at 12 months and all-causemortality between the groups. We matched the thrice-weekly and incremental groups at a 1:2 ratio using propensity score matching. Results: A total of 312 patients (207 in the thrice-weekly group and 105 in the incremental group) were selected. All-cause mortality was comparable between the two groups before and after propensity score matching. The HRQOL tended to be better in the incremental group for the majority of domains of the Kidney Disease Quality of Life Short Form and Beck's Depression Inventory; however, only the symptoms and problems domain was significantly better in the incremental group at 3 months after HD. At 12 months after HD, there were no differences between the groups. The daily urine volume at 12 months after HD was similar between the two groups. Conclusions: Incremental HD initiation showed comparable results to thrice-weekly initiation for HRQOL, residual renal function and all-cause mortality. Incremental HDmay be considered an additional option for HD initiation in selected patients.

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