Effect of dialysis initiation timing on clinical outcomes

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

Jeonghwan Lee, Jung Nam An, Jin Ho Hwang, 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

12 Citations (Scopus)

Abstract

Background: Controversy persists regarding the appropriate initiation timing of renal replacement therapy for patients with end-stage renal disease. We evaluated the effect of dialysis initiation timing on clinical outcomes. Initiation times were classified according to glomerular filtration rate (GFR). Methods: We enrolled a total of 1691 adult patients who started dialysis between August 2008 and March 2013 in a multicenter, prospective cohort study at the Clinical Research Center for End Stage Renal Disease in the Republic of Korea. The patients were classified into the early-start group or the late-start group according to the mean estimated GFR value, which was 7.37 ml/min/1.73 m 2. The primary outcome was patient survival, and the secondary outcomes were hospitalization, cardiovascular events, vascular access complications, change of dialysis modality, and peritonitis. The two groups were compared before and after matching with propensity scores. Results: Before propensity score matching, the early-start group had a poor survival rate (P<0.001). Hospitalization, cardiovascular events, vascular access complications, changes in dialysis modality, and peritonitis were not different between the groups. A total of 854 patients (427 in each group) were selected by propensity score matching. After matching, neither patient survival nor any of the other outcomes differed between groups. Conclusions: There was no clinical benefit after adjustment by propensity scores comparing early versus late initiation of dialysis.

Original languageEnglish
Article numbere105532
JournalPloS one
Volume9
Issue number8
DOIs
Publication statusPublished - 2014 Aug 19

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Dialysis
Korea
dialysis
cohort studies
Korean Peninsula
Propensity Score
Cohort Studies
Prospective Studies
glomerular filtration rate
peritonitis
kidney diseases
Peritonitis
Glomerular Filtration Rate
blood vessels
Chronic Kidney Failure
Blood Vessels
Hospitalization
Republic of Korea
Renal Replacement Therapy
Survival

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, Jeonghwan ; An, Jung Nam ; Hwang, Jin Ho ; Kim, Yong Lim ; Kang, Shin-Wook ; Yang, Chul Woo ; Kim, Nam Ho ; Oh, Yun Kyu ; Lim, Chun Soo ; Kim, Yon Su ; Lee, Jung Pyo. / Effect of dialysis initiation timing on clinical outcomes : A propensity-matched analysis of a prospective cohort study in Korea. In: PloS one. 2014 ; Vol. 9, No. 8.
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Effect of dialysis initiation timing on clinical outcomes : A propensity-matched analysis of a prospective cohort study in Korea. / Lee, Jeonghwan; An, Jung Nam; Hwang, Jin Ho; 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: PloS one, Vol. 9, No. 8, e105532, 19.08.2014.

Research output: Contribution to journalArticle

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T1 - Effect of dialysis initiation timing on clinical outcomes

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

AU - Lee, Jeonghwan

AU - An, Jung Nam

AU - Hwang, Jin Ho

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

PY - 2014/8/19

Y1 - 2014/8/19

N2 - Background: Controversy persists regarding the appropriate initiation timing of renal replacement therapy for patients with end-stage renal disease. We evaluated the effect of dialysis initiation timing on clinical outcomes. Initiation times were classified according to glomerular filtration rate (GFR). Methods: We enrolled a total of 1691 adult patients who started dialysis between August 2008 and March 2013 in a multicenter, prospective cohort study at the Clinical Research Center for End Stage Renal Disease in the Republic of Korea. The patients were classified into the early-start group or the late-start group according to the mean estimated GFR value, which was 7.37 ml/min/1.73 m 2. The primary outcome was patient survival, and the secondary outcomes were hospitalization, cardiovascular events, vascular access complications, change of dialysis modality, and peritonitis. The two groups were compared before and after matching with propensity scores. Results: Before propensity score matching, the early-start group had a poor survival rate (P<0.001). Hospitalization, cardiovascular events, vascular access complications, changes in dialysis modality, and peritonitis were not different between the groups. A total of 854 patients (427 in each group) were selected by propensity score matching. After matching, neither patient survival nor any of the other outcomes differed between groups. Conclusions: There was no clinical benefit after adjustment by propensity scores comparing early versus late initiation of dialysis.

AB - Background: Controversy persists regarding the appropriate initiation timing of renal replacement therapy for patients with end-stage renal disease. We evaluated the effect of dialysis initiation timing on clinical outcomes. Initiation times were classified according to glomerular filtration rate (GFR). Methods: We enrolled a total of 1691 adult patients who started dialysis between August 2008 and March 2013 in a multicenter, prospective cohort study at the Clinical Research Center for End Stage Renal Disease in the Republic of Korea. The patients were classified into the early-start group or the late-start group according to the mean estimated GFR value, which was 7.37 ml/min/1.73 m 2. The primary outcome was patient survival, and the secondary outcomes were hospitalization, cardiovascular events, vascular access complications, change of dialysis modality, and peritonitis. The two groups were compared before and after matching with propensity scores. Results: Before propensity score matching, the early-start group had a poor survival rate (P<0.001). Hospitalization, cardiovascular events, vascular access complications, changes in dialysis modality, and peritonitis were not different between the groups. A total of 854 patients (427 in each group) were selected by propensity score matching. After matching, neither patient survival nor any of the other outcomes differed between groups. Conclusions: There was no clinical benefit after adjustment by propensity scores comparing early versus late initiation of dialysis.

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