Nephrology Dialysis Transplantation, Vol 14, Issue 4 919-922, Copyright © 1999 by Oxford University Press
A Innes, B Charra, R Burden, A Morgan and G Laurent
Background. Long, slow haemodialysis (24 h/week) has
been associated with excellent patient survival and reduced cardiovascular
mortality. Comparisons of patient survival have only been possible with
registry data and other published series which do not control for
individual patient characteristics. This retrospective study compares
actuarial patient survival between a unit using long, slow haemodialysis
(Tassin) and one employing 'conventional' haemodialysis (Nottingham).
Methods. All patients undergoing haemodialysis at each
centre since 1980 were included (Tassin, 452 patients; Nottingham, 282
patients). Actuarial curves of patient survival were calculated by the
life-table method and log rank test was used to compare data. Patients were
grouped as follows: standard (SRD) and non-standard (NSRD) renal diseases;
diabetics and non-diabetics; patients with and without cardiovascular
antecedents; risk stratification based on age and comorbidity.
Results. Overall survival was significantly better in
Tassin. This difference was also noted for patients with SRD and
non-diabetics (both P<0.001) and for those with
(P=0.007) and without
(P<0.001) cardiovascular antecedents. Survival
did not differ significantly for NSRD and diabetics. Survival was better in
Tassin in low-risk (P<0.001) and medium-risk
(P<0.001) groups, but not for high-risk (risk
stratification). Conclusions. Overall survival is
increased on long, slow haemodialysis. Although the benefits are seen in
the most favourable prognostic categories, they are also present in
patients with comorbid illness (medium-risk group) and pre-existing
cardiovascular disease. Keywords: actuarial curves;
comparison; conventional haemodialysis; long, slow haemodialysis; patient
survival; renal disease
ORIGINAL ARTICLES
The effect of long, slow haemodialysis on patient survival
Centre de Rein Artificiel, Tassin, France; Department of Renal Medicine, City Hospital, Nottingham, UK; Corresponding author address: Crosshouse Hospital, Kilmarnock KA2 0BE, UK
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