Nephrology Dialysis Transplantation, Vol 14, Issue 5 1091-1096, Copyright © 1999 by Oxford University Press
N Mazzuchi, E Carbonell and J Fernandez-Cean
Background. Our aim was to identify co-morbid risk
factors in ESRD patients at the start of the treatment, to select patients
in the low-risk group (LRG) and to compare overall survival, adjusted
overall survival and LRG survival in three centres (A, B and C).
Methods. Population includes 531 patients entering
haemodialysis from 1 January 1981 to 31 December 1996 (mean age 59.6
± 16.7 years). Demographics and co-morbidity data collected at
the start of HD were independent variables for the analysis. Univariate and
multivariate analysis of survival were used to identify significant
prognostic factors (Kaplan-Meier and Cox hazard regression model
respectively). According to this analysis the LRG was defined by the
absence of the identified significant mortality risk factors except age.
Results. The overall median survival was 7.92 years,
with 92.0% survival at 1 year, 65.2% at 5 years and 40.4% at 10 years. The
median survival in centre C (10.83 years) was significantly higher than
median survival in centre A (7.0 years) and in centre B (7.83 years).
Centres A and B were afterwards analysed together (A-B). In the
multivariate analysis, five variables (starting age, diabetes, cancer,
smoking habit, and arteriosclerotic heart disease) were associated with
survival. The variable centre (A-B or C) was not significant. The adjusted
survival curve for centres A-B and C were not different. The LRG included
patients of any age, without diabetes, cancer, smoking habit, and
arteriosclerotic heart disease. The frequency of the patients in the LRG
was 66.3% in centre C and 45.7% in centre A-B
(P=0.0004). Taking into account only the LRG, the
survival comparison between centres A-B and C, did not show significant
differences (P=0.196). Conclusions.
We conclude that for purposes of comparison of mortality in
ESRD, low-risk population is better than overall ESRD population.
Keywords: adjusted survival; Cox hazard regression
model; low-risk patients survival; risk factors; statistical analysis;
survival
DIALYSIS AND TRANSPLANTATION NEWS
ESRD patients without co-morbid risk factors at the start of haemodialysis are ideal as survival comparison population
Instituto de Nefrologia y Urologia, Servicio de Asistencia Renal Integral, Ramón y Cajal 2550, Montevideo 11600, C.C. 16217, Uruguay; Corresponding author
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