Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (5)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Iseki, K.
Right arrow Articles by Takishita, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Iseki, K.
Right arrow Articles by Takishita, S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrol Dial Transplant (2003) 18: 782-787
© 2003 European Renal Association-European Dialysis and Transplant Association

Effect of the duration of dialysis on survival in a cohort of chronic haemodialysis patients

Kunitoshi Iseki, Masahiko Tozawa and Shuichi Takishita

Dialysis Unit and Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan

Background. Atherosclerosis and vascular calcification are common in chronic haemodialysis (HD) patients, and usually progress with time. Whether the length of dialysis treatment in chronic HD patients is a significant independent risk factor of death is not clear.

Methods. A cohort of chronic HD patients from the Okinawa Dialysis Study, n=1243 (720 men, 523 women), was followed from January 1991 to December 2000, and their survival rates were compared against the duration of HD, which was calculated in months from the start of dialysis therapy to January 1991. A Cox proportional hazards regression analysis was done to examine the influence of the duration of dialysis on survival, after adjusting for other factors such as age, sex, serum albumin concentration and diastolic blood pressure. The hazards ratio and 95% confidence interval (CI) were calculated in both diabetic and non-diabetic patients.

Results. The mean duration of dialysis was 61.9 months and ranged from 1 to 233 months. The numbers of patients who died, underwent renal transplantation or were transferred outside Okinawa were 568 (45.7%), 61 (4.9%) and 14 (1.1%), respectively, during the study. The hazards ratio (95% CI) was 1.002 (1.000–1.004, P=0.0245) for non-diabetic patients and 1.006 (1.001–1.011, P=0.0214) for diabetic patients, suggesting that the longer the duration of dialysis, the greater the risk of death.

Conclusions. This study shows that prolonged dialysis is a significant predictor of death in chronic HD patients, in particular diabetic patients. Whether this is related to the progression of the atherosclerotic process or to uraemic conditions remains to be shown.

Keywords: dialysis duration; haemodialysis; serum albumin; survival

Correspondence and offprint requests to: Dr Kunitoshi Iseki, MD, Dialysis Unit, University of The Ryukyus, 207 Uehara, Okinawa 903-0215, Okinawa, Japan. Email: chihokun{at}med.u-yukyu.ac.jp


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.