Dataset Information

Temporal changes and risk factors for death from early withdrawal within 12 months of dialysis initiation-a cohort study.

ABSTRACT:

Background

Mortality risk is high soon after dialysis initiation in patients with kidney failure, and dialysis withdrawal is a major cause of early mortality, attributed to psychosocial or medical reasons. The temporal trends and risk factors associated with cause-specific early dialysis withdrawal within 12 months of dialysis initiation remain uncertain.

Methods

Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the temporal trends and risk factors associated with mortality attributed to early psychosocial and medical withdrawals in incident adult dialysis patients in Australia between 2005 and 2018 using adjusted competing risk analyses.

Results

Of 32 274 incident dialysis patients, 3390 (11%) experienced death within 12 months post-dialysis initiation. Of these, 1225 (36%) were attributed to dialysis withdrawal, with 484 (14%) psychosocial withdrawals and 741 (22%) medical withdrawals. These patterns remained unchanged over the past two decades. Factors associated with increased risk of death from early psychosocial and medical withdrawals were older age, dialysis via central venous catheter, late referral and the presence of cerebrovascular disease; obesity and Asian ethnicity were associated with decreased risk. Risk factors associated with early psychosocial withdrawals were underweight and higher socioeconomic status. Presence of peripheral vascular disease, chronic lung disease and cancers were associated with early medical withdrawals.

Conclusions

Death from dialysis withdrawal accounted for >30% of early deaths in kidney failure patients initiated on dialysis and remained unchanged over the past two decades. Several shared risk factors were observed between mortality attributed to early psychosocial and medical withdrawals.

SUBMITTER: Chen JHC

PROVIDER: S-EPMC8951200 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Temporal changes and risk factors for death from early withdrawal within 12 months of dialysis initiation-a cohort study.

Chen Jenny H C JHC Brown Mark A MA Jose Matthew M Brennan Frank F Johnson David W DW Roberts Matthew A MA Wong Germaine G Cheikh Hassan Hicham H Kennard Alice A Walker Rachael R Davies Christopher E CE Boudville Neil N Borlace Monique M Hawley Carmel C Lim Wai H WH

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 20220301 4

<h4>Background</h4>Mortality risk is high soon after dialysis initiation in patients with kidney failure, and dialysis withdrawal is a major cause of early mortality, attributed to psychosocial or medical reasons. The temporal trends and risk factors associated with cause-specific early dialysis withdrawal within 12 months of dialysis initiation remain uncertain.<h4>Methods</h4>Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the temporal trends and ris ...[more]

PMID: 34175956

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Dataset Information

Temporal changes and risk factors for death from early withdrawal within 12 months of dialysis initiation-a cohort study.

Background

Methods

Results

Conclusions

Publications

Temporal changes and risk factors for death from early withdrawal within 12 months of dialysis initiation-a cohort study.

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