Improving Survival Rate of Korean Patients Initiating Dialysis
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Purpose: The aim of this study was to investigate whether the survival rate among Korean dialysis patients changed during the period between 2005 and 2008 in Korea. Materials and Methods: A total of 32357 patients who began dialysis between January 1, 2005 and December 31, 2008 were eligible for analysis. Baseline demographics,comorbidities, and mortality data were obtained from the database of the Health Insurance Review & Assessment Service. Results: Kaplan-Meier curves accordingto the year of dialysis initiation showed that the survival rate was significantlydifferent (log-rank test, p=0.005), most notably among peritoneal dialysis (PD) patients (p<0.001), although not among hemodialysis (HD) patients (p= 0.497). In multivariate analysis, however, patients initiating either HD or PD in 2008 also had a significantly lower risk of mortality compared to those who began dialysis in 2005. Subgroup survival analysis among patients initiating dialysis in 2008 revealed that the survival rate of PD patients was significantly higher than that of HD patients (p=0.001), and the survival benefit of PD over HD remained in non-diabetic patients aged less than 65 years after adjustment of covariates. Conclusion: Survival of Korean patients initiating dialysis from 2005 to 2008 has improved over time, particularly in PD patients. In addition, survival rates among patients initiating dialysis in 2008 were different according to patients’ age and diabetes, thus we need to consider these factors when dialysis modality should be chosen.
Abstract
Purpose: The aim of this study was to investigate whether the survival rate among Korean dialysis patients changed during the period between 2005 and 2008 in Korea. Materials and Methods: A total of 32357 patients who began dialysis between January 1, 2005 and December 31, 2008 were eligible for analysis. Baseline demographics,comorbidities, and mortality data were obtained from the database of the Health Insurance Review & Assessment Service. Results: Kaplan-Meier curves accordingto the year of dialysis initiation showed that the survival rate was significantlydifferent (log-rank test, p=0.005), most notably among peritoneal dialysis (PD) patients (p<0.001), although not among hemodialysis (HD) patients (p= 0.497). In multivariate analysis, however, patients initiating either HD or PD in 2008 also had a significantly lower risk of mortality compared to those who began dialysis in 2005. Subgroup survival analysis among patients initiating dialysis in 2008 revealed that the survival rate of PD patients was significantly higher than that of HD patients (p=0.001), and the survival benefit of PD over HD remained in non-diabetic patients aged less than 65 years after adjustment of covariates. Conclusion: Survival of Korean patients initiating dialysis from 2005 to 2008 has improved over time, particularly in PD patients. In addition, survival rates among patients initiating dialysis in 2008 were different according to patients’ age and diabetes, thus we need to consider these factors when dialysis modality should be chosen.
참고문헌 (34)
- USRDS 2012 Annual Data Report. Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, "U.S. Renal Data System", National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, ~ (2012)
- Murphy SW, "Comparative mortality of hemodialysis and peritoneal dialysis in Canada", Kidney Int, 57, pp.1720~1726 (2000)
- Heaf JG, "Relative survival of peritoneal dialysis and haemodialysis patients: effect of cohort and mode of dialysis initiation", PLoS One, 9, pp.e90119~ (2014)
- Huang CC, "Survival analysis: comparing peritoneal dialysis and hemodialysis in Taiwan", Perit Dial Int, 28(Suppl 3), pp.S15~S20 (2008)
- Lee CC, "Long-term modality-related mortality analysis in incident dialysis patients", Perit Dial Int, 29, pp.182~190 (2009)
- Mehrotra R, "Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease", Arch Intern Med, 171, pp.110~118 (2011)
- Quinn RR, "Selection bias explains apparent differential mortality between dialysis modalities.", J Am Soc Nephrol, 22, pp.1534~1542 (2011)
- Sanabria M, "Dialysis outcomes in Colombia (DOC) study: a comparison of patient survival on peritoneal dialysis vs hemodialysis in Colombia", Kidney Int Suppl, pp.S165~S172 (2008)
- van de Luijtgaarden MW, "Effects of comorbid and demographic factors on dialysis modality choice and related patient survival in Europe", Nephrol Dial Transplant, 26, pp.2940~2947 (2011)
- Weinhandl ED, "Propensity-matched mortality comparison of incident hemodialysis and peritoneal dialysis patients", J Am Soc Nephrol, 21, pp.499~506 (2010)
- Yeates K, "Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada", Nephrol Dial Transplant, 27, pp.3568~3575 (2012)
- Jaar BG, "Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease", Ann Intern Med, 143, pp.174~183 (2005)
- Termorshuizen F, "Hemodialysis and peritoneal dialysis: comparison of adjusted mortality rates according to the duration of dialysis: analysis of The Netherlands Cooperative Study on the Adequacy of Dialysis 2", J Am Soc Nephrol, 14, pp.2851~2860 (2003)
- Liem YS, "Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands", Kidney Int, 71, pp.153~158 (2007)
- Korevaar JC, "Effect of starting with hemodialysis compared with peritoneal dialysis in patients new on dialysis treatment: a randomized controlled trial", Kidney Int, 64, pp.2222~2228 (2003)
- McDonald SP, "Relationship between dialysis modality and mortality", J Am Soc Nephrol, 20, pp.155~163 (2009)
- Kim H, "A population-based approach indicates an overall higher patient mortality with peritoneal dialysis compared to hemodialysis in Korea", Kidney Int, 86, pp.991~1000 (2014)
- Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation", J Chronic Dis, 40, pp.373~383 (1987)
- Hemmelgarn BR, "Adapting the Charlson Comorbidity Index for use in patients with ESRD", Am J Kidney Dis, 42, pp.125~132 (2003)
- Quan H, "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data", Med Care, 43, pp.1130~1139 (2005)
- Mortier S, "Long-term exposure to new peritoneal dialysis solutions: effects on the peritoneal membrane", Kidney Int, 66, pp.1257~1265 (2004)
- Johnson DW, "Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes", J Am Soc Nephrol, 23, pp.1097~1107 (2012)
- Cho Y, "Biocompatible dialysis fluids for peritoneal dialysis", Cochrane Database Syst Rev, 3, pp.CD007554~ (2014)
- Collins AJ, "Mortality risks of peritoneal dialysis and hemodialysis", Am J Kidney Dis, 34, pp.1065~1074 (1999)
- Ganesh SK, "Mortality differences by dialysis modality among incident ESRD patients with and without coronary artery disease", J Am Soc Nephrol, 14, pp.415~424 (2003)
- Stack AG, "Impact of dialysis modality on survival of new ESRD patients with congestive heart failure in the United States", Kidney Int, 64, pp.1071~1079 (2003)
- Vonesh EF, "The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis", Kidney Int, 66, pp.2389~2401 (2004)
- Schaubel DE, "Comparing mortality rates on CAPD", CCPD and hemodialysis. The Canadian experience: fact or fiction?, 1998, pp.18, 478~484
- Heaf JG, "Initial survival advantage of peritoneal dialysis relative to haemodialysis", Nephrol Dial Transplant, 17, pp.112~117 (2002)
- Vonesh EF, "Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us?", Kidney Int Suppl, pp.S3~S11 (2006)
- Held PJ, "Five-year survival for end-stage renal disease patients in the United States, Europe, and Japan, 1982 to 1987", Am J Kidney Dis, 15, pp.451~457 (1990)
- Yoshino M, "International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality", J Am Soc Nephrol, 17, pp.3510~3519 (2006)
- 진동찬, "Brief Report: Renal replacement therapy in Korea, 2010", Kidney Research and Clinical Practice, 31(1), pp.62~71 (2012), 대한신장학회
- Marinovich S, "The lack of income is associated with reduced survival in chronic haemodialysis", Nefrologia, 32, pp.79~88 (2012)
