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Article Open Access

Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis

  • Authors:
    • Yumei Zhang
    • Chun Hu
    • Zhixiang Bian
    • Peihua Chen
  • View Affiliations / Copyright

    Affiliations: Division of Nephrology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 201900, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1209-1215
    |
    Published online on: June 8, 2018
       https://doi.org/10.3892/etm.2018.6281
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Abstract

There are a lot of controversies pertaining to correctness of timing for the initiation of dialysis in chronic kidney disease (CKD) patients. The present study was conducted to examine the potential association of initiation timing of dialyses with long‑term prognosis in CKD patients. In total, 294 patients confirmed as end‑stage renal disease (ESRD) were included as study subjects. According to the estimated glomerular filtration rate (eGFR) at initiation time, the patients were classified into four groups based on eGFR: ≥10.5, 8‑10.4, 6‑8 and <6 ml/min x (1.73 m2)‑1. The primary outcomes were defined by all‑cause mortality. The median eGFR of the 294 patients at initiation time was 5.43 (2.27‑13.92) ml/min x (1.73 m2)‑1. The patients with lower eGFR at the start of hemodialysis had a higher proportion of Charlson comorbidity index (CCI) scores of 0‑2 and had lower hematocrit. The multivariate Cox regression analysis indicated that CCI, cerebrovascular diseases and chronic obstructive pulmonary disease were significantly associated with all‑cause mortality, but not eGFR at the dialysis initiation. Furthermore, stratified analyses confirmed elevated eGFR that had no advantage on long‑term prognosis. The present findings have shown that the prevalence of anemia, hyperuricemia and calcium and phosphorus metabolism disorders of patients with low eGFRs at the initiation of hemodialysis was higher in comparison to the patients with high eGFRs. Therefore, the long‑term prognosis of patients with high eGFRs prior to hemodialysis was not improved.
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Copy and paste a formatted citation
Spandidos Publications style
Zhang Y, Hu C, Bian Z and Chen P: Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis. Exp Ther Med 16: 1209-1215, 2018.
APA
Zhang, Y., Hu, C., Bian, Z., & Chen, P. (2018). Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis. Experimental and Therapeutic Medicine, 16, 1209-1215. https://doi.org/10.3892/etm.2018.6281
MLA
Zhang, Y., Hu, C., Bian, Z., Chen, P."Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis". Experimental and Therapeutic Medicine 16.2 (2018): 1209-1215.
Chicago
Zhang, Y., Hu, C., Bian, Z., Chen, P."Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis". Experimental and Therapeutic Medicine 16, no. 2 (2018): 1209-1215. https://doi.org/10.3892/etm.2018.6281
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang Y, Hu C, Bian Z and Chen P: Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis. Exp Ther Med 16: 1209-1215, 2018.
APA
Zhang, Y., Hu, C., Bian, Z., & Chen, P. (2018). Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis. Experimental and Therapeutic Medicine, 16, 1209-1215. https://doi.org/10.3892/etm.2018.6281
MLA
Zhang, Y., Hu, C., Bian, Z., Chen, P."Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis". Experimental and Therapeutic Medicine 16.2 (2018): 1209-1215.
Chicago
Zhang, Y., Hu, C., Bian, Z., Chen, P."Impact of timing of initiation of dialysis on long‑term prognosis of patients undergoing hemodialysis". Experimental and Therapeutic Medicine 16, no. 2 (2018): 1209-1215. https://doi.org/10.3892/etm.2018.6281
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