演題情報

学会・委員会企画

開催回
第56回・2011年・横浜
 

Current Status of Dialysis Initiation and Survival in Japan: Effect of Transfer and Facility

演題番号 : GI-8-4

Norio Hanafusa:1、Hiroshi Nishi:1、Kunihiro Yamagata:1、Toshio Shinoda:1、Kunitoshi Iseki:1、Yoshiharu Tsubakihara:1

1:The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy

 

【Background】 Little is known about the dynamics and the relationship on survival in Japanese incident hemodialysis (HD) patients. 【Study protocol】 Observational retrospective study using Japanese Renal Data Registry.  【Methods】 We used a standard analysis file from the JSDT registry database (JRDR-09104). All incident HD patients in 2006 were included (N=34,682). The status of transfer was evaluated as comparing both the HD initiated unit and the year-end HD unit in 2006. We examined relationship between the dynamics of the patients and one-year mortality using multivariate logistic analyses.  【Results】 A total of 32,398 were included in this study and 86.2% of them started HD at hospital and the rest of them at clinics. The vast majority of the facilities (81.1%) had one or more incident patients. Those who were transferred from the original HD unit during 2006 were 40.8%. The hospital HD initiation and remained at the original HD unit groups were significantly poor survival, OR 2.73: 95% CI 1.59 - 4.99 and OR 6.52: 95% CI 2.74 - 19.45, respectively. Those who began HD at hospitals and remained at the original HD unit showed higher mortality rate at shorter duration of HD.  【Discussion】 Nursing home residents were reportedly poorest survival after initiating HD. The dynamics of incident HD might warrant further information that covers more socio-economic conditions.  【Conclusions】 Results showed that the dynamics of incident HD patients has impact on survival. Reasons for poorer survival among incident HD patients who did not move remained to be determined.

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