Key result
Patients aged <55 years had higher odds of missing at least one hemodialysis treatment per month, an exposure associated with increased hospitalization and mortality.
Why the study?
Do missed and shortened hemodialysis treatments increase hospitalization and mortality in hemodialysis patients?
Cohort (n=15,340)
Yes
Do missed and shortened hemodialysis treatments increase hospitalization and mortality in hemodialysis patients?
Answers are grounded in this paper and cite their sources.
Missed and shortened hemodialysis treatments are prevalent, especially among younger and minority patients, and are associated with increased hospitalization and mortality.
BACKGROUND: The relationship of missed and shortened hemodialysis (HD) to clinical outcomes has not been well characterized in HD patients in the USA. Here we explored the frequency of missed and shortened treatments and their impact on mortality and hospitalization. METHODS: A retrospective review of data from a cohort of 15 340 HD patients treated in facilities operated by Dialysis Clinics, Inc. We compared the frequency of missed and shortened treatments by gender, race, age and treatment schedules [Mondays, Wednesdays, Fridays (MWF) versus Tuesdays, Thursdays, Saturdays (TTS)]. RESULTS: Of the 15 340 patients, 48% were non-Hispanic whites (NHWs), 41% African Americans (AAs), 6% Hispanics, 2% Native American (NA), 2% Asians and 1% other races. The median number of years on HD was 1.8 years and the median follow-up was 12.4 months. The odds of missing at least one treatment in a month were higher in: patients aged <55 years, odds ratio (OR) 1.33 (P<0.0001); in AAs, OR 1.51 (P < 0.0001); in NAs, OR 1.50 (P = 0.0003); and in Hispanics, OR 1.33 (P = 0.0003) compared with NHWs and in patients who dialyzed on TTS compared with MWF, OR 1.33 (P < 0.0001). Similar findings were observed for treatments shortened by at least 10 min per month. Missed and shortened treatments were most prevalent on Saturdays and were also associated with progressive increases in hospitalization and mortality. CONCLUSION: Missed and shortened HD treatments pose a challenge to providers. Improved adherence to prescribed dialysis may decrease the morbidity and mortality.
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Obialo et al. (2012) conducted a cohort in Hemodialysis (n=15,340). Missed and shortened hemodialysis treatments vs. Adherence to prescribed dialysis schedule was evaluated on Missing at least one treatment in a month (age <55 years) (OR 1.33, p=<0.0001). Patients aged <55 years had higher odds of missing at least one hemodialysis treatment per month, an exposure associated with increased hospitalization and mortality.
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