Effect of dialysis initiation timing on clinical outcomes: a propensity-matched analysis of a prospective cohort study in Korea.
Effect of dialysis initiation timing on clinical outcomes: a propensity-matched analysis of a prospective cohort study in Korea.
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DOI：
10.1371/journal.pone.0105532
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Lee JP
中科院分区：
文献类型：
--
作者：
Lee J;An JN;Hwang JH;Kim YL;Kang SW;Yang CW;Kim NH;Oh YK;Lim CS;Kim YS;Lee JP
对于终末期肾病患者开始肾脏替代治疗的合适时机，争议仍然存在。我们评估了透析开始时间对临床结果的影响。起始时间根据肾小球滤过率（GFR）进行分类。我们在韩国终末期肾脏疾病临床研究中心招募了1691名在2008年8月至2013年3月期间开始透析的成年患者，进行了一项多中心前瞻性队列研究。根据GFR平均值（7.37 ml/min/1.73 m2）分为早启动组和晚启动组。主要结局是患者生存，次要结局是住院、心血管事件、血管通路并发症、透析方式改变和腹膜炎。用倾向得分进行配对前后比较。倾向评分匹配前，早开始组生存率较低（P<0.001）。住院、心血管事件、血管通路并发症、透析方式的改变和腹膜炎在两组之间没有差异。采用倾向评分匹配法共选取854例患者，每组427例。配对后，两组患者的生存率和其他指标均无差异。通过倾向评分调整后，比较早期和晚期开始透析没有临床获益。
Controversy persists regarding the appropriate initiation timing of renal replacement therapy for patients with end-stage renal disease. We evaluated the effect of dialysis initiation timing on clinical outcomes. Initiation times were classified according to glomerular filtration rate (GFR). We enrolled a total of 1691 adult patients who started dialysis between August 2008 and March 2013 in a multi-center, prospective cohort study at the Clinical Research Center for End Stage Renal Disease in the Republic of Korea. The patients were classified into the early-start group or the late-start group according to the mean estimated GFR value, which was 7.37 ml/min/1.73 m2. The primary outcome was patient survival, and the secondary outcomes were hospitalization, cardiovascular events, vascular access complications, change of dialysis modality, and peritonitis. The two groups were compared before and after matching with propensity scores. Before propensity score matching, the early-start group had a poor survival rate (P<0.001). Hospitalization, cardiovascular events, vascular access complications, changes in dialysis modality, and peritonitis were not different between the groups. A total of 854 patients (427 in each group) were selected by propensity score matching. After matching, neither patient survival nor any of the other outcomes differed between groups. There was no clinical benefit after adjustment by propensity scores comparing early versus late initiation of dialysis.
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影响因子：
4.5
作者：
Chang JH;Rim MY;Sung J;Ko KP;Kim DK;Jung JY;Lee HH;Chung W;Kim S
通讯作者：
Kim S
DOI：
10.2215/cjn.00510109
发表时间：
2009-10-01
影响因子：
9.8
作者：
Carson, Rachel C.;Juszczak, Maciej;Burns, Aine
通讯作者：
Burns, Aine
影响因子：
158.5
作者：
Cooper, Bruce A.;Branley, Pauline;Pollock, Carol A.
通讯作者：
Pollock, Carol A.
DOI：
10.1097/01.asn.0000054493.04151.80
发表时间：
2003-04-01
影响因子：
13.6
作者：
Joly, D;Anglicheau, D;Jungers, P
通讯作者：
Jungers, P
影响因子：
13.2
作者：
Derose, Stephen F.;Rutkowski, Mark P.;Jacobsen, Steven J.
通讯作者：
Jacobsen, Steven J.