Long Interdialytic Interval and Mortality among Patients Receiving Hemodialysis
Long Interdialytic Interval and Mortality among Patients Receiving Hemodialysis
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DOI：
10.1056/nejmoa1103313
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发表时间：
2011-09-22
影响因子：
158.5
通讯作者：
Collins, Allan J.
中科院分区：
文献类型：
--
作者：
Foley, Robert N.;Gilbertson, David T.;Collins, Allan J.
需要透析的终末期肾病患者对代谢和容量相关偏离正常范围的耐受性有限；此外，这些患者中心血管疾病的患病率也很高。鉴于这些问题，我们假设透析间隔时间过长与接受血液透析患者的不良事件有关。方法：我们研究了终末期肾病临床表现测量项目的32,065名参与者，这是一个具有全国代表性的样本，在2004年至2007年的日历年底接受每周三次血液透析的美国患者。我们比较了长（2天）透析间隔后一天的死亡率和心血管相关住院率与其他天的比率。结果患者平均年龄为62.2岁；24.2%的患者接受透析治疗1年及以下。在平均2.2年的随访间隔中，长间隔后一天的以下事件发生率高于其他日子：全因死亡率（每100人年22.1 vs 18.0）
BackgroundPatients with end-stage renal disease requiring dialysis have limited tolerance of metabolic and volume-related deviations from normal ranges; in addition, the prevalence of cardiovascular disease is high among such patients. Given these problems, we hypothesized that a long interdialytic interval is associated with adverse events in patients receiving hemodialysis.MethodsWe studied 32,065 participants in the End-Stage Renal Disease Clinical Performance Measures Project, a nationally representative sample of U.S. patients receiving hemodialysis three times weekly, at the end of calendar years 2004 through 2007. We compared rates of death and cardiovascular-related hospital admissions on the day after the long (2-day) interdialytic interval with rates on other days.ResultsThe mean age of the cohort was 62.2 years; 24.2% of the patients had been receiving dialysis treatment for 1 year or less. Over a mean follow-up interval of 2.2 years, the following event rates were higher on the day after the long interval than on other days: all-cause mortality (22.1 vs. 18.0 deaths per 100 person-years, P