Back to Search
Start Over
Long-term survival and predictors for mortality among dialysis patients in an endemic area for chronic liver disease: a national cohort study in Taiwan.
- Source :
-
BMC nephrology [BMC Nephrol] 2012 Jun 18; Vol. 13, pp. 43. Date of Electronic Publication: 2012 Jun 18. - Publication Year :
- 2012
-
Abstract
- Background: Patients with end-stage renal disease (ESRD) are at a higher risk for chronic hepatitis, liver cirrhosis (LC) and mortality than the general population. Optimal modalities of renal replacement therapy for ESRD patients with concomitant end-stage liver disease remain controversial. We investigated the long-term outcome for chronic liver disease among dialysis patients in an endemic area.<br />Methods: Using Taiwan's National Health Insurance claim data (NHRI-NHIRD-99182), We performed a longitudinal cohort study to investigate the impact of comorbidities on mortality in dialysis patients. We followed up 11293 incident hemodialysis (HD) and 761 peritoneal dialysis (PD) patients from the start of dialysis until the date of death or the end of database period (December 31, 2008). A Cox proportional hazards model was used to identify the risk factors for all-cause mortality.<br />Results: Patients receiving PD tended to be younger and less likely to have comorbidities than those receiving HD. At the beginning of dialysis, a high prevalence rate (6.16 %) of LC was found. Other than well-known risk factors, LC (hazard ratio [HR] 1.473, 95 % CI: 1.329-1.634) and dementia (HR 1.376, 95 % CI: 1.083-1.750) were also independent predictors of mortality. Hypertension and mortality were inversely associated. Dialysis modality and three individual comorbidities (diabetes mellitus, chronic lung disease, and dementia) interacted significantly on mortality risk.<br />Conclusions: LC is an important predictor of mortality; however, the effect on mortality was not different between HD and PD patients.
- Subjects :
- Adolescent
Adult
Aged
Cohort Studies
End Stage Liver Disease epidemiology
End Stage Liver Disease therapy
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic epidemiology
Kidney Failure, Chronic therapy
Longitudinal Studies
Male
Middle Aged
Predictive Value of Tests
Renal Dialysis trends
Survival Rate trends
Taiwan epidemiology
Time Factors
Young Adult
End Stage Liver Disease mortality
Endemic Diseases
Kidney Failure, Chronic mortality
Renal Dialysis mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2369
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- BMC nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 22709415
- Full Text :
- https://doi.org/10.1186/1471-2369-13-43