ArticleBMC medicine2014
The impact of dialysis therapy on older patients with advanced chronic kidney disease: a nationwide population-based study.
Article in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Survival of patients who opt for dialysis versus conservative care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Pooled it
- Quality of life, symptoms, and sleep quality of elderly with end-stage renal disease receiving conservative management: a systematic review.Health and quality of life outcomes · 2019Pooled it
- Stage 5-CKD under nephrology care: to dialyze or not to dialyze, that is the question.Journal of nephrology · 2016Pooled it
- Influenza vaccination reduces incidence of peripheral arterial occlusive disease in elderly patients with chronic kidney disease.Scientific reports · 2021Trial
- Article
- Predicting mortality in elderly chronic kidney disease patients using algorithmic risk assessment: a Southeast Asian perspective.BMC nephrology · 2025Article
- Assessing core outcome set uptake in randomized controlled trials for chronic kidney disease: Cross-sectional analysis.Contemporary clinical trials communications · 2024Article
- Factors Associated with Long-Term Survival in Maintenance Hemodialysis Patients: A 5-Year Prospective Follow-Up Study.Sisli Etfal Hastanesi tip bulteni · 2022Article
- Effect of anti-diabetic drugs in dialysis patients with diabetes: a nationwide retrospective cohort study.Cardiovascular diabetology · 2021Observational
- Ethical challenges in nephrology: a call for action.Nature reviews. Nephrology · 2020Review
- Article
- Comparison of medical outcomes and health care costs at the end of life between dialysis patients with and without cancer: a national population-based study.BMC nephrology · 2019Article
- Artificial Intelligence Prediction Model for the Cost and Mortality of Renal Replacement Therapy in Aged and Super-Aged Populations in Taiwan.Journal of clinical medicine · 2019Article
- Article
- Acarbose Use and Liver Injury in Diabetic Patients With Severe Renal Insufficiency and Hepatic Diseases: A Propensity Score-Matched Cohort Study.Frontiers in pharmacology · 2018Article
- Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study.BioMed research international · 2018Article
- Dipeptidyl peptidase 4 inhibitor use is associated with a lower risk of incident acute kidney injury in patients with diabetes.Oncotarget · 2017Article
- Identifying Factors That Influence Physicians' Recommendations for Dialysis and Conservative Management in Indonesia.Kidney international reports · 2017Article
- Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease.PloS one · 2017Article
- The first year on haemodialysis: a critical transition.Clinical kidney journal · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlder patients with advanced chronic kidney disease (CKD) face the decision of whether to undergo dialysis. Currently available data on this issue are limited because they were generated by small, short-term studies with statistical drawbacks. Further research is urgently needed to provide objective information for dialysis decision making in older patients with advanced CKD.
methodsThis nationwide population-based cohort study was conducted using Taiwan's National Health Insurance Research Database. Data from 2000 to 2010 were extracted. A total of 8,341 patients≥70 years old with advanced CKD and serum creatinine levels>6 mg/dl, who had been treated with erythropoiesis-stimulating agents were included. Cox proportional hazard models in which initiation of chronic dialysis was defined as the time-dependent covariate were used to calculate adjusted hazard ratios for mortality. The endpoint was all-cause mortality.
resultsDuring a median follow-up period of 2.7 years, 6,292 (75.4%) older patients chose dialysis therapy and 2,049 (24.6%) received conservative care. Dialysis was initiated to treat kidney failure a median of 6.4 months after enrollment. Dialysis was associated with a 1.4-fold increased risk of mortality compared with conservative care (adjusted hazard ratio 1.39, 95% confidence interval 1.30 to 1.49). In subgroup analyses, the risk of mortality remained consistently increased, independent of age, sex and comorbidities.
conclusionsIn older patients, dialysis may be associated with increased mortality risk and healthcare cost compared with conservative care. For patients who are ≥70 years old with advanced CKD, decision making about whether to undergo dialysis should be weighted by consideration of risks and benefits.
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