Ten-year patient survival on maintenance haemodialysis: association with treatment time and dialysis dose

Seema Singh, Peter Choi, Albert Power, Damien Ashby, Thomas Cairns, Megan Griffith, Adam McLean, Andrew Palmer, David Taube, Neill Duncan

Research output: Contribution to journalArticle (Academic Journal)

10 Citations (Scopus)

Abstract

BACKGROUND: Analyses of national registry-based datasets have demonstrated the association of longer haemodialysis treatment times with lowered mortality risk.

METHODS: We performed a prospective cohort study of 451 incident haemodialysis patients and examined the effect of targeting higher dialysis dose with extended treatment time, on 10-year patient outcomes.

RESULTS: Mean treatment time (TT) was 233 ± 22.8 minutes (median 235, range 180-296). Overall patient survival was 95% at 1 year, 75% at 3 years, 56% at 5 years and 25% at 10 years. Increasing TT was associated with incremental 10-year patient survival (TT >/=241 minutes 39.7%, TT 226-240 minutes 19.6% and TT </=225 minutes 14.7%; p<0.001). Single pool Kt/V and TT were strong independent predictors of patient survival in Cox multivariate analysis (p<0.0001). At 10 years, each 0.1-unit increase in spKt/V and 20-minute increase in TT were associated with a 20% and 32% decrease in the relative risk of death, respectively. Survival benefits of higher dialysis dose and longer TT were cumulative, with highest survival exhibited by patients achieving both Kt/V >1.6 and TT >/=241 minutes, and lowest survival exhibited by patients receiving Kt/V <1.2 and TT </=225 minutes.

CONCLUSION: Extended treatment times are associated with higher patient survival irrespective of dialysis dose. Further study of extended treatment time and effect on patient outcomes is needed.

Original languageEnglish
Pages (from-to)763-70
Number of pages8
JournalJournal of Nephrology
Volume26
Issue number4
DOIs
Publication statusPublished - 14 Nov 2012

Keywords

  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis
  • Survival Rate
  • Time Factors

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