Association of dialyzer reuse with hospitalization and survival rates among U.S. hemodialysis patients : Do comorbidities matter ?
The objective of this study was to detennine whether the associations between reuse of hemodialyzers and higher rates of death and hospitalization persist after adjustment for comorbidity.
This was a nonconcurrent cohort study of survival and hospitalization rates among 1491 U.S. chronic hemodialysis patients beginning treatment in 1986 and 1987.
The impact of dialyzer reuse was compared across three survival models : an unadjusted model, a « base'model adjusted only for demographics and renal diagnosis, and an » augmented model additionally adjusted for comorbidities.
We found that reuse of dialyzers was associated with a similarly higher rate of death in analyses unadjusted for confounders (relative risk [RR] 1.25,95% confidence interval [CI] 0.97-1.61), adjusted for demographics and renal diagnosis (RR 1.16,95% Cl 0.96-1.41), and analyses additionally adjusted for comorbidities (RR=1.25, Cl, 1.03,1.52).
Reusing dialyzers was also associated with a greater rate of hospitalization that was stable regardless of adjustment procedures.
We conclude that higher rates of death and hospitalization associated with dialyzer reuse persist regardless of adjustment for demographic characteristics or baseline comorbidities.
These findings amplify concerns that there exists elevated morbidity among hemodialysis patients treated in facilities that reuse hemodialyzers. (...)
Mots-clés Pascal : Insuffisance rénale, Chronique, Homme, Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Traitement, Hémodialyse, Evolution, Survie, Hospitalisation, Etude longitudinale, Etude cohorte, Réutilisation, Dialyseur, Appareil urinaire pathologie, Rein pathologie
Mots-clés Pascal anglais : Renal failure, Chronic, Human, United States, North America, America, Epidemiology, Treatment, Hemodialysis, Evolution, Survival, Hospitalization, Follow up study, Cohort study, Reuse, Dialyzer, Urinary system disease, Kidney disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0234109
Code Inist : 002B14A05. Création : 16/11/1999.