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Kidney Week

Abstract: SA-PO748

In-Center Extended-Hour Hemodialysis Can Be Effective in Improving the Mortality of Elderly Dialysis Patients

Session Information

  • Geriatric Nephrology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Okazaki, Masaki, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Inaguma, Daijo, Fujita Health University School of Medicine, Toyoake, Japan
  • Imaizumi, Takahiro, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Hishida, Manabu, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Ozeki, Takaya, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Kubo, Yoko, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Yasuda, Yoshinari, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Kato, Sawako, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Tsuboi, Naotake, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Kaneda, Hiroshi, Kamome Clinic, Yokohama, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan
Background

Amid the global problem of aging among dialysis patients, it has become more difficult to improve prognosis among dialysis patients. Despite previous reports that the extended-hour hemodialysis (HD) can reduce the risk of death, the impact of this treatment on elderly patients remains unclear. The aim of this study is to investigate the effect of extended-hour HD on elderly patients, using largest cohort of incident extended-hour HD in Japan.

Methods

Multicenter retrospective cohort study; we included 205 consecutive patients who had received in-center extended-hour HD since the initiation of HD in 4 facilities during Oct. 2008 to Sept. 2017 (extended-HD). We also included 1382 consecutive patients who initiated conventional HD in 17 facilities during Oct. 2011 to Sept. 2013 as the control group (conventional). Each treatment group was divided into two age subgroups (over or less than 70 years old). We compared the risk for mortality during the first 5 years of follow-up among the treatment groups and age subgroups.

Results

The mean age was 63.3±14 years in extended-HD and 68.1±13 years in conventional. The crude mortality in the extended-HD group was 3.9 deaths per 100 patient-years compared with 7.9 deaths per 100 patient-years in the conventional group. Extended-HD was associated with a 37% reduction in mortality after adjustment for age, sex, body mass index, diabetes, and cardiovascular disease (95% confidence interval (CI): 5-58%). In the subgroup analyses, elderly dialysis patients (>70 years old) treated with extended-HD had a 48% lower adjusted mortality than that of conventional (95% CI: 10-71%).

Conclusion

Especially for the elderly, treatment with extended-hour HD was associated with a lower risk of mortality compared to conventional HD.

Funding

  • Government Support - Non-U.S.