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Abstract: PO1137

Variability and Trends over Time and Across Centers in Hemodialysis Weekly Duration in Australia and New Zealand

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ethier, Isabelle, Centre Hospitalier de L'Universite de Montreal, Montreal, Quebec, Canada
  • Cho, Yeoung Jee, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Davies, Christopher E., Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
  • Hawley, Carmel, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Campbell, Scott B., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Isbel, Nicole, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Pascoe, Elaine, The University of Queensland, Saint Lucia, Queensland, Australia
  • Polkinghorne, Kevan, Monash Medical Centre Clayton, Clayton, Victoria, Australia
  • Roberts, Matthew A., Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
  • See, Emily J., The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
  • Semple, David, Department of Renal Medicine, Auckland District Health Board,, Auckland, New Zealand
  • Van Eps, Carolyn L., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Viecelli, Andrea K., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Johnson, David W., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Background

Hemodialysis treatment prescription varies widely around the world. This study explored patient- and center-level characteristics associated with weekly haemodialysis hours.

Methods

Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data was analyzed. Characteristics associated with weekly duration were evaluated using mixed-effects linear regression models with patient- and center-level covariates as fixed effects, and dialysis center and state as random effects using the 2017 prevalent in-centre hemodialysis (ICHD) and home hemodialysis (HHD) cohorts. Evaluation of patterns of weekly duration over time analyzed the 2000 to 2017 incident ICHD and HHD cohorts.

Results

Overall, 12,494 ICHD and 1,493 HHD prevalent patients in 2017 were included. Median weekly treatment duration was 13.5 (interquartile range (IQR) 12-15) hours for ICHD and 16 (IQR 15-20) hours for HHD. Male sex, younger age, higher body mass index, arteriovenous fistula/graft use, Aboriginal and Torres Strait Islander ethnicity and longer dialysis vintage were associated with longer weekly duration for both ICHD and HHD. No center characteristics were associated with weekly duration. Variability in duration across centers was very limited in ICHD compared to HHD, with variation in HHD being associated with state. Duration did not vary significantly over time for ICHD, whereas longer weekly HHD treatments were reported between 2006 and 2012 compared to before and after this period.

Conclusion

This study in the Australian and New Zealand hemodialysis population showed that weekly treatment duration was primarily associated with patient characteristics. No center effect was demonstrated. Practice patterns seemed to differ across states/countries, with more variability in HHD than in ICHD.

Funding

  • Government Support - Non-U.S.