Long-term survival and predictors for mortality among dialysis patients in an endemic area for chronic liver disease: a national cohort study in Taiwan

doi:10.1186/1471-2369-13-43

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標題:	Long-term survival and predictors for mortality among dialysis patients in an endemic area for chronic liver disease: a national cohort study in Taiwan
作者:	Chien, Chih-Chiang Wang, Jhi-Joung Sun, Yih-Min Sun, Ding-Ping Sheu, Ming-Jen Weng, Shih-Feng Chu, Chin-Chen Chen, Hung-An Chio, Chung-Ching Hwang, Jyh-Chang Lu, Yi-Hua Wang, Hsien-Yi Kan, Wei-Chih
貢獻者:	運動管理系
關鍵字:	Hemodialysis Peritoneal Dialysis Mortality Liver Cirrhosis
日期:	2012-06-18
上傳時間:	2014-03-21 16:15:40 (UTC+8)
出版者:	Biomed Central Ltd
摘要:	Background: Patients with end-stage renal disease (ESRD) are at a higher risk for chronic hepatitis, liver cirrhosis (LC) and mortality than the general population. Optimal modalities of renal replacement therapy for ESRD patients with concomitant end-stage liver disease remain controversial. We investigated the long-term outcome for chronic liver disease among dialysis patients in an endemic area.Methods: Using Taiwan's National Health Insurance claim data (NHRI-NHIRD-99182), We performed a longitudinal cohort study to investigate the impact of comorbidities on mortality in dialysis patients. We followed up 11293 incident hemodialysis (HD) and 761 peritoneal dialysis (PD) patients from the start of dialysis until the date of death or the end of database period (December 31, 2008). A Cox proportional hazards model was used to identify the risk factors for all-cause mortality.Results: Patients receiving PD tended to be younger and less likely to have comorbidities than those receiving HD. At the beginning of dialysis, a high prevalence rate (6.16 %) of LC was found. Other than well-known risk factors, LC (hazard ratio [HR] 1.473, 95 % CI: 1.329-1.634) and dementia (HR 1.376, 95 % CI: 1.083-1.750) were also independent predictors of mortality. Hypertension and mortality were inversely associated. Dialysis modality and three individual comorbidities (diabetes mellitus, chronic lung disease, and dementia) interacted significantly on mortality risk.Conclusions: LC is an important predictor of mortality; however, the effect on mortality was not different between HD and PD patients.
關聯:	Bmc Nephrology v.13 n.43
显示于类别:	[運動管理系] 期刊論文

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