The association of standard Kt/V and surface area-normalized standard Kt/V with clinical outcomes in hemodialysis patients
© 2020 International Society for Hemodialysis..
INTRODUCTION: A previous study demonstrated that the surface area-normalized standard Kt/V (SAstdKt/V) was better associated with mortality than standard Kt/V (stdKt/V). This study investigates the association of SAstdKt/V and stdKt/V with mortality, anemia, and hypoalbuminemia in a larger patient cohort with a longer follow-up period.
METHODS: We included adult patients on thrice-weekly hemodialysis in the USRDS database and excluded amputated patients. StdKt/V and SAstdKt/V were calculated from the available single-pool Kt/V. Patients were categorized into five groups according to their stdKt/V and SAstdKt/V: <2.00, 2.00-2.19, 2.20-2.39, 2.40-2.59, and ≥2.60. Hazard ratios (HR) and odds ratios (OR) were calculated using Cox and logistic regression analysis respectively.
FINDINGS: There were 507,656 patients included in the analysis. The patients had a median age of 65.5 years with a median follow-up period of 2 years. Thirty-four percent died during follow-up. HRs for mortality progressively decreased as SAstdKt/V increased in both unadjusted and adjusted models. Unlike SAstdKt/V, HRs were the lowest in the categories with stdKt/V of 2.40-2.59 and they increased in the higher stdKt/V category. The adjusted HR for SAstdKt/V vs. stdKt/V were 0.68 vs. 0.62 in the category of 2.40-2.59, and 0.63 vs. 0.73 in the category of ≥2.60. The adjusted ORs for anemia progressively decreased as SAstdKt/V increased, whereas ORs decreased to the lowest in stdKt/V category 2.40-2.59 and increased in the ≥2.60 category. The adjusted ORs for hypoalbuminemia progressively decreased as SAstdKt/V and stdKt/V increased which were both 0.45 in 2.40-2.59 category and decreased to 0.29 and 0.42 in the ≥2.60 category.
DISCUSSION: SAstdKt/V is better associated with mortality, anemia, and hypoalbuminemia than stdKt/V. SAstdKt/V is a better parameter in defining hemodialysis dosing which can be calculated by an available online tool. Further studies to determine the optimal SAstdKt/V dose required to achieve improved clinical outcomes with better cost-effectiveness are needed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
Hemodialysis international. International Symposium on Home Hemodialysis - 24(2020), 4 vom: 18. Okt., Seite 495-505 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pattharanitima, Pattharawin [VerfasserIn] |
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| Links: |
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| Themen: |
8W8T17847W |
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| Anmerkungen: |
Date Completed 19.03.2021 Date Revised 05.10.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/hdi.12865 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM313837848 |
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| 100 | 1 | |a Pattharanitima, Pattharawin |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The association of standard Kt/V and surface area-normalized standard Kt/V with clinical outcomes in hemodialysis patients |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 19.03.2021 | ||
| 500 | |a Date Revised 05.10.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 International Society for Hemodialysis. | ||
| 520 | |a INTRODUCTION: A previous study demonstrated that the surface area-normalized standard Kt/V (SAstdKt/V) was better associated with mortality than standard Kt/V (stdKt/V). This study investigates the association of SAstdKt/V and stdKt/V with mortality, anemia, and hypoalbuminemia in a larger patient cohort with a longer follow-up period | ||
| 520 | |a METHODS: We included adult patients on thrice-weekly hemodialysis in the USRDS database and excluded amputated patients. StdKt/V and SAstdKt/V were calculated from the available single-pool Kt/V. Patients were categorized into five groups according to their stdKt/V and SAstdKt/V: <2.00, 2.00-2.19, 2.20-2.39, 2.40-2.59, and ≥2.60. Hazard ratios (HR) and odds ratios (OR) were calculated using Cox and logistic regression analysis respectively | ||
| 520 | |a FINDINGS: There were 507,656 patients included in the analysis. The patients had a median age of 65.5 years with a median follow-up period of 2 years. Thirty-four percent died during follow-up. HRs for mortality progressively decreased as SAstdKt/V increased in both unadjusted and adjusted models. Unlike SAstdKt/V, HRs were the lowest in the categories with stdKt/V of 2.40-2.59 and they increased in the higher stdKt/V category. The adjusted HR for SAstdKt/V vs. stdKt/V were 0.68 vs. 0.62 in the category of 2.40-2.59, and 0.63 vs. 0.73 in the category of ≥2.60. The adjusted ORs for anemia progressively decreased as SAstdKt/V increased, whereas ORs decreased to the lowest in stdKt/V category 2.40-2.59 and increased in the ≥2.60 category. The adjusted ORs for hypoalbuminemia progressively decreased as SAstdKt/V and stdKt/V increased which were both 0.45 in 2.40-2.59 category and decreased to 0.29 and 0.42 in the ≥2.60 category | ||
| 520 | |a DISCUSSION: SAstdKt/V is better associated with mortality, anemia, and hypoalbuminemia than stdKt/V. SAstdKt/V is a better parameter in defining hemodialysis dosing which can be calculated by an available online tool. Further studies to determine the optimal SAstdKt/V dose required to achieve improved clinical outcomes with better cost-effectiveness are needed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Adequacy of dialysis | |
| 650 | 4 | |a anemia | |
| 650 | 4 | |a nutrition | |
| 650 | 4 | |a survival | |
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| 700 | 1 | |a El Shamy, Osama |e verfasserin |4 aut | |
| 700 | 1 | |a Chaudhary, Kumardeep |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Shuchita |e verfasserin |4 aut | |
| 700 | 1 | |a Coca, Steven G |e verfasserin |4 aut | |
| 700 | 1 | |a Nadkarni, Girish N |e verfasserin |4 aut | |
| 700 | 1 | |a Uribarri, Jaime |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Lili |e verfasserin |4 aut | |
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