Parameters affecting prognosis after hemodialysis withdrawal: experience from a single center View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-06-06

AUTHORS

Kosei Yamaguchi, Mineaki Kitamura, Takahiro Takazono, Kazuko Yamamoto, Junichiroh Hashiguchi, Takashi Harada, Satoshi Funakoshi, Hiroshi Mukae, Tomoya Nishino

ABSTRACT

IntroductionWithdrawal from maintenance hemodialysis is unavoidable in some patients due to their poor general condition; however, their survival days vary depending on their health status. The factors associated with life prognosis in the terminal phase in patients undergoing hemodialysis remain unclear.MethodsPatients who died after withdrawal from hemodialysis between 2011 and 2021 at Nagasaki Renal Center were included. Patient background data were collected, and the association between the patients’ clinical features and survival duration was analyzed.ResultsThe withdrawal group included 174 patients (79.8 ± 10.8 years old; 50.6% male; median dialysis vintage, 3.6 years). The most common reason for withdrawal (95%) was that hemodialysis was more harmful than beneficial because of the patient’s poor general condition. The median time from withdrawal to death was 4 days (interquartile range, 3–10 days). Multivariable Cox proportional regression analysis showed that oral nutrition (hazard ratio (HR), 1.98; 95% confidence interval (CI), 1.12–3.50; P = 0.03), hypoxemia (HR, 2.32; 95% CI, 1.55–3.47; P < 0.01), ventilator use (HR, 0.26; 95% CI, 0.11–0.58; P < 0.01), and pleural effusion (HR, 1.54; CI, 1.01–2.37; P = 0.04) were associated with increased survival duration. In contrast, antibiotics and vasopressor administration were not associated with the survival duration.ConclusionIn this study, we explored the parameters affecting the survival of patients who withdrew from hemodialysis. Physicians could use our results to establish more accurate predictions, which may help the patient and their family to emotionally accept and implement the desired care plan. More... »

PAGES

1022-1029

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-022-02242-9

DOI

http://dx.doi.org/10.1007/s10157-022-02242-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1148453250

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35666336


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