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Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore.

Publication ,  Journal Article
Feng, L; Jin, AZ; Allen, JC; Chow, KY; Jafar, TH
Published in: BMC nephrology
May 2017

The benefit of early dialysis initiation remains controversial with a paucity of data in Asians. Therefore, we undertook this study to investigate the association between timing of initiation of dialysis and mortality in Singapore.The study used data from the Singapore Renal Registry database on 3286 patients with incident end-stage renal disease (ESRD) who commenced maintenance dialysis between January 2008 and December 2011. The data was further linked with the National Death Registry to acquire survival information until December 2013. We classified serum creatinine-based, estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation at the start of dialysis into 3 categories: Early (≥10 ml/min/1.73m2), intermediate (5 to <10 ml/min/1.73m2) and late (<5 ml/min/1.73m2).In the unadjusted analysis, both early and intermediate dialysis initiation groups were at greater risk of death relative to late dialysis (Early: HR = 2.47; Intermediate: HR = 1.54). In the multivariate model, a significant interaction was detected between age and eGFR at dialysis initiation (p = 0.04). Adjusted mortality risk progressively increased with earlier initiation of dialysis for patients aged 18-54 years (p = 0.006) and aged 55 to 64 years (p < 0.001), and no statistically significant difference was observed for patients aged 65 years or older (p = 0.12).Early versus later initiation of dialysis was associated with significantly higher risk of mortality in Singapore's non-elderly population, and appeared to offer no survival advantage among the elderly.

Duke Scholars

Published In

BMC nephrology

DOI

EISSN

1471-2369

ISSN

1471-2369

Publication Date

May 2017

Volume

18

Issue

1

Start / End Page

176

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Time-to-Treatment
  • Survival Rate
  • Singapore
  • Risk Factors
  • Renal Dialysis
  • Registries
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Feng, L., Jin, A. Z., Allen, J. C., Chow, K. Y., & Jafar, T. H. (2017). Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore. BMC Nephrology, 18(1), 176. https://doi.org/10.1186/s12882-017-0590-x
Feng, Liang, Ai Zhen Jin, John Carson Allen, Khuan Yew Chow, and Tazeen Hasan Jafar. “Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore.BMC Nephrology 18, no. 1 (May 2017): 176. https://doi.org/10.1186/s12882-017-0590-x.
Feng L, Jin AZ, Allen JC, Chow KY, Jafar TH. Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore. BMC nephrology. 2017 May;18(1):176.
Feng, Liang, et al. “Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore.BMC Nephrology, vol. 18, no. 1, May 2017, p. 176. Epmc, doi:10.1186/s12882-017-0590-x.
Feng L, Jin AZ, Allen JC, Chow KY, Jafar TH. Timing of commencement of maintenance dialysis and mortality in young and older adults in Singapore. BMC nephrology. 2017 May;18(1):176.
Journal cover image

Published In

BMC nephrology

DOI

EISSN

1471-2369

ISSN

1471-2369

Publication Date

May 2017

Volume

18

Issue

1

Start / End Page

176

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Time-to-Treatment
  • Survival Rate
  • Singapore
  • Risk Factors
  • Renal Dialysis
  • Registries
  • Middle Aged
  • Male