The Effect of Residual Renal Function at the Initiation of Dialysis on Patient Survival

The Korean Journal of Internal Medicine 2009년 24권 1호 p.55 ~ p.62

김성구(Kim Seoung-Gu) - 광양사랑병원 내과
김남호(Kim Nam-Ho) - 전남대학교 의과대학 내과학교실

Abstract

Background/Aims: The optimal time point for initiating renal replacement therapy in patients with end-stage renal disease remains controversial. The primary objective of our study was to determine the effects of residual renal function at the beginning of renal replacement therapy on the mortality of patients with end-stage renal disease.

Methods:We retrospectively studied the clinical outcomes in patients (n=210) with end-stage renal disease who underwent renal replacement therapy at our hospital between 2000 and 2005; all patients were followed for more than 1 year. We used the Modification of Diet in Renal Disease equation to estimate residual renal function.

Results:Of the 210 patients who received renal replacement therapy, 108 were treated with hemodialysis and 102 were treated with peritoneal dialysis. Thirty-three patients died, and the mean survival period was 37.3?7.7 months. The survival rates were compared based on the estimated glomerular filtration rate; no difference in survival rates was observed (p=0.27). Subgroup analysis in the hemodialysis group showed that patients who began chronic dialysis at a lower estimated glomerular filtration rate had higher mortality rates (p<0.05); patients treated with peritoneal dialysis showed no significant difference in mortality rate (p=0.50).

Conclusion:Although there was no difference in the mortality rate based on residual renal function, hemodialysis patients with a lower estimated glomerular filtration rate showed a higher mortality rate than those with a higher estimated glomerular filtration rate.

키워드

End-stage renal disease, Renal replacement therapy, Prognosis
원문 및 링크아웃 정보
등재저널 정보
SCI(E) MEDLINE 학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
The survival rates in hemodialysis and peritoneal dialysis patients did not differ regardless of the cause for initiating renal replacement therapy (RRT).
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드