Risk factors for dialysis withdrawal: An analysis of the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, 1999-2008

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dc.contributor.authorChan, H.
dc.contributor.authorClayton, P.
dc.contributor.authorMcDonald, S.
dc.contributor.authorAgar, J.
dc.contributor.authorJose, M.
dc.date.issued2012
dc.description.abstract<h4>Background and objectives</h4>Dialysis withdrawal (DW) in patients with ESRD is increasing in importance. This study assessed causes of death and risk factors for DW in Australia and New Zealand in the first year of dialysis.<h4>Design, setting, participants, & measurements</h4>This retrospective observational cohort study included all adult Australians and New Zealanders beginning renal replacement therapy in 1999-2008.<h4>Results</h4>A total of 24,884 patients with 10,073 deaths were included. Deaths from cardiac and social causes (predominantly DW) accounted for 38% and 28% of all deaths, respectively. Cumulative incidence of DW was 3.5% at 1 year (95% confidence interval [CI], 3.3%-3.8%), 9.0% at 3 years (95% CI, 8.6%-9.4%), and 13.4% at 5 years (95% CI, 12.8%-13.9%). In multivariate analysis, predictors for DW in the first year were older age (subhazard ratio [SHR], 1.70 per decade [95% CI, 1.59-1.83]; P<0.001), late referral (SHR, 1.83 [95% CI, 1.59-2.11]; P<0.001), comorbid conditions (SHR, 1.33 per each additional comorbid condition [95% CI, 1.25-1.41]; P<0.001), and diabetes (SHR, 1.16 [95% CI, 1.00-1.34]; P=0.05). Negative predictors for DW included male sex (SHR, 0.75 [95% CI, 0.66-0.87]; P<0.001), indigenous ethnicity (SHR, 0.74 [95% CI, 0.58-0.95]; P=0.02), other nonwhite race (SHR, 0.66 [95% CI, 0.48-0.91]; P=0.01), and peritoneal dialysis user (SHR, 0.59 [95% CI, 0.49-0.72]; P<0.001).<h4>Conclusions</h4>DW is common among dialysis patients in Australia and New Zealand. Risk factors include older age, female sex, white race, diabetes, higher comorbidity burden, hemodialysis user, and late referral to nephrologist.
dc.description.statementofresponsibilityHoi Wong Chan, Philip A. Clayton, Stephen P. McDonald, John W.M. Agar, Matthew D. Jose
dc.identifier.citationAmerican Society of Nephrology. Clinical Journal, 2012; 7(5):775-781
dc.identifier.doi10.2215/CJN.07420711
dc.identifier.issn1555-9041
dc.identifier.issn1555-905X
dc.identifier.orcidClayton, P. [0000-0001-9190-6753]
dc.identifier.orcidMcDonald, S. [0000-0001-6103-1386]
dc.identifier.urihttp://hdl.handle.net/2440/76514
dc.language.isoen
dc.publisherAmerican Society of Nephrology
dc.rightsCopyright © 2012 by the American Society of Nephrology
dc.source.urihttps://doi.org/10.2215/cjn.07420711
dc.subjectHumans
dc.subjectKidney Failure, Chronic
dc.subjectHeart Diseases
dc.subjectDiabetes Mellitus
dc.subjectWithholding Treatment
dc.subjectRenal Dialysis
dc.subjectPeritoneal Dialysis
dc.subjectRegistries
dc.subjectMultivariate Analysis
dc.subjectRetrospective Studies
dc.subjectAge Factors
dc.subjectComorbidity
dc.subjectSex Factors
dc.subjectTime Factors
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectReferral and Consultation
dc.subjectAustralia
dc.subjectNew Zealand
dc.subjectFemale
dc.subjectMale
dc.subjectAsian People
dc.subjectWhite People
dc.titleRisk factors for dialysis withdrawal: An analysis of the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, 1999-2008
dc.typeJournal article
pubs.publication-statusPublished

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