Dialysis outcomes and analysis of practice patterns suggests the dialysis schedule affects day-of-week mortality

摘要: The risk of death for hemodialysis patients is thought to be highest on the days following longest interval without dialysis (usually Mondays and Tuesdays); however, existing results are inconclusive. To clarify this we analyzed Dialysis Outcomes Practice Patterns Study (DOPPS) data 22,163 from United States, Europe, Japan. Our study focused association between schedule day week all-cause, cardiovascular, noncardiovascular mortality with day-of-week coded as a time-dependent covariate. models were adjusted schedule, age, country, DOPPS phase I or II, other demographic clinical covariates, compared each 7-day average. Patients Monday-Wednesday-Friday (MWF) had elevated all-cause Mondays, those Tuesday-Thursday-Saturday (TTS) increased Tuesdays in all three regions. was generally stronger cardiovascular than mortality, most pronounced States. Unexpectedly, Japanese MWF higher Fridays, European TTS experienced an Saturdays. Thus, future studies needed evaluate influence practice patterns schedule-specific factors that could modulate effect.