Survival of Hemodialysis Patients in the United States Is Improved With a Greater Quantity of Dialysis

摘要: The mortality rate for hemodialysis patients in the United States is higher than other industrialized countries. Some attribute this to insufficient quantities of prescribed and delivered dialysis. A multicenter study Dallas dialysis centers (Dallas Nephrology Associates) was begun 1989 assess impact increasing quantity on subsequent years. Dialysis dose measured by urea kinetic modeling. Kt/V, reflecting fractional volume body water clearance during a treatment, purposefully increased from 1.18 starting 1.46 1992. Additionally, reduction ratio, blood nitrogen concentration caused 63.0% 69.6% between 1990 Outcome analytical methods included both crude standardized rates ratios large end-stage renal disease databases at Renal Data System National Medical Care, Inc. Crude Associates decreased 22.5% 18.1% In comparison, 1992 ration Care facilities 57.1% 62.5%. During that time 21.8% 19.5%. remained essentially unchanged same period. By 1992, had 0.77 0.74, respectively, compared with US population, indicating almost 30% fewer observed deaths expected. Monitoring modeling or ratio are equally effective predicting improvement patient survival. Improved survival possible program greater amounts This strategy can save an estimated 8,000 16,000 lives per year.