Dialysis withdrawal in The Netherlands between 2000 and 2019: time trends, risk factors and centre variation
| العنوان: | Dialysis withdrawal in The Netherlands between 2000 and 2019: time trends, risk factors and centre variation |
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| المؤلفون: | Mathijs van Oevelen, Willem Jan W Bos, Marjolijn van Buren, Marc A.G.J. ten Dam, Tiny Hoekstra, Alferso C. Abrahams, Marc H Hemmelder |
| المساهمون: | Nephrology, ACS - Diabetes & metabolism, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage |
| المصدر: | van Oevelen, M, Abrahams, A C, Bos, W J W, Hoekstra, T, Hemmelder, M H, ten Dam, M & van Buren, M 2021, ' Dialysis withdrawal in the Netherlands between 2000 and 2019 : Time trends, risk factors and centre variation ', Nephrology Dialysis Transplantation, vol. 36, no. 11, pp. 2112-2119 . https://doi.org/10.1093/ndt/gfab244 Nephrology Dialysis Transplantation, 36(11), 2112-2119. OXFORD UNIV PRESS Nephrology Dialysis Transplantation Nephrology Dialysis Transplantation, 36(11), 2112-2119. Oxford University Press |
| بيانات النشر: | OXFORD UNIV PRESS, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Advance care planning, end of life, Funnel plot, medicine.medical_specialty, HEMODIALYSIS, medicine.medical_treatment, Logistic regression, End stage renal disease, INITIATION, Renal Dialysis, Risk Factors, SUPPORTIVE CARE, medicine, Humans, Registries, STAGE KIDNEY-DISEASE, AcademicSubjects/MED00340, advance care planning, Dialysis, Netherlands, Cause of death, PERITONEAL-DIALYSIS, Transplantation, end-stage renal disease, OLDER PATIENTS, business.industry, Confounding, OF-LIFE, RANDOMIZED CONTROLLED-TRIAL, mortality, kidney failure, Nephrology, Emergency medicine, END, SURVIVAL, Kidney Failure, Chronic, Female, Original Article, Hemodialysis, business |
| الوصف: | Background Dialysis withdrawal is a common cause of death in dialysis-dependent patients. This study aims to describe dialysis withdrawal practice in The Netherlands, focussing on time trends, risk factors and centre variation. Methods Data were retrieved from the Dutch registry of kidney replacement therapy patients. All patients who started maintenance dialysis and died in the period 2000–2019 were included. The main outcome was death after dialysis withdrawal; all other causes of death were used for comparison. Time trends were analysed as unadjusted data (proportion per year) and the year of death was included in a multivariable logistic model. Univariable and multivariable analyses were performed to identify factors associated with withdrawal. Centre variation was compared using funnel plots. Results A total of 34 692 patients started dialysis and 18 412 patients died while on dialysis. Dialysis withdrawal was an increasingly common cause of death, increasing from 18.3% in 2000–2004 to 26.8% in 2015–2019. Of all patients withdrawing, 26.1% discontinued treatment within their first year. In multivariable analysis, increasing age, female sex, haemodialysis as a treatment modality and year of death were independent factors associated with death after dialysis withdrawal. Centre variation was large (80.7 and 57.4% within 95% control limits of the funnel plots for 2000–2009 and 2010–2019, respectively), even after adjustment for confounding factors. Conclusions Treatment withdrawal has become the main cause of death among dialysis-dependent patients in The Netherlands, with large variations between centres. These findings emphasize the need for timely advance care planning and improving the shared decision-making process on choosing dialysis or conservative care. |
| اللغة: | English |
| تدمد: | 0931-0509 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d45e952ddc669c04476fcecc26016d32 https://hdl.handle.net/1887/3277774 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....d45e952ddc669c04476fcecc26016d32 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09310509 |
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