Missed Hemodialysis Treatments: International Variation, Predictors, and Outcomes in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Issa Al SalmiRonald L Pisoni

Abstract

Missed hemodialysis (HD) treatments not due to hospitalization have been associated with poor clinical outcomes and related in part to treatment nonadherence. Using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 5 (2012-2015), we report findings from an international investigation of missed treatments among patients prescribed thrice-weekly HD. Prospective observational study. 8,501 patients participating in DOPPS, on HD therapy for more than 120 days, from 20 countries. Longitudinal and cross-sectional analyses were performed based on the 4,493 patients from countries in which 4-month missed treatment risk was > 5%. The main predictor of patient outcomes was 1 or more missed treatments in the 4 months before DOPPS phase 5 enrollment; predictors of missed treatments included country, patient characteristics, and clinical factors. Mortality, hospitalization, laboratory measures, patient-reported outcomes, and 4-month missed treatment risk. Outcomes were assessed using Cox proportional hazards, logistic, and linear regression, adjusting for case-mix and country. The 4-month missed treatment risk varied more than 50-fold across all 20 DOPPS countries, ranging from < 1% in Italy and Japan to 24% in the Un...Continue Reading

Citations

Mar 4, 2019·Seminars in Dialysis·Richard A Sherman
May 28, 2019·International Journal of Environmental Research and Public Health·Beata Hornik, Jan Duława
Oct 7, 2020·The Journal of Vascular Access·Seung Don BaekJae-Young Kang
Oct 10, 2020·Seminars in Dialysis·Karumathil M Murali, Maureen Lonergan
Jun 2, 2021·Journal of Cachexia, Sarcopenia and Muscle·Hirotaka KomabaMasafumi Fukagawa

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