Pre-End-Stage Renal Disease Care and Early Survival among Incident Dialysis Patients in the US Military Health System

American Journal of Nephrology
Robert NeeKevin C Abbott

Abstract

Previous reports showed an increased early mortality after chronic dialysis initiation among the end-stage renal disease (ESRD) population. We hypothesized that ESRD patients in the Military Health System (MHS) would have greater access to pre-ESRD care and hence better survival rates during this early high-risk period. In this retrospective cohort study, using the US Renal Data System database, we identified 1,256,640 patients initiated on chronic dialysis from January 2, 2004 through December 31, 2014, from which a bootstrap sample of 3,984 non-MHS incident dialysis patients were compared with 996 MHS patients. We assessed care by a nephrologist and dietitian, erythropoietin administration, and vascular access use at dialysis initiation as well as all-cause mortality as outcome variables. MHS patients were significantly more likely to have had pre-ESRD nephrology care (adjusted OR [aOR] 2.9; 95% CI 2.3-3.7) and arteriovenous fistula used at dialysis initiation (aOR 2.2; 95% CI 1.7-2.7). Crude mortality rates peaked between the 4th and the 8th week for both cohorts but were reduced among MHS patients. The baseline adjusted Cox model showed significantly lower death rates among MHS vs. non-MHS patients at 6, 9, and 12 months. T...Continue Reading

References

Mar 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·G T Obrador, B J Pereira
Sep 29, 2001·Kidney International·R K DhingraF K Port
Dec 6, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·P JungersJ P Grünfeld
Jul 12, 2002·Kidney International·Stephen PastanWilliam M McClellan
Sep 17, 2002·Annals of Internal Medicine·Kraig S KinchenNeil R Powe
Jan 23, 2003·Journal of the American Society of Nephrology : JASN·Wolfgang C WinkelmayerJerry Avorn
Jan 29, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Austin G Stack
Sep 5, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michèle KesslerSerge Briançon
Oct 29, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jay L XueAllan J Collins
Jan 30, 2004·Journal of the American Society of Nephrology : JASN·Kevan R PolkinghornePeter G Kerr
May 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Vctor LorenzoJuan Carlos Ayus
Jun 17, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Waqar H KazmiAnnamaria T Kausz
Feb 9, 2005·Kidney International·Samina S KhanAllan J Collins
Mar 25, 2005·Journal of the American Society of Nephrology : JASN·Brad C AstorUNKNOWN CHOICE Study
Jan 7, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Vedat SchwengerEberhard Ritz
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Brian D BradburyBrenda W Gillespie
Oct 17, 2008·Hospital Topics·Brad BeauvaisEric Schmacker
Jan 20, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ronald L PisoniFriedrich K Port
Mar 6, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Takeshi HasegawaRonald L Pisoni
Jul 29, 2009·Archives of Internal Medicine·Elisabeth Botelho-NeversDidier Raoult
Aug 14, 2010·Journal of the American Society of Nephrology : JASN·Frank P HurstRahul M Jindal
Mar 23, 2011·Medical Care·Ann D BagchiThomas Croghan
Oct 1, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Kevin E ChanRaymond M Hakim
Apr 21, 2012·Journal of the American Society of Nephrology : JASN·Jane Paik KimWolfgang C Winkelmayer
Feb 23, 2013·Journal of the American Society of Nephrology : JASN·Pietro RavaniMatthew T James
Mar 19, 2013·Military Medicine·Kevin A DorranceHarry Fisher
Jun 27, 2013·Kidney International·Bruce M RobinsonRonald L Pisoni
Feb 14, 2014·Kidney International·Robert N FoleyAllan J Collins
Feb 21, 2014·Kidney International·Rajni SinghalMatthew J Oliver
Mar 20, 2014·American Journal of Nephrology·Areef IshaniAllan J Collins
Mar 5, 2015·JAMA Surgery·Mahmoud B MalasJulie A Freischlag
Nov 28, 2015·Clinical Kidney Journal·Brenda W GillespieRajiv Saran
Sep 9, 2016·Journal of the American Society of Nephrology : JASN·Robert S BrownAlexander S Goldfarb-Rumyantzev
Feb 2, 2017·Journal of the American Society of Nephrology : JASN·Robert R QuinnPietro Ravani

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Citations

May 16, 2017·American Journal of Nephrology·Jerry Yee, Ruth C Campbell
Oct 2, 2019·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Adil M Hazara, Sunil Bhandari
Aug 2, 2019·Current Opinion in Nephrology and Hypertension·Adil M Hazara, Sunil Bhandari
Sep 14, 2019·The Journal of Vascular Access·Rita L McGill, Eduardo K Lacson
Aug 13, 2021·Military Medicine·Trevor W TobinJohn S Thurlow

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