Hemodialysis interval and its association with emergency care and mortality: A nationwide population-based cohort study


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Abstract

End-stage renal disease (ESRD) incidence in Taiwan is highest worldwide. This study analyzed the relationship between health resource use and patients on hemodialysis (HD) asking for medical help as well as the outcomes in Taiwan.This was a retrospective cohort study that analyzed the medical data of patients on dialysis, which were collected from the National Health Insurance Database of Taiwan for the period 2000 to 2010. The study sample was screened out, and new patients starting HD from 2001 to 2005 were considered.The daily distribution of patients with ESRD in the Monday, Wednesday, and Friday (MWF) and Tuesday, Thursday, and Saturday (TTS) groups who underwent emergent HD showed remarkable person–time on Monday and Tuesday, respectively. The disease (complication) distribution in the MWF group was higher than that in the TTS group, and the statistics of heart-failure-associated diseases were significantly different. Considering 5-year survival status, the mortality rate of patients with HD was 21.94% (255 of 1162), among which those with a history of cerebrovascular disease and diabetes were 68.63% and 72.16%, respectively.Long interdialytic intervals may induce emergency dialysis. Therefore, the frequency of emergent HD therapy has increased (thrice a week), as predicted in the current HD policy.

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