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Table of Contents
Vol. 121, No. 1-2, 2012
Issue release date: December 2012
Section title: Original Paper
Nephron Clin Pract 2012;121:c54–c59
(DOI:10.1159/000342389)

Four Decades of Chronic Haemodialysis: Lessons from the Past and Implications for the Future

Prabhavalkar S.M.a · Verghis R.b · McNamee P.T.a · Courtney A.E.a
aRegional Nephrology Unit, Belfast City Hospital, and bNorthern Ireland Clinical Research and Support Centre, Royal Victoria Hospital, Belfast, UK

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 22, 2012
Accepted: August 03, 2012
Published online: October 19, 2012
Issue release date: December 2012

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: There have been substantial changes in the provision of chronic haemodialysis (HD) therapy over time, yet data regarding the impact of these differences on clinical outcomes are limited. Aim: To identify factors which have significantly changed over the last 40 years in relation to patients receiving maintenance HD therapy. Methods: All 2,647 patients who were established on the chronic HD programme in Northern Ireland between 1970 and 2010 were included. Clinical data and survival outcomes were obtained from a prospectively recorded database. The study period was divided into four decades in order to assess the temporal changes. Results: The total number of patients receiving HD therapy has risen, and the mean age of the HD population has increased significantly (39.0 years in the 1970s vs. 66.8 years in the 2000s, p < 0.001). Diabetic nephropathy has emerged as the commonest aetiology for ESRD (0% in the 1970s to 20.3% in the 2000s, p < 0.001). The median survival of patients on HD has improved significantly over time from 5.2 months (95% CI 2.6–15.5) in the 1970s to 41.7 months (95% CI 38–45.2) in the 2000s (p < 0.0001). Factors that remained significant in determining survival were age, primary renal diagnosis, and decade of commencement of dialysis. Conclusions: Survival on HD has significantly improved despite older patients with multiple co-morbidities being accepted for treatment reflecting both increased dialysis frequency and better management of cardiovascular risk factors. The increasing age of HD patients and their improved survival have implications for future planning and delivery of dialysis.

© 2012 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 22, 2012
Accepted: August 03, 2012
Published online: October 19, 2012
Issue release date: December 2012

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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