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논문분류	춘계학술대회 초록집
제목	Spherical Adsorptive Carbon Use and Risks of Dialysis Initiation and Mortality in Advanced Chronic Kidney Disease: A Real-world Cohort Study
저자	Hyo Jin Kim
출판정보	2026; 2026(1):
키워드	chronic kidney disease, dialysis, mortality, spherical adsorptive carbon, uremic toxin
초록	Objectives: The benefits of spherical adsorptive carbon for individuals with chronic kidney disease remain uncertain. This study investigated the association between spherical adsorptive carbon use, dialysis initiation, and all-cause mortality in patients with advanced chronic kidney disease using large-scale, real-world data. Methods: This multicenter, retrospective cohort study analyzed electronic health record data standardized through the Observational Medical Outcomes Partnership Common Data Model across three tertiary hospitals. Patients with chronic kidney disease and serum creatinine levels ≥2.0 mg/dL who received spherical adsorptive carbon at ≥4 g/day for ≥90 days were included, along with non-users. Risks of dialysis initiation and all-cause mortality were estimated using inverse probability of treatment weighting-weighted Cox proportional hazards models adjusted for relevant clinical variables. Results: Among 15,324 patients, 3,989 received spherical adsorptive carbon. Over a mean follow-up of 5.31 years, non-use of spherical adsorptive carbon was associated with a higher risk of dialysis initiation (hazard ratio, 1.13; 95% confidence interval, 1.02–1.24; P = 0.020). Non-users also demonstrated a higher risk across multiple subgroups, including patients aged <65 years, females, individuals with diabetes mellitus or hypertension, and those with estimated glomerular filtration rate values ≥30 mL/min/1.73 m². Additionally, spherical adsorptive carbon non-use was associated with increased all-cause mortality (hazard ratio, 1.66; 95% confidence interval, 1.49–1.85; P < 0.001). Conclusion: The use of spherical adsorptive carbon was associated with a lower risk of dialysis initiation and all-cause mortality in patients with advanced chronic kidney disease, suggesting a potential role for its use as an adjunctive therapy to slow disease progression.
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