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논문분류	춘계학술대회 초록집
제목	The Impact of Timing of Dialysis Initiation on Mortality in Patients with Peritnoeal Dialysis
저자	Kyung Yoon Chang1, Hyung Wook Kim1, Su-Hyun Kim2, Yong Kyun Kim1, Young Ok Kim1,Dong Chan Jin1, Ho Chul Song1, Euy Jin Choi1, Yong-Lim Kim3, Yon-Su Kim4,Shin-Wook Kang5, Nam-Ho Kim6, Chul Woo Yang1
출판정보	2014; 2014(1):
키워드	복막 투석, 사구체 여과율, 사망률
초록	Background: The impact of timing of dialysis initiation on mortality is controversial in patients with peritoneal dialysis (PD). In this study, we analyzed the impact of timing of dialysis initiation on mortality in the incident PD population. Methods: Incident patients with PD were selected from the Clinical Research Center (CRC) registry for end-stage renal disease (ESRD), a prospective cohort study on dialysis in Korea. Patients were categorized into three groups according to the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation at the initiation of PD. ‘group A’ was defined as eGFR <5 ml/min/1.73m2, ‘group B’ as 5-10 ml/min/1.73m2 and ‘group C’ as eGFR >10 ml/min/1.73m2 at the initiation of PD. Cox regression analysis was used to calculate the adjusted hazard ratio (HR) of mortality with late start group as the reference. The primary outcome was all-cause mortality. Results: A total of 495 incident PD patients were included. The number of patients in group A was 109, group B was 279 and group C was 107. The median follow-up period was 23 months. The group A had a significantly higher risk of all-cause mortality compared with the group B (HR 3.54, 95% CI, 1.39-9.06, p=0.008). There was no significant difference in mortality between the group C and the group B (HR 1.54, 95% CI, 0.62-3.87, p=0.354) after adjustment for clinical variables. Conclusion: Too-late start of PD (eGFR <5 ml/min/1.73m2 at the initiation of PD) was a significant risk factor for death, while early start of PD (eGFR >10 ml/min/1.73m2 at the initiation of PD) was not associated with improved survival compared with the group with eGFR 5-10 ml/min/1.73m2 at the initiation of PD.
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