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논문분류	춘계학술대회 초록집
제목	Technique Failure among Korean Incident Dialysis Patients: A National Population-based Study
저자	Shina Lee1, Hyunwook Kim3, Hyeong Sik Ahn4, Hoojae Hann2, Kyoung Hoon Kim5, Seung-Jung Kim1, Duk-Hee Kang1, Kyu Bok Choi1, Dong-Ryeol Ryu1
출판정보	2015; 2015(1):
키워드	기술실패, 혈액투석, 복막투석
초록	Technique failure is a major burden for dialysis patients. In this study, we aimed to analyze a detailed technique failure rate and to determine the predictors for technique failure, using the Korean Health Insurance Review and Assessment Service (HIRA) database. We included all patients who had started dialysis between January 1, 2005 and December 31, 2008 in Korea, and analyzed 32,357 eligible patients [24,743 hemodialysis (HD) patients and 7,614 peritoneal dialysis (PD) patients]. During the median follow-up of 26.4 months, the crude incidence rates of technique failure among HD patients and PD patients were 3.4 and 54.1 per 1000 patient-years, respectively. When comparing technique survival rate between HD and PD in Kaplan-Meyer analysis and competing risks analysis, it was significantly higher in patients on HD than in those on PD. However, the gap of technique failure incidence between HD and PD was exaggerated in Kaplan- Meier analysis compared to competing risks analysis. In multivariate analyses, diabetes mellitus and Medical aid as a crude reflection of low socioeconomic status were independent risk factors in both Cox proportional hazard model and Fine and Gray subdistribution model. In addition, cancer was independently associated with a lower risk of technique failure in Fine and Gray model. In conclusion, technique failure in PD is higher than that in HD, and it is major concern in patients initiating dialysis in Korea. The results of our study offer a basis for risk stratification and customized care for technique failure, particularly in Asian dialysis patients.
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