TY - JOUR
T1 - Is the decline of renal function different before and after the start of dialysis?
AU - de Jager, Dinanda J.
AU - Halbesma, Nynke
AU - Krediet, Raymond T.
AU - Boeschoten, Elisabeth W.
AU - le Cessie, Saskia
AU - Dekker, Friedo W.
AU - Grootendorst, Diana C.
AU - AUTHOR GROUP
AU - Apperloo, A. J.
AU - Bijlsma, J. A.
AU - Boekhout, M.
AU - Boer, W. H.
AU - van der Boog, P. J. M.
AU - Büller, H. R.
AU - van Buren, M.
AU - de Charro, F. Th
AU - Doorenbos, C. J.
AU - van den Dorpel, M. A.
AU - van Es, A.
AU - Fagel, W. J.
AU - Feith, G. W.
AU - de Fijter, C. W. H.
AU - Frenken, L. A. M.
AU - van Geelen, J. A. C. A.
AU - Gerlag, P. G. G.
AU - Grave, W.
AU - Gorgels, J. P. M. C.
AU - Huisman, R. M.
AU - Jager, K. J.
AU - Jie, K.
AU - Koning-Mulder, W. A. H.
AU - Koolen, M. I.
AU - Hovinga, T. K. Kremer
AU - Lavrijssen, A. T. J.
AU - Luik, A. J.
AU - van der Meulen, J.
AU - Parlevliet, K. J.
AU - Raasveld, M. H. M.
AU - van der Sande, F. M.
AU - Schonck, M. J. M.
AU - Schuurmans, M. M. J.
AU - Siegert, C. E. H.
AU - Stegeman, C. A.
AU - Stevens, P.
AU - Thijssen, J. G. P.
AU - Valentijn, R. M.
AU - Vastenburg, G. H.
AU - Verburgh, C. A.
AU - Vincent, H. H.
AU - Vos, P. F.
PY - 2013
Y1 - 2013
N2 - The presence of glomerular filtration in dialysis patients is associated with improved survival and quality of life. This study explores the time course of the glomerular filtration rate (GFR) between 1 year before and 1 year after the start of haemodialysis (HD) and peritoneal dialysis (PD). This study included 1861 incident dialysis patients (NECOSAD cohort; 62% male, 60 ± 15 years, 61% HD, GFR 5.2 ± 3.6 mL/min/1.73 m(2)). A decline of the GFR was estimated using linear mixed-effects models adjusted for age, sex, primary kidney disease, cardiovascular disease and diabetes. The rate of decline was allowed to change at a certain point in time. The decline of the GFR attenuated from -0.53 mL/min/1.73 m(2)/month (95% CI: -0.58, -0.48) in the period before the start of dialysis to -0.12 (95% CI: -0.20, -0.04) at 2-4 months of dialysis in all patients. In HD, decline attenuated from -0.51 (95% CI: -0.57, -0.44) to -0.14 (95% CI: -0.26, -0.02); in PD from -0.55 (95% CI: -0.62, -0.48) to -0.11 (95% CI: -0.23, 0.01). In patients who started dialysis with a GFR equal/above median GFR at dialysis start, the decline attenuated (at 3 months) from -0.70 (95% CI: -0.78; -0.62) to -0.21 (95% CI: -0.36; -0.05). In patients who started dialysis with a GFR below median GFR at dialysis start, the decline attenuated (at 1 month) from -0.73 (95% CI: -0.88; -0.58) to -0.04 (95% CI: -0.27 , 0.19). The apparent decline of the GFR slows down after 2-4 months of dialysis. This decline was similar in HD and PD patients, although at a different level of GFR. Further studies are needed to examine explanations for this phenomenon
AB - The presence of glomerular filtration in dialysis patients is associated with improved survival and quality of life. This study explores the time course of the glomerular filtration rate (GFR) between 1 year before and 1 year after the start of haemodialysis (HD) and peritoneal dialysis (PD). This study included 1861 incident dialysis patients (NECOSAD cohort; 62% male, 60 ± 15 years, 61% HD, GFR 5.2 ± 3.6 mL/min/1.73 m(2)). A decline of the GFR was estimated using linear mixed-effects models adjusted for age, sex, primary kidney disease, cardiovascular disease and diabetes. The rate of decline was allowed to change at a certain point in time. The decline of the GFR attenuated from -0.53 mL/min/1.73 m(2)/month (95% CI: -0.58, -0.48) in the period before the start of dialysis to -0.12 (95% CI: -0.20, -0.04) at 2-4 months of dialysis in all patients. In HD, decline attenuated from -0.51 (95% CI: -0.57, -0.44) to -0.14 (95% CI: -0.26, -0.02); in PD from -0.55 (95% CI: -0.62, -0.48) to -0.11 (95% CI: -0.23, 0.01). In patients who started dialysis with a GFR equal/above median GFR at dialysis start, the decline attenuated (at 3 months) from -0.70 (95% CI: -0.78; -0.62) to -0.21 (95% CI: -0.36; -0.05). In patients who started dialysis with a GFR below median GFR at dialysis start, the decline attenuated (at 1 month) from -0.73 (95% CI: -0.88; -0.58) to -0.04 (95% CI: -0.27 , 0.19). The apparent decline of the GFR slows down after 2-4 months of dialysis. This decline was similar in HD and PD patients, although at a different level of GFR. Further studies are needed to examine explanations for this phenomenon
U2 - https://doi.org/10.1093/ndt/gfs578
DO - https://doi.org/10.1093/ndt/gfs578
M3 - Article
C2 - 23300262
SN - 0931-0509
VL - 28
SP - 698
EP - 705
JO - Nephrology, dialysis, transplantation
JF - Nephrology, dialysis, transplantation
IS - 3
ER -