Length with Mortality in Australia and New Zealand

This study was reported simultaneously [4] with the DOPPS study. It was an OS using data from the Australia New Zealand Dialysis Registry (ANZDATA). It is of interest to note that 20% of patients in ANZADATA are on home dialysis which is not a generalizable therapy category with external validity in view of the very low frequency of home dialysis in most countries. Further, the dialyzers most often used are low flux which also raises question about the generalizability of the data. Certainly arguments about time and minimum mortality cannot be compared in low flux compared to high flux therapy.

The reported outcome as a function of treatment time and Kt//V in the ANZDATA study are shown in figure 14. The analyses of categorical outcomes follow the typical

1.00 0.90 -0.80 -0.70 -0.60 -0.50 -0.40 -0.30 -0.20 -0.10 0

3. EDTA, Age- and DM-matched

4. Australia, Age- and DM-matched

5. Japan, Age-matched DM?

6. USA, Age- and DM-matched

3. EDTA, Age- and DM-matched

4. Australia, Age- and DM-matched

5. Japan, Age-matched DM?

6. USA, Age- and DM-matched

Follow-up (years)

Fig. 15. Mortality rate in hemodialysis patients is dependent on the quality of treatment time not necessarily the quantity of treatment time. From Gotch and Uehlinger [12].

linear response seen with a dose targeting error in OS for both treatment time and Kt/V. The authors also reported a continuous polynomial U-shaped regression which they used to locate an inflection point of minimum mortality in the region of 4-5 h which is contradictory to the categorical analysis.

0 0

Post a comment