Abstract
Aim: To determine the relationship of dialysis attendance with wait‐listing for kidney transplantation (KT) among NT based end stage kidney disease (ESKD) patients.
Background: Substantial differences exist in the rates of wait‐listing of Indigenous ESKD patients. Little is known about the association of dialysis attendance and wait‐listing. When dialysis attendance is less than prescribed, it may affect nephrologists’ decision whether or not to refer patient for transplantation due to concerns about outcomes in the post‐transplant period. We examined the relationship of facility haemodialysis (FHD) attendance with wait‐listing in NT based ESKD patients.
Methods: We used NT hospital separations data, linked with waiting‐list, demographic, comorbidity and transplant related information from the ANZDATA registry. Inclusion criteria: NT based ESKD patients who started renal replacement therapy between 28th June 2006 and 31st December 2011, were on FHD and wait‐listed by 30th June 2012 censored for transplantation, death, renal recovery and lost to follow‐up (n=295). Outcome measure: first active placement on waiting list. Predictors: attendance at FHD during the study period.
Results: Of 295 participants, 266 (90.2%) were Indigenous. Based on mean weekly FHD attendance, patients were divided in three groups: >2.75/week (n=106), 2.5 to 2.75/week (n=55) and <2.5/week (n=134). 21 patients (7.0%) were listed, of whom 15 (71.4%) received deceased donor transplants. Of 19 KT, there were 4 (21.04%) live donor transplants. Compared to >2.75 dialysis sessions/week, likelihood for listing was similar in those attending 2.5‐2.75/week (HR 0.8 [95% CI 0.2‐4.2]) and < 2.5/ week, (HR 1.7 [0.5‐5.5]).
Conclusions: In the NT, rates of placement on the waiting list among those receiving FHD are low. FHD attendance was not associated with wait‐listing, although the statistical power was limited.
Background: Substantial differences exist in the rates of wait‐listing of Indigenous ESKD patients. Little is known about the association of dialysis attendance and wait‐listing. When dialysis attendance is less than prescribed, it may affect nephrologists’ decision whether or not to refer patient for transplantation due to concerns about outcomes in the post‐transplant period. We examined the relationship of facility haemodialysis (FHD) attendance with wait‐listing in NT based ESKD patients.
Methods: We used NT hospital separations data, linked with waiting‐list, demographic, comorbidity and transplant related information from the ANZDATA registry. Inclusion criteria: NT based ESKD patients who started renal replacement therapy between 28th June 2006 and 31st December 2011, were on FHD and wait‐listed by 30th June 2012 censored for transplantation, death, renal recovery and lost to follow‐up (n=295). Outcome measure: first active placement on waiting list. Predictors: attendance at FHD during the study period.
Results: Of 295 participants, 266 (90.2%) were Indigenous. Based on mean weekly FHD attendance, patients were divided in three groups: >2.75/week (n=106), 2.5 to 2.75/week (n=55) and <2.5/week (n=134). 21 patients (7.0%) were listed, of whom 15 (71.4%) received deceased donor transplants. Of 19 KT, there were 4 (21.04%) live donor transplants. Compared to >2.75 dialysis sessions/week, likelihood for listing was similar in those attending 2.5‐2.75/week (HR 0.8 [95% CI 0.2‐4.2]) and < 2.5/ week, (HR 1.7 [0.5‐5.5]).
Conclusions: In the NT, rates of placement on the waiting list among those receiving FHD are low. FHD attendance was not associated with wait‐listing, although the statistical power was limited.
| Original language | English |
|---|---|
| Pages (from-to) | 21-21 |
| Number of pages | 1 |
| Journal | Nephrology |
| Volume | 22 |
| Issue number | S3 |
| Early online date | 30 Aug 2017 |
| DOIs | |
| Publication status | Published - 1 Sept 2017 |