New statistical method shows importance of dialysis dose

Jul 30, 2009

A new approach to statistical analysis may be better suited to study the relationship between higher "dose" of dialysis and survival time for patients with advanced kidney disease, according to an upcoming paper in the Journal of the American Society of Nephrology (JASN).

Some studies have shown longer survival times for patients receiving a higher dose of , while others show no such relationship. Thus, Christos Argyropoulos, MD, PhD (University of Pittsburgh Medical Center) and colleagues analyzed data from a large group of U.S. dialysis patients using the new statistical technique as well as conventional methods.

The "accelerated failure time" model (inspired by considerations of what happens when kidneys cease working and many unidentified toxins start building up in the patient's bloodstream) showed longer survival times at a higher dose of dialysis, compared to no significant effect with the conventional model. Upon analysis using this technique, patient survival increased steadily along with dialysis dose, after adjustment for other risk factors (age, heart disease, diabetes, comorbid conditions, etc).

The results suggest that the conflicting results of previous studies may be related to the limitations of the statistical methods used. Small to moderately sized clinical trials may be particularly sensitive to this effect, adds Argyropoulos. "From a public health perspective, it may be reasonable to re-examine the clinical trial data with unconventional, yet scientifically valid statistical techniques and encourage relevant basic research in statistics and epidemiology to facilitate future clinical studies in this area."

The study was limited by the lack of follow-up information on the dose of dialysis the patients received at multiple clinic visits. "Consequently, no conclusions could or should be drawn about the validity of existing national and international guidelines concerning an adequate dialysis dose," says Argyropoulos. He also stresses that the findings cannot be generalized to non-U.S. .

More information: The study entitled, "Considerations in the Statistical Analysis of Hemodialysis Patient Survival," will appear online on July 30, 2009, doi 10.1681/ASN.2008050551 .

Source: American Society of Nephrology (news : web)

Explore further: Senegal closes border as UN warns on Ebola flare-up

add to favorites email to friend print save as pdf

Related Stories

Before starting dialysis, patients need nephrologist care

Mar 25, 2009

For patients with end-stage renal disease (ESRD), receiving care from a nephrologist in the months before starting dialysis reduces the risk of death during the first year on dialysis, reports a study in the May 2009 issue ...

Sleeping through dialysis: No nightmare for kidney patients

May 21, 2009

Dialysis takes hours of kidney disease patients' time several days a week, so why not do it at night while sleeping? Overnight dialysis is more convenient for some patients and offers significant benefits over shorter daytime ...

Overnight hemodialysis dramatically improves survival

Nov 08, 2008

For hemodialysis patients, undergoing dialysis for eight hours overnight, three times weekly, reduces the risk of death by nearly 80 percent, compared to conventional, four-hour dialysis, according to research being presented ...

Recommended for you

Senegal closes border as UN warns on Ebola flare-up

2 hours ago

Senegal has become the latest country to seal its border with a west African neighbour to ward off the deadly Ebola virus, as the new UN pointman on the epidemic said preparations must be made for a possible flare-up of the ...

Climate change could see dengue fever come to Europe

2 hours ago

Dengue fever could make headway in popular European holiday destinations if climate change continues on its predicted trajectory, according to research published in open access journal BMC Public Health.

American Ebola doc: 'I am thrilled to be alive'

10 hours ago

Calling it a "miraculous day," an American doctor infected with Ebola left his isolation unit and warmly hugged his doctors and nurses on Thursday, showing the world that he poses no public health threat ...

User comments : 0