Revisiting Interdialytic Weight Gain and Mortality Association With Serum Albumin Interactions: The Japanese Dialysis Outcomes and Practice Pattern Study 

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Revisiting Interdialytic Weight Gain and Mortality Association With Serum Albumin Interactions: The Japanese Dialysis Outcomes and Practice Pattern Study  Noriaki Kurita, MD, PhD, FACP, Yasuaki Hayashino, MD, DMSc, MPH, Shin Yamazaki, PhD, Tadao Akizawa, MD, PhD, Takashi Akiba, MD, PhD, Akira Saito, MD, PhD, Shunichi Fukuhara, MD, DMSc, MACP  Journal of Renal Nutrition  Volume 27, Issue 6, Pages 421-429 (November 2017) DOI: 10.1053/j.jrn.2017.05.003 Copyright © 2017 The Authors Terms and Conditions

Figure 1 Conceptual framework used in time-varying Cox models. IDWG, interdialytic weight gain; nPCR, normalized protein catabolic rate; sp-Kt/V, single-pool Kt/V; Ca, serum calcium; P, serum phosphorus. Journal of Renal Nutrition 2017 27, 421-429DOI: (10.1053/j.jrn.2017.05.003) Copyright © 2017 The Authors Terms and Conditions

Figure 2 Association between interdialytic weight gain and mortality by serum albumin subcategories (n = 8,661).a aEstimated from time-varying Cox regression models stratified by Dialysis Outcomes and Practice Pattern Study phase considering cluster effects by facilities, with restricted cubic spline (with 3 knots, P for nonlinearity <.001) adjusted for covariates (age, gender, renal disease, vintage, residual renal function, body mass index, comorbid conditions [hypertension, diabetes, coronary artery disease, congestive heart failure, other cardiovascular disease, cerebrovascular disease, lung disease, and malignancy] and laboratory measurements [hemoglobin, serum total calcium, serum phosphorus, single-pool Kt/V, and normalized protein catabolic rate]) and treatment time. Within each serum albumin subcategory, the hazard ratios were estimated with a reference interdialytic weight gain of 3% because serum albumin modified the association between the interdialytic weight gain and mortality (P for interaction <.001). Journal of Renal Nutrition 2017 27, 421-429DOI: (10.1053/j.jrn.2017.05.003) Copyright © 2017 The Authors Terms and Conditions