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Volume 77, Issue 7, Pages 630-636 (April 2010)
Shorter dialysis times are associated with higher mortality among incident hemodialysis patients Steven M. Brunelli, Glenn M. Chertow, Elizabeth D. Ankers, Edmund G. Lowrie, Ravi Thadhani Kidney International Volume 77, Issue 7, Pages (April 2010) DOI: /ki Copyright © 2010 International Society of Nephrology Terms and Conditions
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Figure 1 Observed hemodialysis session lengths among study cohort. (a) Distribution of observed session length at baseline (n=8552). (b) Representative transitions among strata of session length at baseline, months 3 and 6. At the start of at-risk time (at-risk day 0, corresponding to dialysis day 31), 2020 (23.6%) patients had session length ≤180 min; of these 303 (15.0%), 703 (34.8%), and 852 (42.2%) had session length of ≥240, 181–239, and ≤180 min, respectively, at the start of month 3; the remaining 162 (8.0%) had died or were censored by that time. Interpretation is analogous for other session-length strata and time intervals. Kidney International , DOI: ( /ki ) Copyright © 2010 International Society of Nephrology Terms and Conditions
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Figure 2 Hazard ratios (95% CIs) for all-cause mortality for shorter session length (<240 min) in baseline, time-updated, and marginal structural analyses. The referent category is session length ≥240 min (hazard ratio=1 by definition; not shown). Gray bars represent unadjusted estimates. White bars represent estimates adjusted for age, sex, race (white versus nonwhite), vascular access (fistula, graft, catheter), body mass index (≤20, 20–25, 25–30, and >30 kg/m2), congestive heart failure, eKt/V (≤1.0, 1.0–1.2, 1.2–1.4, 1.4–1.6, >1.6), systolic blood pressure, serum albumin, and creatinine. CI, confidence interval. Kidney International , DOI: ( /ki ) Copyright © 2010 International Society of Nephrology Terms and Conditions
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Figure 3 Adjusted hazard ratios (95% CIs) for all-cause mortality for shorter session length (<240 min) in prespecified subgroups. The referent category was session length ≥240 min. Estimates were adjusted through marginal structural analysis in an analogous manner to that used in the primary analysis; stabilized weights were reestimated for each subgroup. Baseline (B/l) eKt/V and congestive heart failure (CHF) refer to those values updated through dialysis day 30; baseline hospitalization refers to any hospitalization occurring between dialysis days 0–30. Kidney International , DOI: ( /ki ) Copyright © 2010 International Society of Nephrology Terms and Conditions
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Figure 4 Association between incremental decrements in session length and all-cause mortality. White bars represent session length ≤180 min, gray bars 181–239 min; the referent category was session length ≥240 min (hazard ratio=1 by definition; not shown). Marginal structural analyses were adjusted for age, sex, race (white versus nonwhite), vascular access (fistula, graft, catheter), body mass index (≤20, 20–25, 25–30, >30 kg/m2), congestive heart failure, eKt/V (≤1.0, 1.0–1.2, 1.2–1.4, 1.4–1.6, >1.6), systolic blood pressure, serum albumin, and creatinine. MSM, marginal structural model Kidney International , DOI: ( /ki ) Copyright © 2010 International Society of Nephrology Terms and Conditions
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