Abstract：
BACKGROUND: Functional decline occurs during dialysis initiation, particularly in unplanned cases. To prevent unplanned hemodialysis, we aimed to identify associated factors from the first referral to the nephrology department to hemodialysis initiation and assess patient prognosis post-unplanned hemodialysis initiation.
METHODS: This retrospective study involved 257 Japanese patients initiating hemodialysis and compared patient characteristics based on whether hemodialysis was planned or unplanned at a single center. Patient outcomes were evaluated in collaboration with maintenance hemodialysis centers.
RESULTS: Unplanned hemodialysis initiation correlated with heart failure history (p < 0.05) and infections like pneumonia (p < 0.001). Patients with unplanned hemodialysis initiation had a worse prognosis than those with planned initiation (p < 0.001), and multivariable Cox regression showed it as an independent risk factor for death (p < 0.05).
CONCLUSIONS: Hygiene and careful attention to heart failure may reduce unplanned hemodialysis and improve patient well-being and healthcare efficiency. This retrospective analysis highlights crucial considerations for optimizing the initiation of hemodialysis.
METHODS: This retrospective study involved 257 Japanese patients initiating hemodialysis and compared patient characteristics based on whether hemodialysis was planned or unplanned at a single center. Patient outcomes were evaluated in collaboration with maintenance hemodialysis centers.
RESULTS: Unplanned hemodialysis initiation correlated with heart failure history (p < 0.05) and infections like pneumonia (p < 0.001). Patients with unplanned hemodialysis initiation had a worse prognosis than those with planned initiation (p < 0.001), and multivariable Cox regression showed it as an independent risk factor for death (p < 0.05).
CONCLUSIONS: Hygiene and careful attention to heart failure may reduce unplanned hemodialysis and improve patient well-being and healthcare efficiency. This retrospective analysis highlights crucial considerations for optimizing the initiation of hemodialysis.
摘要：
背景：透析开始时出现功能下降，特别是在计划外的情况下。为了防止计划外的血液透析,我们旨在确定从首次转诊到肾内科至开始血液透析的相关因素,并评估非计划血液透析开始后患者的预后.
方法：这项回顾性研究纳入了257名开始血液透析的日本患者，并根据血液透析在一个中心是计划的还是非计划的比较了患者的特征。与维持性血液透析中心合作评估患者的预后。
结果：非计划性血液透析开始与心力衰竭病史（p<0.05）和肺炎等感染（p<0.001）相关。非计划开始血液透析的患者比计划开始血液透析的患者预后差（p<0.001），多因素Cox回归分析显示为死亡的独立危险因素(p<0.05)。
结论：卫生和对心力衰竭的仔细关注可以减少非计划的血液透析，提高患者的健康和医疗效率。这项回顾性分析强调了优化血液透析启动的关键考虑因素。
方法：这项回顾性研究纳入了257名开始血液透析的日本患者，并根据血液透析在一个中心是计划的还是非计划的比较了患者的特征。与维持性血液透析中心合作评估患者的预后。
结果：非计划性血液透析开始与心力衰竭病史（p<0.05）和肺炎等感染（p<0.001）相关。非计划开始血液透析的患者比计划开始血液透析的患者预后差（p<0.001），多因素Cox回归分析显示为死亡的独立危险因素(p<0.05)。
结论：卫生和对心力衰竭的仔细关注可以减少非计划的血液透析，提高患者的健康和医疗效率。这项回顾性分析强调了优化血液透析启动的关键考虑因素。
