Title :

Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model

Author(s) :

BEUSCART, Jean-Baptiste [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Pagniez, Dominique [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Boulanger, Eric [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Journal title :

Journal of epidemiology

Abbreviated title :

J. Epidemiol.

Volume number :

25

Pages :

133-141

Publication date :

2015-02-01

ISSN :

0917-5040

Keyword(s) :

Mesh:Female
Mesh:Comorbidity
Mesh:Follow-Up Studies
Mesh:France/epidemiology
Mesh:Humans
Mesh:Kidney Transplantation*
Mesh:Male
Mesh:Middle Aged
Mesh:Models
Mesh:Statistical
Mesh:Registries*
Mesh:Regression Analysis
Mesh:Renal Dialysis/mortality*
Mesh:Risk Factors
Mesh:Survival Analysis
Mesh:Waiting Lists*
Mesh:Aged
waiting list
survival analysis
multi-state model
renal dialysis
kidney transplantation

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Abstract Background: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression ...
Show more >Abstract Background: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration. Methods: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states (‘HD, not wait-listed’, ‘HD, wait-listed’, ‘death’, and ‘RT’) was used to estimate the effect of being wait-listed on the probability of death. Results: During the study, 1392 (19.5%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9%) were observed in the not wait-listed group compared with only 33 (1.1%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95% CI, 1.70–7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age. Conclusions: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Glycation from inflammation to aging

Submission date :

2019-03-01T14:58:43Z
2020-03-20T16:26:15Z