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Title: Variability and trends over time and across centres in haemodialysis weekly duration in Australia and New Zealand.
Austin Authors: Ethier, Isabelle;Cho, Yeoungjee;Davies, Christopher E;Hawley, Carmel M;Campbell, Scott B;Isbel, Nicole M;Pascoe, Elaine M;Polkinghorne, Kevan R;Roberts, Matthew;See, Emily J ;Semple, David;van Eps, Carolyn;Viecelli, Andrea K;Johnson, David W
Affiliation: Translational Research Institute, Brisbane, Australia
Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
School of Medicine, University of Melbourne, Melbourne, Australia
Intensive Care
Department of Nephrology, Monash Medical Centre, Melbourne, Australia
Department of Medicine, Monash University, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
Department of Renal Medicine, Auckland District Health Board, Auckland, New Zealand
School of Medicine, University of Auckland, Auckland, New Zealand
Eastern Health Clinical School, Monash University, Melbourne, Australia
Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
School of Medicine, University of Queensland, Brisbane, Australia
Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
Adelaide Medical School, University of Adelaide, Adelaide, Australia
Issue Date: Feb-2020
Date: 2020-10-22
Publication information: Nephrology 2021; 26(2): 153-16
Abstract: Haemodialysis treatment prescription varies widely internationally. This study explored patient- and centre-level characteristics associated with weekly haemodialysis hours. Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data were analysed. Characteristics associated with weekly duration were evaluated using mixed-effects linear regression models with patient- and centre-level covariates as fixed effects, and dialysis centre and state as random effects using the 2017 prevalent in-centre haemodialysis (ICHD) and home haemodialysis (HHD) cohorts. Evaluation of patterns of weekly duration over time analysed the 2000 to 2017 incident ICHD and HHD cohorts. Overall, 12 494 ICHD and 1493 HHD prevalent patients in 2017 were included. Median weekly treatment duration was 13.5 (interquartile range [IQR] 12-15) hours for ICHD and 16 (IQR 15-20) hours for HHD. Male sex, younger age, higher body mass index, arteriovenous fistula/graft use, Aboriginal and Torres Strait Islander ethnicity and longer dialysis vintage were associated with longer weekly duration for both ICHD and HHD. No centre characteristics were associated with duration. Variability in duration across centres was very limited in ICHD compared with HHD, with variation in HHD being associated with state. Duration did not vary significantly over time for ICHD, whereas longer weekly HHD treatments were reported between 2006 and 2012 compared with before and after this period. This study in the Australian and New Zealand haemodialysis population showed that weekly duration was primarily associated with patient characteristics. No centre effect was demonstrated. Practice patterns seemed to differ across states/countries, with more variability in HHD than ICHD.
DOI: 10.1111/nep.13782
ORCID: 0000-0003-4909-0417
Journal: Nephrology
PubMed URL: 33094549
Type: Journal Article
Subjects: dialysis
dialysis duration
end-stage kidney disease
treatment time
Appears in Collections:Journal articles

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