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February 20, 1991

Mortality and Duration of Hemodialysis Treatment

Author Affiliations

From the Renal Research Program, the Urban Institute, Washington, DC (Dr Held and Mr Bovbjerg); the Department of Nephrology, Beth Israel Medical Center, New York, NY (Dr Levin); The Wharton School, University of Pennsylvania, Philadelphia (Dr Pauly); and the Department of Nephrology, Georgetown University and District of Columbia General Hospital, Washington, DC (Dr Diamond).

From the Renal Research Program, the Urban Institute, Washington, DC (Dr Held and Mr Bovbjerg); the Department of Nephrology, Beth Israel Medical Center, New York, NY (Dr Levin); The Wharton School, University of Pennsylvania, Philadelphia (Dr Pauly); and the Department of Nephrology, Georgetown University and District of Columbia General Hospital, Washington, DC (Dr Diamond).

JAMA. 1991;265(7):871-875. doi:10.1001/jama.1991.03460070053041
Abstract

Decrease in the average duration of hemodialysis treatment time is a continuing phenomenon. We investigated the relationship of 3-year mortality to duration of dialysis in a 1984-1985 national random sample of 600 hemodialysis patients from 36 dialysis units. Mortality was negatively associated with duration of dialysis treatments, as shown by the Cox model, adjusted for other patient and dialysis unit covariates. With adjustment for other covariates, patients receiving an average dialysis treatment duration of less than 3.5 hours had relative mortality risks of 1.17 to 2.18 compared with those with treatments longer than 3.5 hours (mortality risk of 1.0). Reverse causation (the possibility that more seriously ill patients received dialysis for a shorter time) appears unlikely. We conclude that duration of the dialysis procedure is an important element in determining patient mortality as one of the factors determining the adequacy of dialysis.

(JAMA. 1991;265:871-875)

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