Predialysis nephrology care and dialysis-related health outcomes among older adults initiating dialysis

BMC Nephrology

Table 4 Association of dialysis-related health outcomes with Intensity of predialysis nephrology care

Predialysis nephrology care	Adjusted relative risk ratio (99 % CI)^a
	Low intensity^b	Moderate intensity^b	High intensity^b
	N = 12,566	N = 7,688	N = 10,956
At Dialysis Initiation, %
Very low eGFR^c	0.72 (0.66 to 0.80)	0.67 (0.59 to 0.77)	0.66 (0.59 to 0.75)
Severe anemia^d	0.96 (0.92 to 1.01)	0.84 (0.79 to 0.90)	0.70 (0.65 to 0.74)
Permanent vascular access^b	1.57 (1.48 to 1.67)	2.61 (2.45 to 2.77)	3.60 (3.42 to 3.79)
Fistula	1.66 (1.52 to 1.80)	2.72 (2.50 to 2.97)	3.85 (3.58 to 4.14)
Graft	1.65 (1.46 to 1.87)	3.20 (2.84 to 3.61)	4.28 (3.83 to 4.77)
Other (graft or fistula)	1.15 (0.96 to 1.38)	1.18 (0.94 to 1.49)	1.60 (1.30 to 1.97)
Peritoneal Dialysis	1.44 (1.29 to 1.60)	2.01 (1.77 to 2.27)	2.12 (1.90 to 2.37)
At Dialysis Follow-up, %
Mortality at 2 years	0.94 (0.92 to 0.97)	0.87 (0.84 to 0.91)	0.80 (0.77 to 0.82)
Kidney transplant at 2 years	1.41 (0.95 to 2.10)	2.13 (1.39 to 3.27)	2.72 (1.91 to 3.88)

^aWeighted by propensity scores derived from logistic regression models including age, sex, race, Hispanic ethnicity, body mass index, hospital and physician density, urban residence, median income, region, predialysis comorbidities (listed in Table 1), veteran status, and predialysis outpatient care venue. No predialysis nephrology care visits is the reference group in each of the 3 propensity score models
^bPatients were categorized by intensity of predialysis nephrology care: low intensity care (1–3 nephrology visits), moderate intensity care (4–6 nephrology visits), and high intensity care (>6 nephrology visits). Patients with no predialysis nephrology care were the reference group
^ceGFR <5 mL/min/1.73m2
^dhemoglobin level <9 g/dL
^eN = Low Intensity = 11,649; Moderate Intensity = 6,894; High Intensity = 9,708

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