Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study
Abstract Routine laboratory tests are regularly performed in patients undergoing maintenance hemodialysis (HD) to detect anemia, chronic kidney disease-mineral bone disorders, and cardiovascular disease. More frequent laboratory tests may be associated with better outcomes. However, there is little...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-45502-8 |
| _version_ | 1797647307554947072 |
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| author | Do Hyoung Kim AJin Cho Hayne Cho Park Bo Yeon Kim Miri Lee Gui Ok Kim Jinseog Kim Young-Ki Lee |
| author_facet | Do Hyoung Kim AJin Cho Hayne Cho Park Bo Yeon Kim Miri Lee Gui Ok Kim Jinseog Kim Young-Ki Lee |
| author_sort | Do Hyoung Kim |
| collection | DOAJ |
| description | Abstract Routine laboratory tests are regularly performed in patients undergoing maintenance hemodialysis (HD) to detect anemia, chronic kidney disease-mineral bone disorders, and cardiovascular disease. More frequent laboratory tests may be associated with better outcomes. However, there is little evidence supporting a specific monitoring interval. This study evaluated the impact of regular laboratory testing on mortality in Korean patients undergoing maintenance HD. We used HD quality assessments, and National Health Insurance Service claims data from October to December 2015. In HD quality assessment, 22 tests are recommended every 1–6 months. A total of 34,950 patients were divided into two groups based on the regularity of laboratory testing. A Cox proportional hazards model was used to assess the effects of regular laboratory tests on patient mortality during a mean follow-up duration of 53.7 months. The proportion of patients with and without regular laboratory testing was 85.6% (n = 29,914) and 14.4% (n = 5036), respectively. Patients who underwent regular laboratory testing had a longer dialysis duration, lower serum phosphorus levels and diastolic blood pressure, and higher hemoglobin and single-pool Kt/V levels than those who did not. After adjusting for demographic and clinical parameters, regular laboratory testing independently reduced mortality risk (hazard ratio, 0.90; 95% confidence interval 0.85–0.95; P < 0.001). Regular laboratory testing was associated with a decreased mortality risk among patients undergoing HD. Management of end-stage kidney disease-related complications based on laboratory tests can improve survival. |
| first_indexed | 2024-03-11T15:14:26Z |
| format | Article |
| id | doaj.art-0f41dc637c3c4095aab94cfb59e01c6e |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-11T15:14:26Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-0f41dc637c3c4095aab94cfb59e01c6e2023-10-29T12:21:32ZengNature PortfolioScientific Reports2045-23222023-10-011311810.1038/s41598-023-45502-8Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort studyDo Hyoung Kim0AJin Cho1Hayne Cho Park2Bo Yeon Kim3Miri Lee4Gui Ok Kim5Jinseog Kim6Young-Ki Lee7Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of MedicineDepartment of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of MedicineDepartment of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of MedicineHealthcare Review and Assessment Committee, Health Insurance Review and Assessment ServiceDivision of Quality Assessment 1, Health Insurance Review and Assessment ServiceDivision of Quality Assessment Management, Health Insurance Review and Assessment ServiceDepartment of Bigdata and Applied Statistics, Dongguk UniversityDepartment of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of MedicineAbstract Routine laboratory tests are regularly performed in patients undergoing maintenance hemodialysis (HD) to detect anemia, chronic kidney disease-mineral bone disorders, and cardiovascular disease. More frequent laboratory tests may be associated with better outcomes. However, there is little evidence supporting a specific monitoring interval. This study evaluated the impact of regular laboratory testing on mortality in Korean patients undergoing maintenance HD. We used HD quality assessments, and National Health Insurance Service claims data from October to December 2015. In HD quality assessment, 22 tests are recommended every 1–6 months. A total of 34,950 patients were divided into two groups based on the regularity of laboratory testing. A Cox proportional hazards model was used to assess the effects of regular laboratory tests on patient mortality during a mean follow-up duration of 53.7 months. The proportion of patients with and without regular laboratory testing was 85.6% (n = 29,914) and 14.4% (n = 5036), respectively. Patients who underwent regular laboratory testing had a longer dialysis duration, lower serum phosphorus levels and diastolic blood pressure, and higher hemoglobin and single-pool Kt/V levels than those who did not. After adjusting for demographic and clinical parameters, regular laboratory testing independently reduced mortality risk (hazard ratio, 0.90; 95% confidence interval 0.85–0.95; P < 0.001). Regular laboratory testing was associated with a decreased mortality risk among patients undergoing HD. Management of end-stage kidney disease-related complications based on laboratory tests can improve survival.https://doi.org/10.1038/s41598-023-45502-8 |
| spellingShingle | Do Hyoung Kim AJin Cho Hayne Cho Park Bo Yeon Kim Miri Lee Gui Ok Kim Jinseog Kim Young-Ki Lee Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study Scientific Reports |
| title | Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study |
| title_full | Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study |
| title_fullStr | Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study |
| title_full_unstemmed | Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study |
| title_short | Regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis: a Korean nationwide cohort study |
| title_sort | regular laboratory testing and patient survival among patients undergoing maintenance hemodialysis a korean nationwide cohort study |
| url | https://doi.org/10.1038/s41598-023-45502-8 |
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