Table 3.
Variables associated with withdrawal from dialysis for all patients and per age group
| Variable | Hazard Ratio (95% CI) | ||
|---|---|---|---|
| All Patients | Patients Age < 75 yr | Patients Age ≥ 75 yr | |
| Demographic | |||
| Age (10-yr increments) | 1.81 (1.75–1.88) | 1.80 (1.69–1.91) | 1.92 (1.72–1.15) |
| Male versus female | 0.85 (0.79–0.92) | 0.89 (0.81–0.97) | 0.83 (0.75–0.93) |
| Race | 1.00 | 1.00 | 1.00 |
| White (reference) | |||
| Black | 0.31 (0.22–0.44) | 0.29 (0.19–0.43) | 0.37 (0.24–0.56) |
| Asian | 0.38 (0.28–0.51) | 0.42 (0.29–0.59) | 0.36 (0.25–0.51) |
| Native Canadian | 0.76 (0.59–0.99) | 0.87 (0.63–1.20) | 0.58 (0.35–0.97) |
| Weight | 1.00 | 1.00 | 1.00 |
| Normal (BMI > 18.5–24.9 kg/m2) | |||
| Underweight (BMI < 18.5 kg/m2) | 1.37 (1.16–1.61) | 1.45 (1.12–1.86) | 1.30 (1.05–1.62) |
| Overweight (BMI, 25–29.9 kg/m2) | 0.92 (0.83–1.02) | 0.90 (0.78–1.05) | 0.93 (0.82–1.06) |
| Obese (BMI ≥ 30 kg/m2) | 0.93 (0.84–1.03) | 0.93 (0.81–1.07) | 093 (0.81–1.0) |
| Urban versus rural dewller | 0.89 (0.80–1.00) | 0.97 (0.82–1.14) | 0.82 (0.73–0.93) |
| Income quintile | 1.00 | 1.00 | 1.0 |
| 1 (lowest) (reference) | |||
| 2 | 0.98 (0.88–1.10 | 1.00 (0.87–1.17) | 0.97 (0.84–1.12) |
| 3 | 0.90 (0.80–1.01) | 0.96 (0.81–1.14) | 0.84 (0.71–0.99) |
| 4 | 0.91 (0.80–1.04) | 0.92 (0.77–1.12) | 0.89 (0.75–1.06) |
| 5 | 0.94 (0.84–1.05) | 0.98 (0.84–1.14) | 0.91 (0.76–1.09) |
| Hemodialysis versus peritoneal dialysis | 1.09 (0.79,1.50) | 1.13 (0.71–1.80) | 1.01 (0.58–1.75) |
| Home versus in-center hemodialysis | 0.78 (0.56–1.09) | 0.80 (0.48–1.33) | 0.75 (0.45–1.24) |
| Community center versus hospital | 0.50 (0.26–0.94) | 0.52 (0.19–1.42) | 0.46 (0.20–1.06) |
| Laboratory values | |||
| Hemoglobin (g/dl) | 1.00 (0.97–1.02) | 0.99 (0.96–1.02) | 1.01 (0.97–1.04) |
| Albumin (g/L) | 0.86 (0.80–0.92) | 0.83 (0.74–0.92) | 0.90 (0.81–0.99) |
| Timing | |||
| Early versus late initiationa | 1.17 (1.06–1.30) | 1.17(1.03,1.32) | 1.16 (1.03–1.32) |
| Late versus early referralb | 1.27 (1.16–1.39) | 1.30 (1.15–1.47) | 1.23 (1.09–1.38) |
| Era: dialysis initiation 2006–2009 versus 2001–2005 | 1.15 (1.02–1.30) | 1.18 (1.02,1.36) | 1.13 (0.97–1.31) |
| ESRD primary diagnosis | |||
| GN (reference) | 1.0 | 1.0 | 1.0 |
| Diabetes | 1.58 (1.37–1.82) | 1.86 (1.50–2.32) | 1.31 (1.10–1.57) |
| Renovascular | 1.26 (1.06–1.49) | 1.43 (1.12–1.82) | 1.07 (0.86–1.32) |
| Other | 1.46 (1.23–1.72) | 1.68 (1.32–2.14) | 1.25 (1.00–1.57) |
| Comorbid conditions | |||
| Coronary artery disease | 1.04 (0.96–1.12) | 1.04 (0.93–1.17) | 1.03 (0.94–1.13) |
| Peripheral vascular disease | 1.19 (1.08–1.31) | 1.26 (1.11–1.42) | 1.13 (0.99–1.30) |
| Diabetes | 1.15 (1.02–1.31) | 1.15 (0.94–1.40) | 1.15 (0.98–1.36) |
| Hypertension | 0.75 (0.67–0.85) | 0.73 (0.64–0.84) | 0.78 (0.68–0.91) |
| Congestive heart failure | 0.97 (0.87–1.08) | 1.01 (0.87–1.17) | 0.94 (0.81–1.08) |
| Cerebrovascular disease | 1.30 (1.21–1.41) | 1.39(1.22,1.59) | 1.24(1.11,1.37) |
| Lung disease | 1.04 (0.9–1.18) | 1.04 (0.88–1.23) | 1.04 (0.89–1.21) |
| Malignancy | 1.62 (1.47–1.78) | 2.01 (1.75–2.30) | 1.35 (1.19–1.54) |
| Provinces (compared with Canada) | |||
| Ontario | 1.15 (0.96–1.38) | 1.18 (0.96,1.46) | 1.11 (0.93–1.33) |
| Alberta | 0.41 (0.19–0.86) | 0.39 (0.17–0.90) | 0.42 (0.21–0.86) |
| British Columbia | 0.88 (0.74–1.05) | 0.86(0.67–1.09) | 0.91 (0.74–1.11) |
| Manitoba | 1.21 (1.01–1.44) | 1.17 (1.00–1.37) | 1.28 (0.96–1.71) |
| New Brunswick | 0.76 (0.61–0.94) | 0.72 (0.51–1.03) | 0.69 (0.52–0.92) |
| Newfoundland | 1.19 (1.02–1.40) | 0.98 (0.61–1.56) | 1.44 (1.18–1.76) |
| Nova Scotia | 1.67 (1.40–2.00) | 1.84 (1.54–2.20) | 1.53 (1.18–1.98) |
| Quebec | 1.31 (1.05–1.62) | 1.45 (1.13–1.86) | 1.16 (0.92–1.46) |
| Saskatchewan | 1.01 (0.96–1.38) | 0.96 (0.75–1.25) | 1.04 (0.71–1.51) |
CI, confidence interval; BMI, body mass index.
a
Early initiation defined as estimated GFR > 10.5 ml/min per 1.73 m2; late initiation defined as estimated GFR ≤ 10.5 ml/min per 1.73 m2.
b
Late referral defined as first seen by a nephrologist <90 days before initiation of dialysis.