In the U.S. only a small minority of dialysis patients become waitlisted (~23%) or receive a transplant (~3.7%) in a given year. The process of becoming waitlisted or transplanted requires multiple transitions after the initial referral, which may be influenced by several patient level variables. The present study was performed to identify factors impacting this process during the first year of dialysis. Methods: To address this issue we studied incident patients who began dialysis between 2009-2017 in clinics operated by a large not-for-profit provider. We constructed Cox proportional hazards regression models to assess the relationships between the time to reach predetermined states in the transplant evaluation process and covariates of interest. The Cox models included data on 16,579 hemodialysis (HD) and 2,614 peritoneal dialysis (PD) (total n=19,193) patients less than 71 years of age and who had been in the clinic at least 30 days. Fixed covariates included modality at 30 days, race, sex, diabetes status, and age at ESRD onset. We also included all interactions of the covariates with dialysis modality at 30 days. We followed patients for up one year. Mean follow-up for PD and HD patients was 330 and 324 days, respectively. We also constructed a multi-state model, fit to longitudinal data, to monitor transitions through the evaluation process for all 32,805 incident dialysis patients.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.