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BMC Nephrol. 2019 Mar 5;20(1):81. doi: 10.1186/s12882-019-1251-z.

Potential life-years gained over a 5-year period by correcting DOPPS-identified modifiable practices in haemodialysis: results from the European MONITOR-CKD5 study.

Author information

1
Centre Hospitalier Universitaire de Bordeaux and Unité INSERM 1026, University of Bordeaux, Bordeaux, France.
2
Friedrich Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
3
Guy's and St Thomas' NHS Foundation Hospital, London, UK.
4
DaVita Clinical Research Germany, Duesseldorf, Germany.
5
Université de Grenoble, Grenoble, France.
6
Centre Hospitalier F.H. Manhés, Fleury-Mérogis, France.
7
Matrix45, Tucson, AZ, USA.
8
Department of Public Health, University of Basel, Basel, Switzerland.
9
Hexal AG, Holzkirchen, Germany.
10
Matrix45, Tucson, AZ, USA. iabraham@matrix45.com.
11
University of Arizona College of Pharmacy and College of Medicine, Tucson, AZ, USA. iabraham@matrix45.com.

Abstract

BACKGROUND:

DOPPS reported that thousands of life-years could be gained in the US and Europe over 5 years by correcting six modifiable haemodialysis practices. We estimated potential life-years gained across 10 European countries using MONITOR-CKD5 study data.

METHODS:

The DOPPS-based target ranges were used, except for haemoglobin due to label changes, as well as DOPPS-derived relative mortality risks. Percentages of MONITOR-CKD5 patients outside targets were calculated. Consistent with the DOPPS-based analyses, we extrapolated life-years gained for the MONITOR-CKD5 population over 5 years if all patients were within targets.

RESULTS:

Bringing the 10 MONITOR-CKD5 countries' dialysis populations into compliance on the six practices results in a 5-year gain of 97,428 patient-years. In descending order, survival impact was the highest for albumin levels, followed by phosphate levels, vascular access, haemoglobin, dialysis adequacy, and interdialytic weight gain.

CONCLUSIONS:

Optimal management of the six modifiable haemodialysis practices may achieve 6.2% increase in 5-year survival.

TRIAL REGISTRATION:

NCT01121237 . Clinicaltrials.gov registration May 12, 2010 (retrospectively registered).

KEYWORDS:

Anaemia; Biosimilar epoetin alfa; Haemodialysis; Life-years; Modifiable haemodialysis practices

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