@article{bd6140e975dd452f92f83b5fb0c6fce7,
title = "Variability and trends over time and across centres in haemodialysis weekly duration in Australia and New Zealand",
abstract = "Aim: Haemodialysis treatment prescription varies widely internationally. This study explored patient- and centre-level characteristics associated with weekly haemodialysis hours. Methods: Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data were analysed. Characteristics associated with weekly duration were evaluated using mixed-effects linear regression models with patient- and centre-level covariates as fixed effects, and dialysis centre and state as random effects using the 2017 prevalent in-centre haemodialysis (ICHD) and home haemodialysis (HHD) cohorts. Evaluation of patterns of weekly duration over time analysed the 2000 to 2017 incident ICHD and HHD cohorts. Results: Overall, 12 494 ICHD and 1493 HHD prevalent patients in 2017 were included. Median weekly treatment duration was 13.5 (interquartile range [IQR] 12-15) hours for ICHD and 16 (IQR 15-20) hours for HHD. Male sex, younger age, higher body mass index, arteriovenous fistula/graft use, Aboriginal and Torres Strait Islander ethnicity and longer dialysis vintage were associated with longer weekly duration for both ICHD and HHD. No centre characteristics were associated with duration. Variability in duration across centres was very limited in ICHD compared with HHD, with variation in HHD being associated with state. Duration did not vary significantly over time for ICHD, whereas longer weekly HHD treatments were reported between 2006 and 2012 compared with before and after this period. Conclusion: This study in the Australian and New Zealand haemodialysis population showed that weekly duration was primarily associated with patient characteristics. No centre effect was demonstrated. Practice patterns seemed to differ across states/countries, with more variability in HHD than ICHD.",
keywords = "dialysis, dialysis duration, end-stage kidney disease, haemodialysis, treatment time",
author = "Isabelle Ethier and Yeoungjee Cho and Davies, {Christopher E.} and Hawley, {Carmel M.} and Campbell, {Scott B.} and Isbel, {Nicole M.} and Pascoe, {Elaine M.} and Polkinghorne, {Kevan R.} and Matthew Roberts and See, {Emily J.} and David Semple and {van Eps}, Carolyn and Viecelli, {Andrea K.} and Johnson, {David W.}",
note = "Funding Information: Yeoungjee Cho reports personal fees from Baxter, and grant support from Fresenius Medical Care, PKD Australia, NHMRC and Baxter CEC Grant, outside the submitted work. Christopher E. Davies reports grant support from NHMRC, outside the submitted work. Carmel M. Hawley reports personal fees from Janssen, GlaxoSmithKline and Osuka, and grant support from Baxter, Fresenius, Shire, PKD Aus and NHMRC, outside the submitted work. Kevan R. Polkinghorne declared having received consultancy fees from Medtronic Australasia Pty Ltd and grant support from NHMRC outside the submitted work. David W. Johnson reports personal fees from AWAK, Astra‐Zeneca, Baxter Healthcare and Fresenius Medical Care, and grant support from Baxter Extramural Grant and Baxter CEC Grant, outside the submitted work. The other authors do not have any interest in the information contained in the manuscript to disclose. Funding Information: The authors gratefully acknowledge the contributions of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators, and patients) in providing information for and maintaining the ANZDATA database. Reporting and interpretation of these data should in no way be seen as an official policy or interpretation of the ANZDATA Registry and are the responsibility of the authors. Isabelle Ethier would like to acknowledge the Centre Hospitalier de l'Universit{\'e} de Montr{\'e}al and the Fondation du CHUM for their support through a fellowship grant. Emily J. See receives support from the National Health and Medical Research Council (Postgraduate Scholarship) and the Royal Australasian College of Physicians (NHMCR Jacquot Award for Excellence). Andrea K. Viecelli receives grant support from the Royal Australasian College of Physicians (Jacquot Research Establishment Award) and the Princess Alexandra Research Foundation. David W. Johnson is supported by an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellowship. Yeoungjee Cho is supported by an Australian NHMRC Early Career Fellowship. Funding Information: Centre Hospitalier de l'Universit{\'e} de Montr{\'e}al and Fondation du CHUM, Grant/Award Number: Fellowship grant; National Health and Medical Research Council, Grant/Award Numbers: Early Career Fellowship, Postgraduate Scholarship, Practitioner Fellowship; Royal Australasian College of Physicians, Grant/Award Numbers: Jacquot Research Establishment Award, NHMCR Jacquot Award for Excellence Funding information Funding Information: The authors gratefully acknowledge the contributions of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators, and patients) in providing information for and maintaining the ANZDATA database. Reporting and interpretation of these data should in no way be seen as an official policy or interpretation of the ANZDATA Registry and are the responsibility of the authors. Isabelle Ethier would like to acknowledge the Centre Hospitalier de l'Universit? de Montr?al and the Fondation du CHUM for their support through a fellowship grant. Emily J. See receives support from the National Health and Medical Research Council (Postgraduate Scholarship) and the Royal Australasian College of Physicians (NHMCR Jacquot Award for Excellence). Andrea K. Viecelli receives grant support from the Royal Australasian College of Physicians (Jacquot Research Establishment Award) and the Princess Alexandra Research Foundation. David W. Johnson is supported by an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellowship. Yeoungjee Cho is supported by an Australian NHMRC Early Career Fellowship. Publisher Copyright: {\textcopyright} 2020 Asian Pacific Society of Nephrology Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = feb,
doi = "10.1111/nep.13782",
language = "English",
volume = "26",
pages = "153--163",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",
number = "2",
}