國家衛生研究院 NHRI:Item 3990099045/11804
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/11804


    Title: Icodextrin is associated with a lower mortality rate in peritoneal dialysis patients
    Authors: Yang, JY;Chen, L;Peng, YS;Chen, YY;Huang, JW;Hung, KY
    Contributors: Institute of Population Health Sciences
    Abstract: BACKGROUND: Icodextrin (ICO) improves fluid removal in peritoneal dialysis (PD) patients. However, whether physiological benefits of ICO translate into patient survival remains unclear. We examine the association of ICO and clinical outcomes. METHODS: We identified patients who initiated long-term PD from the National Health Insurance Research Database of Taiwan. We matched ICO users with non-users according to propensity score and survival status when ICO was prescribed. We utilized time-dependent analyses to avoid immortal time bias. Additional competing risk models were utilized for the outcomes except for death. The outcomes of interest were time to death, technique failure, peritonitis, major adverse cardiovascular events (MACE), and hospitalization. RESULTS: A total of 4,914 PD patients were enrolled and 2,836 PD patients (57.7%) were identified as ICO users. The ICO users had significantly better overall survival (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.63 - 0.86), especially among early ICO users (HR 0.64; 95% CI 0.54 - 0.77, p value for interaction: 0.007). The ICO users were associated with higher risk of peritonitis (subdistribution HR 1.22, 95% CI 1.06 - 1.14) and hospitalization (subdistribution HR 1.14, 95% CI 1.05 - 1.24), considering competing risk of death. However, when considering ICO use as a time-varying covariate, ICO users shared similar risks for technique failure, peritonitis, MACE, and hospitalization as non-users. The effect of ICO on mortality was especially prominent among those early users. CONCLUSIONS: After adjustments for immortal time biases, ICO users were significantly associated with approximately 20% reduction in mortality, especially among early users.
    Date: 2019-05
    Relation: Peritoneal Dialysis International. 2019 May;39(3):252-260.
    Link to: http://dx.doi.org/10.3747/pdi.2018.00217
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0896-8608&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000467793700008
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85066866627
    Appears in Collections:[Li-Kwang Chen] Periodical Articles

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