Journal of Clinical Epidemiology
Volume 52, Issue 3 , Pages 209-217 , March 1999

Association of Dialyzer Reuse with Hospitalization and Survival Rates Among U.S. Hemodialysis Patients: Do Comorbidities Matter?

  • Harold I. Feldman

      Affiliations

    • Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA
    • Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
    • Corresponding Author InformationAddress correspondence to: Harold I. Feldman, M.D., M.S., Assistant Professor of Medicine and Epidemiology, University of Pennsylvania Medical Center, 423 Service Drive, 720 Blockley Hall, Philadelphia, PA 19104-6021
    • ,
  • Warren B. Bilker

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics and the Department of Biostatistics and Epidemiology, University of Pennsylvania Medical Center, Philadelphia, PA USA
    • ,
  • Monica H. Hackett

      Affiliations

    • Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA USA
    • Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
    • ,
  • Christopher W. Simmons

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics and the Department of Biostatistics and Epidemiology, University of Pennsylvania Medical Center, Philadelphia, PA USA
    • ,
  • John H. Holmes

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics and the Department of Biostatistics and Epidemiology, University of Pennsylvania Medical Center, Philadelphia, PA USA
    • ,
  • Mark V. Pauly

      Affiliations

    • Department of Health Care Systems, Wharton School, University of Pennsylvania, Philadelphia, PA USA
    • Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
    • ,
  • José J. Escarce

      Affiliations

    • Rand Health Program, Santa Monica, CA USA

,Accepted 30 October 1998.

References 

  1. Tokars JI, Alter MJ, Favero MS. National surveillance of dialysis associated diseases in the United State, 1992. Atlanta, GA: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1992.
  2. Hakim RM, Lowrie EG. Effect of dialyzer reuse on leukopenia, hypoxemia and total hemolytic complement system. ASAIO J. 1980;20:159–164
  3. National Institute of Diabetes and Digestive and Kidney Diseases. The USRDS case mix study: preliminary results on dialyzer reuse. Presented to an open meeting of the Food and Drug Administration; 1992.
  4. Held PJ, Wolfe RA, Gaylin DS, Port FK, Levin NW, Turenne MN. Analysis of the association of dialyzer reuse practices and patient outcomes. Am J Kidney Dis. 1994;23:692–708
  5. Feldman HI, Kinosian M, Bilker W, Simmons C, Holmes J, Pauly MV, et al.  Effect of dialyzer reuse on survival of patients treated with hemodialysis. JAMA. 1996;276:620–625
  6. Bok D, Pascual L, Hergerger C, et al.  Effect of multiple use of dialyzers on intradialytic symptoms. Proc Dial Transplant Forum. 1980;10:92–96
  7. Health Care Financing Administration. End-stage Renal Disease Program: Instruction Manual for Renal Providers, Program Management and Medical Information System. Baltimore, MD: U.S. Department of Health and Human Services; 1989. 3278. HCFA Publication.
  8. Tokars JI, Alter MJ, Favero MS, Moyer LA, Bland LA. National surveillance of dialysis associated diseases in the Untied States, 1991. ASAIO J. 1993;39:966–975
  9. U.S. Renal Data System. USRDS 1994 Annual Data Report. 1994. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
  10. Cox D. Regression models and life tables. R Stat Soc. 1972;34:187
  11. Lee E. Statistical Models for Survival Data Analysis. Belmont, CA: Lifetime Learning Publications; 1980;
  12. McCullagh P, Nelder J. Generalized Linear Models. 2d Edition. New York: Chapman and Hall; 1989;
  13. Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 198; 129: 125–137. (Published erratum appears in Am J Epidemiol 1989; 130: 1066.)
  14. Efron B. The jackknife, the bootstrap and other resampling plans. 1982. Society for Industrial and Applied Mathematics, Philadelphia, PA.
  15. Feldman HI, Bilker WB, Hackett M, Simmons C, Holmes JH, Pauly MV, Escarce JJ. Hospitalization of hemodialysis patients in the U.S.: The impact of dialyzer reuse. American Journal of Nephrology 1999. (In Press)
  16. Held PJ, Port FK, Wolfe RA, Stannard DC, Carroll CE, Daugirdas JT, et al.  The dose of hemodialysis and patient mortality. Kidney Int. 1996;50:550–556
  17. Owen WF, Lew NL, Liu Y, Lowrie EG, Lazarus JM. The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis [see comments]. N Engl J Med. 1993;329:1001–1006

PII: S0895-4356(98)00162-0

Journal of Clinical Epidemiology
Volume 52, Issue 3 , Pages 209-217 , March 1999

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