{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:49Z","timestamp":1787015869227,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Many patients, especially the elderly, who require renal replacement therapies (RRT) have delayed or rejected dialysis for various reasons. Current dialysis guidelines may not be relevant for the elderly or frail patients. We aim to determine survival advantage of initiating dialysis in patients deemed to require RRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational cohort on incident end\u2010stage kidney disease (ESKD) patients from January 1, 2007 to December 31, 2008. The primary outcome was all\u2010cause mortality. Patients contributed person\u2010time from the date of ESKD diagnosis until death, transplant or end of study on December 31, 2014, whichever occurred first. An extended Cox regression model with time\u2010varying exposure to dialysis was used to account for immortal time bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 3990 incident ESKD patients included, 70.2% patients initiated dialysis; 78.8% with haemodialysis (HD) while the remaining 21.2% with peritoneal dialysis (PD). Dialysis reduced hazard of death in both elderly and non\u2010elderly patients even after controlling for comorbidities (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.50, 0.68 and HR 0.76, 95% CI 0.69, 0.85, respectively). HD was protective in both the elderly and non\u2010elderly (HR 0.53, 95% CI 0.45, 0.63 and HR 0.71, 95% CI 0.64, 0.80, respectively). PD significantly reduced risk of death compared to no dialysis in the elderly but not in the non\u2010elderly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dialysis improved survival in all incident ESKD patients. The findings suggested a larger protection offered by HD. Although improvement in survival from initiating dialysis was large, its true benefit should take overall quality of life into account.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>SUMMARY AT A GLANCE<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>This observational study showed that initiation of dialysis improves the survival of end\u2010stage kidney disease (ESKD) patients of all age groups, but the quality of life is an important aspect that has not been explored.<\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.13689","type":"journal-article","created":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T04:19:56Z","timestamp":1578111596000},"page":"644-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Survival advantage of initiating dialysis in elderly and non\u2010elderly incident end\u2010stage kidney disease patients"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9716-9061","authenticated-orcid":false,"given":"Chin C.","family":"Ch'ng","sequence":"first","affiliation":[{"name":"Clinical Research Centre Hospital Pulau Pinang, Ministry of Health Malaysia  Penang Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loke M.","family":"Ong","sequence":"additional","affiliation":[{"name":"Clinical Research Centre Hospital Pulau Pinang, Ministry of Health Malaysia  Penang Malaysia"},{"name":"Nephrology Unit Hospital Pulau Pinang, Ministry of Health Malaysia  Penang Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin K. M.","family":"Beh","sequence":"additional","affiliation":[{"name":"Clinical Research Centre Hospital Pulau Pinang, Ministry of Health Malaysia  Penang Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan S.","family":"Md Yusuf","sequence":"additional","affiliation":[{"name":"Hospital Tuanku Ja'afar Seremban Ministry of Health Malaysia  Seremban Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thian F.","family":"Chew","sequence":"additional","affiliation":[{"name":"Hospital Tuanku Ja'afar Seremban Ministry of Health Malaysia  Seremban Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming L.","family":"Lee","sequence":"additional","affiliation":[{"name":"Hospital Tuanku Ja'afar Seremban Ministry of Health Malaysia  Seremban Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai S.","family":"Hooi","sequence":"additional","affiliation":[{"name":"Department of Medicine Hospital Sultanah Aminah, Ministry of Health Malaysia  Johor Bahru Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hin\u2010Seng","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Selayang, Ministry of Health Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnaz","family":"Shah Firdaus Khan","sequence":"additional","affiliation":[{"name":"Nephrology Unit Hospital Tengku Ampuan Rahimah, Ministry of Health Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazali","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Kuala Lumpur, Ministry of Health Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158765"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.5935\/0101-2800.20130022"},{"key":"e_1_2_7_4_1","unstructured":"Ageing and health[Internet].2019.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ageing-and-health. 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