Personalization of renal replacement therapy and its effect on survival of patients with stage 5 chronic kidney disease aged 60 and older

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Abstract

Objective. Evaluation of the effectiveness of alternative treatment options (ATOs) for stage 5 chronic kidney disease in patients aged ≥60 years and development of algorithm for choosing ATOs.

Materials and methods. The historical control group (HCG) (237 patients) received a standard dialysis regimen, while the experimental group (EG) (62 patients) received ATOs (conservative treatment, palliative, incremental, or standard dialysis regimens).

Results. Survival on the 90th day was 73.4±3% in the HCG, 84.4±4.8% in the EG, on the 365th day: 51.4±3.4% in the HCG, 69.6±6.9% in the EG. Evaluation of the adverse outcome risk reduction showed that treatment with ATOs reduced the risk of adverse outcome by 48 (95% confidence interval 12–69)%.

Conclusion. Due to the effectiveness of ATOs, it is necessary to consider the possibility of their inclusion in clinical protocols for the treatment of patients.

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About the authors

Krystsina A. Kurylovich

1st City Clinical Hospital

Author for correspondence.
Email: khruns89@gmail.com
ORCID iD: 0000-0002-9112-4863

Nephrologist, Hemodialysis Department

Belarus, 64 Nezavisimosti Ave, Minsk, 220013

Kirill S. Komissarov

Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology

Email: kirill_ka@tut.by
ORCID iD: 0000-0002-2648-0642

Cand.Sci. (Med.), Associate Professor, Head of the Department of Nephrology

Belarus, 8 Semashko st., Minsk, 220087

Olga V. Krasko

United Institute of Informatics Problems of the National Academy of Sciences of Belarus

Email: krasko@newman.bas-net.by
ORCID iD: 0000-0002-4150-282X

Cand.Sci.(Tech.), Leading Researcher, Bioinformatics Laboratory

Belarus, 6 Surganov St., Minsk, 220012

Siarhei I. Kamisarau

16th City Children's Polyclinic, Minsk

Email: serge.kom142@gmail.com
ORCID iD: 0009-0003-2966-3780

Pediatrician

Belarus, 45 Odoevsky st., Minsk, 220074

Aksana V. Ilyinchyk

1st City Clinical Hospital

Email: i_o_v@tut.by
ORCID iD: 0009-0006-3243-9503

Nephrologist, Head of the Hemodialysis Department

Belarus, 64 Nezavisimosti Ave, Minsk, 220013

Siarhei V. Prylutski

Minsk Order of the Red Banner of Labor Regional Clinical Hospital

Email: priluckii.s@mokb.by
ORCID iD: 0009-0004-5174-1893

Nephrologist, Head of the Department of Hemodialysis with Extracorporeal Detoxification Methods

Belarus, Borovlyansky village council, 201 near the Lesnoy agricultural complex, Minsk district, Minsk region, 223040

Yauheni Y. Zhaholkin

Mogilev Regional Clinical Hospital

Email: Zhagolkin69@mail.ru
ORCID iD: 0009-0003-5441-9018

Nephrologist, Head of the Hemodialysis and Nephrology Department

Belarus, 12 Byalynitsky-Biruli Street, Mogilev, 212026

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Supplementary files

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2. Fig. 1. RRT option 90 days after the start of dialysis in 2-4 treatment subgroups

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3. Fig. 2. Cumulative survival of EG subgroups

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4. Fig. 3. Algorithm for choosing a treatment option in patients aged 60 years and older with CKD C5

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