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

Kurylovich K.A., Komissarov K.S., Krasko O.V., Kamisarau S.I., Ilyinchyk А.V., Prylutski S.V., Zhaholkin Y.Y.

1) 1st City Clinical Hospital, Minsk, Republic of Belarus; 2) Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Republic of Belarus; 3) United Institute of Informatics Problems of the National Academy of Sciences of Belarus, Minsk, Republic of Belarus; 4) 16th City Children's Polyclinic, Minsk, Republic of Belarus; 5) Minsk Order of the Red Banner of Labor Regional Clinical Hospital, Minsk Region, Republic of Belarus; 6) Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus

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.

Keywords

About the Authors

Krystsina A. Kurylovich – Nephrologist, Hemodialysis Department, 1st City Clinical Hospital. Address: 64 Nezavisimosti Ave, Minsk, 220013; Tel.: +3 (7544) 740-32-95;
e-mail: khruns89@gmail.com. ORCID: 0000-0002-9112-4863
Kirill S.Komissarov – Cand.Sci. (Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology. Address: 8 Semashko st., Minsk, 220087; tel.: +3 (7517) 277-20-35, +3 (7529) 680-70-97;
e-mail: kirill_ka@tut.by. ORCID: 0000- 0002-2648-0642
Olga V. Krasko – Cand.Sci.(Tech.), Leading Researcher, Bioinformatics Laboratory, United Institute for Informatics Problems of the National Academy of Sciences of Belarus. Address: 6 Surganov St., Minsk, 220012; tel.: + 3 (7529) 707-88-03; e-mail: krasko@newman/bas-net.by. ORCID: 0000-0002-4150-282X
Siarhei I. Kamisarau – Pediatrician, 16th City Children's Polyclinic. Address: 45 Odoevsky st., Minsk, 220074; tel.: +3 (7517) 304-33- 55, +3 (7544) 547-48-47; e-mail: serge.kom142@gmail.com. ORCID: 0009-0003-2966-3780
Aksana V. Ilyinchyk – Nephrologist, Head of the Hemodialysis Department, 1st City Clinical Hospital. Address: 64 Nezavisimosti Ave, Minsk, 220013; tel.: +3 (7517) 379-63-39, +3 (7529) 645-07-77; e-mail: i_o_v@tut.by. ORCID: 0009-0006-3243-9503
Siarhei V. Prylutski – Nephrologist, Head of the Department of Hemodialysis with Extracorporeal Detoxification Methods, Minsk Order of the Red Banner of Labor Regional Clinical Hospital. Address: Borovlyansky village council, 201 near the Lesnoy agricultural complex, Minsk district, Minsk region, 223040; tel.: +3 (7517) 265- 48-64, + 3 (7544) 787-03-40; e-mail: priluckii.s@mokb.by. ORCID: 0009-0004-5174-1893
Yauheni Y. Zhaholkin – Nephrologist, Head of the Hemodialysis and Nephrology Department, Mogilev Regional Clinical Hospital. Address: 12 Byalynitsky-Biruli Street, Mogilev, 212026; tel.: +3 ( 7522) 63-86-86, +3 (7529) 648-13-64, e-mail: Zhagolkin69@mail.ru. ORCID: 0009-0003-5441-9018

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