• Yen-Chung Lin, Chia-Te Liao, Cai-Mei Zheng, Ming-Huang Lin, Chih-Cheng Hsu, Yung-Ho Hsu, and Mai-Szu Wu.
• Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, 252, Wu-xing St., Taipei, 110, Taiwan, ROC; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 252, Wu-xing St., Taipei, 110, Taiwan, ROC; TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
• J Formos Med Assoc. 2022 Feb 1; 121 Suppl 1: S56-S63.

BackgroundDespite having a well-established pre-end-stage kidney disease (pre-ESKD) care program, Taiwan has a high incidence of ESKD. Unrecovered incident dialysis may lead to the maintenance of dialysis. Contrast medium (CM) or general anesthesia (GA) may also induce dialysis. We aimed to examine the trends for incident dialysis, use of CM or GA, and its long-term trajectory outcomes.MethodsPatients who received at least one dialysis intervention between 2010 and 2017 were identified using the National Health Insurance Research Database. We collected information on age, sex, comorbidities, causes of dialysis in outpatient or inpatient settings, use of CM or GA or pre-ESKD program enrolment before incident dialysis, and trajectory outcomes.ResultsIncident dialysis occurred more frequently in elderly inpatients with infectious diseases or previous chronic kidney disease (CKD). The number of patients who had a pre-ESKD care plan before incident dialysis increased from 25% in 2010 to 41% in 2017 (P < 0.001). In general, CM or GA exposure related with a higher mortality rate. Over the five-year longitudinal follow-up, patients without a history of CKD had a higher mortality rate than those with a history of CKD.ConclusionEnrolment in the pre-ESKD care program increased, and inpatient incident dialysis decreased. The long-term survival of patients with CKD was higher than that of non-CKD patients after incident dialysis. CM or GA exposure appears to be related to dialysis-induced mortality, and further investigations are warranted.Copyright © 2022. Published by Elsevier B.V.

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