TY  - JOUR
TI  - Main Outcomes of the DIYAL-TR Study: Regional
Differences of Mortality and Morbidity in Chronic
Hemodialysis Patients
AB  - Objective: Variations in care at national or global level may have an impact on the prognosis of patients on chronic hemodialysis.
We aimed to describe regional differences in all-cause mortality or cardiovascular morbidity in chronic hemodialysis
patients in Turkey.
Methods: We enrolled 2461 patients who were initiated chronic hemodialysis in 93 centers in Turkey between January 27,
2017, and February 09, 2018. We included 2-year follow-up data of 1877 patients in this prospective study. The primary
outcome, the rate of composite endpoint of all-cause mortality or cardiovascular morbidity, was compared between geographical
regions. Secondary outcomes were the rates of hospitalization and infections.
Results: In total, 552 patients (29.4%) developed the primary outcome. The highest and lowest rates of primary outcome
occurred in the Mediterranean (34.5%) and Southeastern (26.5%) & Central Anatolian regions (26.5%), respectively, with no
significant differences across regions (P = .82). Hospitalization events were detected in 377 patients (20.1%). The highest
rate of hospitalization was detected in the Black Sea region (33.8%), and the lowest (7.6%) in the Southeastern region. The
regions did not differ in hospitalization rates (P = .88). Infections occurred in 11.3% (n = 212) of the patients. The highest and
lowest rates of infections occurred in the Aegean (18.2%) and the Southeastern (2.9%) regions, respectively. We detected
significant difference between geographic regions (P = .02).
Conclusions: Our study showed that almost 3 in every 10 chronic hemodialysis patients reached the primary endpoint
of all-cause mortality/cardiovascular morbidity during the 2 years of follow-up. The occurrence of this outcome does not
seem to exhibit geographical variation across the country.
AU  - Kızılırmak, Pınar
AU  - Ateş, Kenan
AU  - Ecder, Tevfik
AU  - Kaptanoğulları, Hakan
AU  - ARICI, Mustafa
AU  - ARINSOY, TURGAY
AU  - SEZER, SİREN
DO  - 10.5152/turkjnephrol.2022.21133
PY  - 2022
JO  - Turkish journal of nephrology (Online)
VL  - 31
IS  - 2
SN  - 2667-4440
SP  - 116
EP  - 126
DB  - TRDizin
UR  - http://search/yayin/detay/531310
ER  -