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논문분류	춘계학술대회 초록집
제목	Effects of Nursing Facility Residency on Mortality in Patients Initiating Hemodialysis: A Retrospective Cohort Study
저자	Myeon Kyu Cho
출판정보	2026; 2026(1):
키워드	Chronic kidney disease, Hemodialysis, Mortality, Nursing facility, Older adults
초록	Objectives: As the population of older adults grows and nuclear families become increasingly prevalent, the number of older adults cared for in nursing facilities is rising. We investigated whether undergoing dialysis while residing in a nursing facility impacts mortality rates among dialysis patients. Methods: We enrolled 2,597 patients who visited hemodialysis clinics at 17 teaching hospitals and collected data on underlying diseases, laboratory findings, and medications, comparing patients who initiated dialysis during residency in a nursing facility with those who did not. Multivariate survival analysis was then performed to determine whether initiating dialysis while in a nursing facility increased mortality. Results: Of the subjects, 9.1% (n=237) started dialysis while residing in a nursing facility. This group was predominantly female and older. Additionally, this group had higher prevalence rates of diabetes, dementia, heart failure, and atrial fibrillation, and greater use of antiplatelet agents, warfarin, dementia medications, and antidepressants. They exhibited lower body weight, lymphocyte counts, intact parathyroid hormone, albumin, phosphorus, and total cholesterol, as well as longer diabetes duration and higher alkaline phosphatase levels. Multivariate analysis, adjusting for age, sex, access type, dementia, malignancy, ischemic heart disease, cerebrovascular accident, heart failure, atrial fibrillation, liver cirrhosis, fracture, coronary artery disease, ejection fraction, lymphocyte count, platelet count, blood urea nitrogen, creatinine, albumin, phosphorus, total cholesterol, use of renin-angiotensin system blockers, beta-blockers, calcium channel blockers, warfarin, hyperlipidemia drugs, calcium-based phosphate binders, sevelamer, antidepressants, and dementia medications, showed that patients who initiated dialysis in a nursing facility had a significantly higher hazard ratio for mortality: 1.509 [95% confidence interval: 1.217, 1.871]. Conclusion: In summary, the current study suggests a correlation between starting dialysis in a nursing facility and a higher mortality rate among dialysis patients.
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