The extension of the interdialytic interval due to due to dialysis session non-attendance varies according to which session of the week the patient misses. The impact of this on subsequent hospitalization and mortality is unknown. The ARO cohort study prospectively collected data from hemodialysis patients across 15 European countries on demography, comorbidity, laboratory, hospitalisation, mortality and individual hemodialysis sessions from 2007 to 2014. Event rates for death and hospitalisation according to dialysis day of the week were calculated for patients who attended the three previous scheduled hemodialysis sessions, who then on the next scheduled dialysis day either attended or did not attend. The hazard ratio for these events following non-attendance for the first compared to the second dialysis session of the week was estimated using Cox proportional hazards model adjusted for patient demographics. 3.8 million hemodialysis sessions in 9397 patients were analysed. The non-attendance rates for Monday/Wednesday/Friday sessions were 0.8, 0.9% & 1.4% respectively, and for Tuesday/Thursday/Saturday sessions were 0.6, 1.0% & 1.2% respectively. Compared to those who attended, for the 48–72 h between non-attendance and the next scheduled haemodialysis session, mortality significantly increased from 4.86 to 51.9/100 pt-yrs and hospitalisation increased from 0.58 to 2.1/yr. As time from the two-day break increased, the risk associated with non-attendance lessened: compared to missing the second hemodialysis session, missing the first session had a hazard ratio for mortality of 2.04 (95% CI 1.27–3.29), and for hospitalisation 1.78 (95% CI 1.29–2.47). In patients who attended their scheduled dialysis session and the three preceding, after the two-day break there were absolute increases in mortality (8.3 vs. 4.9/100 pt-yrs) and hospitalisation (1.0 vs. 0.6/yr for the rest of the week) comparable to previous studies. In addition to hospitalisation and mortality increases seen after the two-day break, additional harm may be manifested in the greater increases in mortality and hospitalisation observed after non-attendance for the first hemodialysis session after the two-day break compared to missing other sessions.

中文翻译：

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根据每周透析日不参加血液透析后的住院率和死亡率：一项欧洲队列研究。

由于透析期间未出席而导致的透析间期的延长根据患者错过一周的哪个期间而有所不同。这对随后的住院治疗和死亡率的影响尚不清楚。ARO 队列研究前瞻性地收集了 2007 年至 2014 年来自 15 个欧洲国家的血液透析患者的人口学、合并症、实验室、住院、死亡率和个体血液透析疗程的数据。根据每周透析日计算了患者的死亡和住院事件率谁参加了前三个预定的血液透析课程，然后在下一个预定的透析日参加或没有参加。使用针对患者人口统计数据调整的 Cox 比例风险模型估计第一次缺席与本周第二次透析后的这些事件的风险比。对 9397 名患者的 380 万次血液透析进行了分析。周一/周三/周五会议的缺席率分别为 0.8、0.9% 和 1.4%，周二/周四/周六会议的缺席率分别为 0.6、1.0% 和 1.2%。与那些参加的人相比，在不参加和下一次预定的血液透析期间之间的 48-72 小时，死亡率从 4.86 显着增加到 51.9/100 pt-yrs，住院率从 0.58 增加到 2.1/yr。随着两天休息时间的增加，与缺席相关的风险降低：与错过第二次血液透析相比，错过第一次治疗的死亡率风险比为 2.04 (95% CI 1.27–3.29)，住院风险比为 1.78 (95% CI 1.29–2.47)。在参加预定透析会议和前三天的患者中，两天休息后死亡率（8.3 vs. 4.9/100 pt-yrs）和住院率（1.0 vs. 0.6/yrs，其余时间为1.0 vs. 0.6/yr）绝对增加周）与以前的研究相当。除了两天休息后住院和死亡率增加外，与错过其他时间相比，在两天休息后第一次血液透析不参加后观察到的死亡率和住院率增加更多，可能会表现出额外的危害。在参加预定透析会议和前三天的患者中，两天休息后死亡率（8.3 vs. 4.9/100 pt-yrs）和住院率（1.0 vs. 0.6/yr，其余时间为1.0 vs. 0.6/yr）绝对增加周）与以前的研究相当。除了两天休息后住院和死亡率增加外，与错过其他时间相比，在两天休息后第一次血液透析不参加后观察到的死亡率和住院率增加更多，可能会表现出额外的危害。在参加预定透析会议和前三天的患者中，两天休息后死亡率（8.3 vs. 4.9/100 pt-yrs）和住院率（1.0 vs. 0.6/yr，其余时间为1.0 vs. 0.6/yr）绝对增加周）与以前的研究相当。除了两天休息后住院和死亡率增加外，与错过其他时间相比，在两天休息后第一次血液透析不参加后观察到的死亡率和住院率增加更多，可能会表现出额外的危害。