{"doi":"10.1111/hdi.12346","title":"Institutional factors influencing regional differences in the 1‐year survival of dialysis patients","abstract":"<jats:title>Abstract</jats:title><jats:p>There are regional differences in the survival of incident dialysis patients, but few studies have investigated the reasons. We assessed the effect of institutional factors on factors on survival (by both cross‐sectional assessment and after a 1‐year investigation) in a cohort of the <jats:styled-content style=\"fixed-case\">J</jats:styled-content>apanese <jats:styled-content style=\"fixed-case\">S</jats:styled-content>ociety for <jats:styled-content style=\"fixed-case\">D</jats:styled-content>ialysis <jats:styled-content style=\"fixed-case\">T</jats:styled-content>herapy (<jats:styled-content style=\"fixed-case\">JSDT</jats:styled-content>). We investigated 20 institutional factors from 3958 dialysis institution data of the 47 prefectures in <jats:styled-content style=\"fixed-case\">J</jats:styled-content>apan in 2005 and the <jats:styled-content style=\"fixed-case\">JSDT</jats:styled-content> database of 102,011 patients who commenced dialysis during 2004–2006. Univariate regression analysis between 20 factors and 1‐year survival rate, Kaplan–Meier method, log‐rank test, and <jats:styled-content style=\"fixed-case\">C</jats:styled-content>ox's proportional hazard model between the upper 24 and the lower 23 prefectures of the significant factors were carried out. The age‐adjusted 1‐year survival rate was 0.832 ± 0.027. Deaths occurred in 15.0% in 24 upper survival prefectures and 18.7% in 23 lower survival prefectures (P &lt; 0.0001, unadjusted hazard ratio [<jats:styled-content style=\"fixed-case\">HR</jats:styled-content>] of death in lower survival prefectures: 1.26, 95% confidence interval [CI]: 1.17–1.40). A total of five factors among males were significantly correlated with 1‐year survival according to the univariate regression analysis. Among them, three factors (night‐time center/total dialysis center ratio [males: P &lt; 0.0001, age, genders, and presence of diabetes adjusted HR: 0.88, 95% CI: 0.81–0.93], number of full‐time dialysis nurses [males: P = 0.0427, 0.94, 0.87–1.00], number of full‐time dialysis dietitians [males: P = 0.0084, 0.92, 0.85–0.98], respectively) were significant in <jats:styled-content style=\"fixed-case\">K</jats:styled-content>aplan–<jats:styled-content style=\"fixed-case\">M</jats:styled-content>eier analysis, log‐rank test, and the <jats:styled-content style=\"fixed-case\">C</jats:styled-content>ox's model. Institutional factors were closely related to the survival of incident dialysis patients, and regional differences in the survival may be explained, at least partly, by these factors.</jats:p>","journal":"Hemodialysis International","year":2015,"id":16766,"datarank":0.12297772558321611,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.019005648499224304,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.019005648499224304,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":122498,"name":"Shinichi Nishi","orcid":null,"position":1,"is_corresponding":false},{"id":122499,"name":"Kenji Wakai","orcid":null,"position":2,"is_corresponding":false},{"id":122500,"name":"Norio Hanafusa","orcid":null,"position":3,"is_corresponding":false},{"id":122501,"name":"Kunitoshi Iseki","orcid":null,"position":4,"is_corresponding":false},{"id":122502,"name":"Yoshiharu Tsubakihara","orcid":null,"position":5,"is_corresponding":false},{"id":122503,"name":"Ikuto Masakane","orcid":null,"position":6,"is_corresponding":false},{"id":122496,"name":"Satoshi Ogata","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26448388","pmcid":null,"openalex_id":"https://openalex.org/W2137072291","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.06528546,"influential_citations":0,"citation_trend":[{"year":2022,"count":1}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fhdi.12346","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/hdi.12346","host_type":"publisher"},{"url":"https://doi.org/10.1111/hdi.12346","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/26448388","host_type":"repository"}],"fields_of_study":["Dialysis and Renal Disease Management","Healthcare Policy and Management","Health Systems, Economic Evaluations, Quality of Life","Medicine","Cohort Studies","Cross-Sectional Studies","Female","Humans","Kaplan-Meier Estimate","Kidney Failure, Chronic","Male","Proportional Hazards Models","Renal Dialysis","Survival Analysis","Survival Rate","Time Factors"],"mesh_terms":["Cross-Sectional Studies","Female","Renal Dialysis","Humans","Kidney Failure, Chronic","Male","Time Factors","Cohort Studies","Survival Rate","Proportional Hazards Models","Survival Analysis","Kaplan-Meier Estimate"],"keywords":["Medicine","Hemodialysis","Dialysis","Intensive care medicine","Internal medicine","Survival","Nurse","End-stage Renal Disease","Dietitian"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-02T14:40:26.371938Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}