High mortality rates after both open surgical and endovascular thoracic aortic interventions in patients with end-stage renal disease

Abstract Objectives To characterize a LN cohort over 40 years, assessing its evolution, analysing two major outcomes: the development of end-stage renal disease and mortality rates in the first 5 years after LN diagnosis. Methods An observational retrospective study of patients with LN, followed up from 1975 at University College Hospital. Patients were divided into four groups, depending on the decade of LN diagnosis: 1975–1985 (D1), 1986–1995 (D2), 1996–2005 (D3) and 2006–2015 (D4). Comparison between groups was performed with respect to demographic, clinical, serological and histological characteristics and outcome. Results Two hundred and nineteen patients with LN were studied. There was a change in ethnic distribution, with a decreasing proportion of Caucasians (58.6% in D1 to 31.3% in D4, P = 0.018) and increase in African-ancestry (17.2% in D1 to 39.6% in D4, P = 0.040). Serological and histological patterns changed throughout time, with a reduction in class IV nephritis (51.7% in D1 to 27.1% in D4, P = 0.035), and increase in class II nephritis (10% in D2 to 18.8% in D4, P = 0.01) and anti-extractable nuclear antigen antibody positivity (17.2% in D1 to 83.3% in D4, P = 0.0001). The 5-year mortality rates decreased from D1 (24.1%) to D2 (4%), stabilizing for the next 30 years. The 5-year progression to end-stage renal disease remained stable over the decades. Conclusion Despite the changes in treatment of LN in the past 20 years, we have reached a plateau in 5-year mortality and progression to end-stage renal disease rates, suggesting that new therapeutic and management approaches, and strategies to enhance adherence, are needed to improve outcomes further in LN patients.

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Effect of Intradialytic Parenteral Nutrition on Mortality Rates in End-Stage Renal Disease Care

American Journal of Kidney Diseases ◽

10.1016/s0272-6386(12)80134-x ◽

1994 ◽

Vol 23 (6) ◽

pp. 808-816 ◽

Cited By ~ 105

Author(s):

John P. Capelli ◽

Harvey Kushner ◽

Theodore C. Camiscioli ◽

Shwu-Miin Chen ◽

Mario A. Torres

Keyword(s):

Parenteral Nutrition ◽

Renal Disease ◽

End Stage Renal Disease ◽

Mortality Rates ◽

Stage Renal Disease ◽

End Stage ◽

Intradialytic Parenteral Nutrition

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Facility Mortality Rates for New End-Stage Renal Disease Patients: Implications for Quality Improvement

American Journal of Kidney Diseases ◽

10.1016/s0272-6386(12)80193-4 ◽

1994 ◽

Vol 24 (2) ◽

pp. 280-289 ◽

Cited By ~ 16

Author(s):

William McClellan ◽

J. Michael Soucie

Keyword(s):

Quality Improvement ◽

Renal Disease ◽

End Stage Renal Disease ◽

Mortality Rates ◽

Stage Renal Disease ◽

End Stage

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One-Year Mortality Rates in US Children with End-Stage Renal Disease

American Journal of Nephrology ◽

10.1159/000380828 ◽

2015 ◽

Vol 41 (2) ◽

pp. 121-128 ◽

Cited By ~ 23

Author(s):

Blanche M. Chavers ◽

Julia T. Molony ◽

Craig A. Solid ◽

Michelle N. Rheault ◽

Allan J. Collins

Keyword(s):

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Mortality Rates ◽

Transplant Recipients ◽

Dialysis Patients ◽

One Year ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Background/Aims: Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. Methods: In this retrospective cohort study, we used the US Renal Data System database to identify period-prevalent cohorts of patients aged younger than 19 for each year during the period 1995-2010. Yearly cohorts averaged approximately 1,200 maintenance dialysis patients (60% hemodialysis, 40% peritoneal dialysis) and 1,100 transplant recipients. Patients were followed for up to 1 year and censored at change in modality, loss to follow-up, or death. We calculated the unadjusted model-based mortality rates per time at risk, within each cohort year, by treatment modality (hemodialysis, peritoneal dialysis, transplant) and patient characteristics; percentage of deaths by cause; and overall adjusted odds of mortality by characteristics and modality. Results: Approximately 50% of patients were in the age group 15-18, 55% were male, and 45% were female. The most common causes of ESRD were congenital/reflux/obstructive causes (55%) and glomerulonephritis (30%). One-year mortality rates showed evidence of a decrease in the number of peritoneal dialysis patients (6.03 per 100 patient-years, 1995; 2.43, 2010; p = 0.0263). Mortality rates for transplant recipients (average 0.68 per 100 patient-years) were consistently lower than the rates for all dialysis patients (average 4.36 per 100 patient-years). Conclusions: One-year mortality rates differ by treatment modality in pediatric ESRD patients.

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Spatiotemporal trends and prognosis of end-stage renal disease patients with biopsy-proven immunoglobulin A nephropathy in France from 2010 to 2014

Clinical Kidney Journal ◽

10.1093/ckj/sfaa029 ◽

2020 ◽

Author(s):

Thomas Robert ◽

Rodolphe Jantzen ◽

Alexandra Cambier ◽

Matthieu Jamme ◽

Cecile Couchoud ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Immunoglobulin A ◽

Mortality Rates ◽

Treatment Modalities ◽

Immunoglobulin A Nephropathy ◽

Spatiotemporal Trends ◽

Stage Renal Disease ◽

End Stage ◽

Preemptive Transplantation

Abstract Background Although end-stage renal disease (ESRD) is frequently used as an outcome marker for primary immunoglobulin A nephropathy (IgAN), the clinical course after reaching ESRD is not well documented. This study examined patients’ characteristics and survival in ESRD-related biopsy-proven IgAN in France. Methods French Renal Epidemiology and Information Network Registry data from 2010 to 2014 were used to analyse patients’ survival and outcome in incident ESRD patients >16 years of age with biopsy-proven primary IgAN, in comparison with other primary and secondary glomerulonephritis (GN), adult polycystic kidney disease (ADPKD) or diabetes. Multivariable survival analysis was adjusted for age, sex, time on dialysis and comorbidities. Results Among 17 138 incident dialysis patients with ESRD, IgAN (242.8/10 000 dialysis initiation) represents the most common GN related to ESRD during 2010. IgAN patients were the youngest, and had the fewest comorbidities and the highest use of peritoneal dialysis (PD) (17%). In comparison with the haemodialysis group, hazard ratios for death were not different in the preemptive transplantation group [0.46, 95% confidence interval (CI) 0.17–1.28] and in the PD group (0.77, 95% CI 0.44–1.33). Mortality rates in IgAN patients with preemptive transplantation and in those receiving dialysis waiting for transplantation were 2.9% (95% CI 0.0–5.6) and 6.7% (95% CI 0.9–12.3). Mortality rates of ADPKD patients receiving dialysis waiting for transplantation were higher (18%, 95% CI 3.1–30.6). Conclusion IgAN has the best prognosis among primary and secondary GN. IgAN patients receiving dialysis waiting transplantation seem to have a more favourable prognosis than ADPKD patients, who usually comprise the reference population. The underlying reasons for the difference in access treatment modalities should be investigated to improve survival with respect to renal disease.

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NEPHROLOGY CARE AND MORTALITY RATES AMONG PATIENTS WITH END-STAGE RENAL DISEASE IN PUERTO RICO AND THE UNITED STATES

Innovation in Aging ◽

10.1093/geroni/igz038.2083 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S563-S564

Author(s):

Maricruz Rivera-Hernandez ◽

Shailender Swaminathan ◽

Rebecca Thorsness ◽

Yoojin Lee ◽

Rajnish Mehrotra ◽

...

Keyword(s):

Puerto Rico ◽

Renal Disease ◽

End Stage Renal Disease ◽

Mortality Rates ◽

Dialysis Initiation ◽

Absolute Difference ◽

The Us ◽

Nephrology Care ◽

Stage Renal Disease ◽

End Stage

Abstract Hispanics with incidence of end-stage renal disease (ESRD) have shown lower mortality despites their high incidence rates; However, prior research has excluded Puerto Rico (PR). This study compared mortality rates and predialysis nephrology care among Hispanics in the US, Hispanics in PR, and Whites in the US with ESRD from 2006-2015. We identified 791,443 patients using the Renal Management Information System. The primary outcome was age-adjusted 1-year mortality beginning with the 91st day following dialysis initiation. Secondary outcomes were the presence of arteriovenous fistula or graft at dialysis initiation, and receipt of predialysis nephrology care. Despite higher rates of insurance coverage, we identified substantial disparities in access to recommended nephrology care between PR and the US. In addition, the adjusted absolute difference in mortality rates was higher for PR Hispanics. This finding indicates shortcomings in quality of care for Puerto Rico with serious chronic illness and complex care needs.

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Recent advances in treatment of haemodialysis

Journal of the Royal Society of Medicine ◽

10.1177/0141076820972669 ◽

2020 ◽

pp. 014107682097266

Author(s):

James O. Burton ◽

Richard W. Corbett ◽

Philip A. Kalra ◽

Prashanth Vas ◽

Vivian Yiu ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Diabetes Management ◽

Mortality Rates ◽

Standards Of Care ◽

Improved Outcomes ◽

Collaborative Paper ◽

Clinical Benefits ◽

Stage Renal Disease ◽

End Stage

Haemodialysis remains the most widely used treatment for patients with end-stage renal disease. Despite the progress that has occurred in the treatment of end-stage renal disease over the last six decades, there has been a failure to translate this into the desired clinical benefits, with morbidity and mortality rates among patients on haemodialysis remaining unacceptably high. Recently, however, there have been expectations that the significant advances that took place over the last few years may result in improved outcomes. New medications for the treatment of anaemia and secondary hyperparathyroidism, as well as novel trends in the areas of iron therapy, diabetes management and physical exercise are among the most important advances which, taken together, are changing the standards of care for patients on haemodialysis. The latest advances, of relevance not only to specialists in Renal Medicine but also to general practitioners caring for these patients, are reviewed in this collaborative paper.

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