scholarly journals P1493CORRELATION BETWEEN END-DIALYSIS OVER-WEIGHT IN INITIAL STAGE OF HEMODIALYSIS AND PROGNOSIS IN INCIDENT HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ping Zhang ◽  
Ying Wang ◽  
Xi Yao ◽  
Shaohua Chen ◽  
Chunping Xu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cardiovascular Mortality ◽  
Multivariate Regression ◽  
Independent Risk Factor ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Interdialytic Weight Gain ◽  
The Relationship

Abstract Background and Aims The volume factor of maintenance hemodialysis patients is closely related to the prognosis. We hypothesized that the excess weight after dialysis (end-dialysis over-weight, edOW) is an important factor of volume impact survival in hemodialysis (HD) patients. The purpose of this study was to analyze the relationship between edOW and long-term prognosis of patients with maintenance hemodialysis. Method This retrospective study observed incident hemodialysis patients who treated in Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017, three times a week for at least one year. The end point of follow-up was death, abdominal dialysis, kidney transplantation, transfer or until April 30, 2018. The general data of the patients included age, gender, BMI, primary renal disease, CVD, first hemodialysis access, albumin(Alb), Haemoglobin(Hb), blood pressure, heart rate, ultrafiltration rate(UFR), interdialytic weight gain IDWG, end -dialysis overweight (edOW). Cox multivariate regression was used to analyze the relationship between edow and all-cause mortality and cardiovascular mortality. Results Totally 469 patients male, 64% were enrolled, with an average age of 56.9 ± 17.1 years. During the follow-up period, 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.7%. The mean value of edow was 0.28 ± 0.02 kg. Kaplan-Meier(Log-rank test) survival analysis showed that the long-term survival rate of the group with edow ≤ 0.28kg was better than that of the group with edow > 0.28kg (P = 0.042), and the cardiovascular mortality of the group with edow > 0.28kg was significantly higher than that of the group with edow ≤ 0.28kg (P = 0.001). Cox multivariate regression analysis showed that edow was an independent risk factor for all-cause death in hemodialysis patients (P = 0.025, AhR = 1.541, 95% CI 1.057-2.249), and also an independent risk factor for CVD death in hemodialysis patients (P = 0.007, AhR = 1.929, 95% CI 1.198-3.107). Conclusion EdOW is an independent risk factor of long-term all-cause and cardiovascular death in hemodialysis patients.

scholarly journals Impact of ventricular arrhythmias on survival in patients after myocardial infarction

2014 ◽  
Vol 1 (1) ◽  
pp. 21 ◽  
Author(s):  
Katarzyna Anna Mitręga ◽  
Agnieszka Kolczyńska ◽  
Joanna Hanzel ◽  
Sylwia Cebula ◽  
Stanisław Morawski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Ventricular Arrhythmias ◽  
Independent Risk Factor ◽  
Premature Ventricular Beats ◽  
Large Numbers ◽  
Ventricular Extrasystoles ◽  
Long Term Follow Up

Introduction: Despite the continuous development of new methods of pharmacological and invasive treatment for patients with acute myocardial infarction (MI) the prognosis of long-term survival is still uncertain. Therefore, there is still need to look for new noninvasive predictors of death in patients after MI. Aim: To analyze the prognostic value of ventricular arrhythmias in predicting mortality following MI in long-term follow-up. Methods: We analyzed 390 consecutive patients (114 females and 276 males, aged 63.9 ± 11.15 years, mean EF: 43.8 ± 7.9%) with MI treated invasively.  On the 5th day after MI 24-hour digital Holter recording was performed to assess the number of premature ventricular beats (VPB) and their sustained forms such as: salvos and nonsustained ventricular tachycardia (nsVT <  30 s). The large numbers of ventricular extrasystoles: ≥ 10 VPB / hour were considered as abnormal. In echocardiography the size of heart cavities and cardiac contractile function were evaluated. Within 30.1 ± 15.1 months of follow-up 38 patients died. Results: In the group of patients with MI the mean value of ventricular ectopy during the day was: 318.8 ± 1447.6. Large numbers of ventricular extrasystoles were observed in 75% patients, while nsVT in 6% patients. Significant differences in the incidence of death after MI were observed in patients with nsVT and ventricular salvos. In the group of patients who died in comparison to the group of patients who survived in long-term follow-up, a significantly less ventricular ectopic incidence was noted (9.83% vs 90.17%, p < 0.01). In patients who died after MI more premature ventricular beats (≥ 10 VPB / h) and a greater nsVT incidence were observed; however not significant. Moreover, in patients with MI the systolic and diastolic LV dimension, decreased values of hemoglobin, salvos and nsVT incidence are the independent risk factors of death. The strongest independent risk factor of death after MI is salvos (HR: 1.32, P < 0.01). Conclusions: In long term follow-up the largest differences in death were observed in patients with ventricular salvos and nsVT. Furthermore, ventricular salvos are the strongest independent risk factor of death in patients with AMI. 

Intradialytic Hypotension as an Independent Risk Factor for Long-Term Mortality in Maintaining Hemodialysis Patients: A 5-Year Follow-Up Cohort Study

2018 ◽  
Vol 45 (4) ◽  
pp. 320-326 ◽  
Author(s):  
Jinbo Yu ◽  
Zhonghua Liu ◽  
Bo Shen ◽  
Jie Teng ◽  
Jianzhou Zou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Independent Risk Factor ◽  
Left Ventricular ◽  
Intradialytic Hypotension ◽  
Ultrafiltration Rate ◽  
Long Term Mortality

Aims: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. Methods: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. Results: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH. During the 5-year follow-up, 84 patients died with a mortality rate 5.2 per 100 person-year. IDH-prone patients had a higher all-cause mortality rate. IDH and left ventricular mass index were independent risk factors for death (HR 1.655, 95% CI 1.061–2.580; HR 1.008, 95% CI 1.001–1.016). Conclusion: IDH is an independent risk factor for long-term mortality in MHD patients. Patients with older age, high ultrafiltration rate, high level of serum NT-proBNP and β2MG, hypoalbuminemia, and shorter AoRD are at high risk of IDH.

Impact of Early Nephrology Referral on Mortality and Hospitalization in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Kai Ming Chow ◽  
Cheuk Chun Szeto ◽  
Man Ching Law ◽  
Bonnie Ching-Ha Kwan ◽  
Chi Bon Leung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Mortality ◽  
Univariate Analysis ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
Poor Outcomes ◽  
The Relationship ◽  
Late Referral ◽  
Relevant Factors

Objectives Several studies have examined the possible association between late referral to a nephrologist and mortality on maintenance hemodialysis. However, we lack information on the benefit of early nephrologist referral in patients receiving peritoneal dialysis (PD). Patients and Methods In an inception cohort of 102 consecutive PD patients identified in a single center between 2003 and 2004, we sought to determine whether late nephrologist referral was associated with poor outcomes. The primary end point was all-cause mortality. The effects of early referral to a multidisciplinary low clearance clinic on cardiovascular mortality and length of hospitalization were also evaluated. Results Of 102 incident PD patients, 61 subjects (59.8%) were referred early to the nephrologist (more than 3 months) before dialysis initiation. During the study period of 284.9 patient-years (median follow-up period 36.8 months), 25 patients died, 12 due to cardiovascular causes. Both cardiovascular and all-cause mortality were significantly increased among PD patients with late referral, but the relationship between late referral and all-cause mortality was mitigated substantially by adjusting for relevant factors. In univariate analysis, late nephrology referral was associated with increased cardiovascular mortality, with a hazard ratio of 5.43 (95% confidence interval 1.46 – 20.21, p = 0.012). Annual adjusted days of hospitalization were similar between the early and late nephrology referral groups. Conclusions A comprehensive analysis of incident PD subjects confirmed the significant relationship between late nephrology referral and all-cause and cardiovascular mortality. A causal relationship remains to be established and validated.

scholarly journals A data analysis study: is there a relationship between 25(OH)D deficiency and iron-deficient anaemia in the pediatric population?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Huseyin Fatih Gul ◽  
Hayrunnisa Bekis Bozkurt ◽  
Güluzar Özbolat ◽  
Seda Celik
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Serum Vitamin ◽  
Iron Deficient ◽  
25 Oh Vitamin D ◽  
Positive Correlations ◽  
The Relationship

AbstractObjectivesThe purpose of this retrospective study was to investigate the relationship between 25 OH vitamin D (25[OH]D) deficiency and iron-deficient anaemia (IDA) in the pediatric population. This was aimed to provide a better insight to IDA follow-up and treatment.MethodsThe data of 120 patients diagnosed with IDA and 125 healthy pediatric patients were analyzed retrospectively. Serum vitamin B12, Folate and 25(OH)D levels, between IDA and healthy groups were evaluated. The relationship between vitamins levels and IDA parameters were examined. Logistic regression analysis was used to assess whether 25(OH)D deficiency levels were an independent risk factor for diagnosing IDA.ResultsIn the comparison of vitamins levels between groups, only mean serum 25(OH)D levels were found to be statistically significantly (p=0.000) lower (13.00 ± 2.50 ng/mL) in the group with IDA compared to the healthy group (25.98 ± 3.66 ng/mL). There were strong positive correlations between 25(OH)D deficiency levels and IDA. The deficiency of 25(OH)D levels was not found to be an independent risk factor for IDA (ORs: 0.958, 95%CI: 0.917–1.000).ConclusionsAlthough current results confirm the association between 25(0H)D deficiency and IDA in pediatric patients, they indicate that there was no independent risk factor for IDA.

scholarly journals Annual change in the extracellular fluid/intracellular fluid ratio and mortality in patients undergoing maintenance hemodialysis

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Takahiro Yajima ◽  
Kumiko Yajima ◽  
Hiroshi Takahashi
Keyword(s):  
Cardiovascular Mortality ◽  
Risk Model ◽  
Extracellular Fluid ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
First Year ◽  
Annual Change ◽  
Intracellular Fluid ◽  
All Cause Mortality

AbstractWe aimed to investigate whether annual change in the extracellular fluid to intracellular fluid (ΔECF/ICF) ratio can accurately predict mortality in hemodialysis patients. Totally, 247 hemodialysis patients were divided into two groups according to the median baseline ECF/ICF ratio of 0.563 and ΔECF/ICF ≥ 0% or < 0% during the first year, respectively. Thereafter, they were divided into four groups according to each cutoff point and were followed up for mortality assessment. The ECF/ICF ratio increased from 0.566 ± 0.177 to 0.595 ± 0.202 in the first year (P = 0.0016). During the 3.4-year median follow-up, 93 patients died (42 cardiovascular-specific causes). The baseline ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% were independently associated with all-cause mortality (adjusted hazard ratio [aHR] 4.55, 95% confidence interval [CI] 2.60–7.98 and aHR 8.11, 95% CI 3.47–18.96, respectively). The aHR for ECF/ICF ≥ 0.563 and ΔECF/ICF ≥ 0% vs. ECF/ICF < 0.563 and ΔECF/ICF < 0% was 73.49 (95% CI 9.45–571.69). For model discrimination, adding the ΔECF/ICF (0.859) alone and both the baseline ECF/ICF and ΔECF/ICF (0.903) to the established risk model (0.746) significantly improved the C-index. Similar results were obtained for cardiovascular mortality. In conclusion, the ΔECF/ICF ratio could not only predict all-cause and cardiovascular mortality but also improve predictability of mortality in hemodialysis patients.

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