Clinical significance of multi-frequency bioimpedance spectroscopy in peritoneal dialysis patients: independent predictor of patient survival

Purpose: Cardiovascular diseases are the main causes of morbidity and mortality in children with end-stage renal disease and the relationships among several relevant potential biomarkers were investigated in pediatric peritoneal dialysis patients. Methods: Serum homocysteine, von Willebrand factor (vWF), apolipoproteins A and B, lipoprotein-a, high sensitive-CRP, hemoglobin, phosphorus and parathyroid hormone (PTH) levels, systolic (SBP) and diastolic (DBP) blood pressure, carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured in 21 pediatric peritoneal dialysis patients and control subjects. Results: All risk factors were higher in patients than controls. LVMI values were negatively correlated with hemoglobin and positively correlated with PTH and phosphorus levels (p=0.007, r= - 0.573; p=0.013, r= 0.532 and p=0.035, r= 0.461, respectively). cIMT was negatively associated with serum albumin and positively correlated with vWF levels and with SBP and DBP (p=0.006, r= - 0.578; p=0.039, r= 0.453; p=0.02, r= 0.503; p=0.024, r= 0.491, respectively). Robust regression analyses showed that hemoglobin was an independent predictor of LVMI and serum albumin was an independent predictor of cIMT. Conclusion: Only uremia-related factors were independent risk factors for predicting LVMI and cIMT. Hemoglobin level may be a critical factor in the development of left ventricular hypertrophy; therefore, effective treatment of anemia is crucial. Low serum albumin and high hsCRP and vWF levels, and their correlations with cIMT, indicate these patients could be at risk of developing malnutrition–inflammation–atherosclerosis syndrome and suggest that serum albumin and vWF levels may be useful markers for early detection of vascular damage.

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Volume Control in Peritoneal Dialysis Patients Guided by Bioimpedance Spectroscopy Assessment

Blood Purification ◽

10.1159/000322617 ◽

2011 ◽

Vol 31 (4) ◽

pp. 296-302 ◽

Cited By ~ 31

Author(s):

Ya-Jun Luo ◽

Xin-Hong Lu ◽

Feidhlim Woods ◽

Tao Wang

Keyword(s):

Peritoneal Dialysis ◽

Volume Control ◽

Bioimpedance Spectroscopy ◽

Dialysis Patients

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Significant Decreasing Incidence of Encapsulating Peritoneal Sclerosis in the Dutch Population of Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00109 ◽

2017 ◽

Vol 37 (2) ◽

pp. 230-234 ◽

Cited By ~ 11

Author(s):

Michiel G.H. Betjes ◽

Sayed M. Habib ◽

Els W. Boeschoten ◽

Aline C. Hemke ◽

Dick G. Struijk ◽

...

Keyword(s):

Peritoneal Dialysis ◽

The Netherlands ◽

Patient Survival ◽

Average Duration ◽

Dutch Population ◽

Dialysis Patients ◽

Post Transplantation ◽

Surgical Interventions ◽

Yearly Incidence

The Dutch Encapsulating Peritoneal Sclerosis (EPS) Registry was started in 2009. Cases were identified by contacting all Dutch nephrologists twice yearly. The predefined criteria for EPS allowed for inclusion of patients with diagnosed and suspected EPS. Cases registered between January 2009 and January 2015 were analyzed with follow-up until September 2015. Fifty-three EPS cases were identified, of which 28.3% were post-transplantation EPS cases. Fourteen patients were initially categorized as suspected EPS, of whom 13 developed EPS. A remarkable 6-fold decrease in the yearly incidence of EPS was observed, from 0.85% in 2009 to 0.14% in 2014. This decrease could not be explained by a decrease in the number of PD patients or average duration of PD treatment in this period. Two-year survival of EPS patients was 52%. The use of tamoxifen and surgical interventions increased significantly over the years. Tamoxifen-treated cases showed a trend to better patient survival and post-transplantation EPS had a significantly favorable outcome. In conclusion, the incidence of EPS has declined significantly in the Netherlands from 2009 to 2014.

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SP501EARLY CATHETER REMOVAL IMPROVES PATIENT SURVIVAL IN PERITONEAL DIALYSIS PATIENTS WITH FUNGAL PERITONITIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfx151.sp501 ◽

2017 ◽

Vol 32 (suppl_3) ◽

pp. iii297-iii297

Author(s):

Andrey Yankovoy ◽

Alexey Zulkarnaev ◽

Vadim Stepanov

Keyword(s):

Peritoneal Dialysis ◽

Patient Survival ◽

Catheter Removal ◽

Dialysis Patients ◽

Fungal Peritonitis

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Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

10.21203/rs.2.21343/v2 ◽

2020 ◽

Author(s):

Gordon Chun-Kau CHAN ◽

Jack Kit-Chung NG ◽

Kai-Ming CHOW ◽

Bonnie CH Kwan ◽

Vickie Wai-Ki KWONG ◽

...

Keyword(s):

Multivariate Analysis ◽

Peritoneal Dialysis ◽

Clinical Outcome ◽

Patient Survival ◽

Independent Predictor ◽

Univariate Analysis ◽

Adverse Clinical Outcome ◽

Duration Of Hospitalization ◽

One Year ◽

Frailty Score

Abstract Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

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Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

10.21203/rs.2.21343/v1 ◽

2020 ◽

Author(s):

Gordon Chun-Kau CHAN ◽

Jack Kit-Chung NG ◽

Kai-Ming CHOW ◽

Bonnie CH Kwan ◽

Vickie Wai-Ki KWONG ◽

...

Keyword(s):

Multivariate Analysis ◽

Peritoneal Dialysis ◽

Clinical Outcome ◽

Patient Survival ◽

Independent Predictor ◽

Univariate Analysis ◽

Adverse Clinical Outcome ◽

Duration Of Hospitalization ◽

One Year ◽

Frailty Score

Abstract Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

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Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) Peritoneal Dialysis Study Group.

Journal of the American Society of Nephrology ◽

10.1681/asn.v971285 ◽

1998 ◽

Vol 9 (7) ◽

pp. 1285-1292 ◽

Cited By ~ 10

Author(s):

D N Churchill ◽

K E Thorpe ◽

K D Nolph ◽

P R Keshaviah ◽

D G Oreopoulos ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Serum Albumin ◽

Membrane Transport ◽

Patient Survival ◽

Peritoneal Membrane ◽

Dialysis Patients ◽

Technique Survival ◽

Survival Probabilities ◽

The Mean ◽

Technique Failure

The objective of this study was to evaluate the association of peritoneal membrane transport with technique and patient survival. In the Canada-USA prospective cohort study of adequacy of continuous ambulatory peritoneal dialysis (CAPD), a peritoneal equilibrium test (PET) was performed approximately 1 mo after initiation of dialysis; patients were defined as high (H), high average (HA), low average (LA), and low (L) transporters. The Cox proportional hazards method evaluated the association of technique and patient survival with independent variables (demographic and clinical variables, nutrition, adequacy, and transport status). Among 606 patients evaluated by PET, there were 41 L, 192 LA, 280 HA, and 93 H. The 2-yr technique survival probabilities were 94, 76, 72, and 68% for L, LA, HA, and H, respectively (P = 0.04). The 2-yr patient survival probabilities were 91, 80, 72, and 71% for L, LA, HA, and H, respectively (P = 0.11). The 2-yr probabilities of both patient and technique survival were 86, 61, 52, and 48% for L, LA, HA, and H, respectively (P = 0.006). The relative risk of either technique failure or death, compared to L, was 2.54 for LA, 3.39 for HA, and 4.00 for H. The mean drain volumes (liters) in the PET were 2.53, 2.45, 2.33, and 2.16 for L, LA, HA, and H, respectively (P < 0.001). After 1 mo CAPD treatment, the mean 24-h drain volumes (liters) were 9.38, 8.93, 8.59, and 8.22 for L, LA, HA, and H, respectively (P < 0.001); the mean 24-h peritoneal albumin losses (g) were 3.1, 3.9, 4.3, and 5.6 for L, LA, HA, and H, respectively (P < 0.001). The mean serum albumin values (g/L) were 37.8, 36.2, 33.8, and 32.8 for L, LA, HA, and H, respectively (P < 0.001). Among CAPD patients, higher peritoneal transport is associated with increased risk of either technique failure or death. The decreased drain volume, increased albumin loss, and decreased serum albumin concentration suggest volume overload and malnutrition as mechanisms. Use of nocturnal cycling peritoneal dialysis should be considered in H and HA transporters.

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Bioimpedance spectroscopy‐guided fluid management in peritoneal dialysis patients with residual kidney function: A randomized controlled trial

Nephrology ◽

10.1111/nep.13571 ◽

2019 ◽

Vol 24 (12) ◽

pp. 1279-1289 ◽

Cited By ~ 3

Author(s):

Hye Eun Yoon ◽

Young Joo Kwon ◽

Seok Joon Shin ◽

So‐Young Lee ◽

Sangho Lee ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Peritoneal Dialysis ◽

Kidney Function ◽

Controlled Trial ◽

Fluid Management ◽

Bioimpedance Spectroscopy ◽

Dialysis Patients ◽

Randomized Controlled ◽

Residual Kidney Function

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Survival analysis in the incident dialysis patients by different modalities

The International Journal of Artificial Organs ◽

10.1177/03913988211041638 ◽

2021 ◽

pp. 039139882110416

Author(s):

Wenlv Lv ◽

Xiaohong Chen ◽

Yaqiong Wang ◽

Jiawei Yu ◽

Xuesen Cao ◽

...

Keyword(s):

Patient Survival ◽

Independent Predictor ◽

Final Analysis ◽

First Year ◽

Dialysis Modality ◽

Dialysis Patients ◽

All Cause Mortality ◽

Analysis Survival ◽

Patient Prognosis

Background: To analysis survival in onset uremic patients who initiating HD or PD dialysis in our dialysis center. Methods: Between Jan. 2015 and June. 2018, patients with onset uremia and initiating planned-start dialysis were retrospectively enrolled in this study and followed up to January, 2019. The relationships between the types of dialysis modality and patient prognosis were assessed. Results: A total of 460 patients were included in the final analysis. Of which, 213 patient (46.30%) undergoing PD and 247 patients (53.70%) undergoing HD with arteriovenous fistula. The average follow-up time was 27.9 months. Eighty-seven (18.91%) patients died during the study period. The all-cause mortality was 127 per 1000 person-year. It was 102 per 1000 person-year in the HD group and 171 per 1000 person-year in the PD group ( p < 0.01). However, dialysis modality was not an independent predictor for survival. During the first year after dialysis initiation, patient survival was comparable between the PD and HD groups (log-rank p = 0.14). As the dialysis age increased over 1 year, HD patients seemed to have a better survival as compared to that of PD patient (log-rank p < 0.05), especially those older than 65 years and without DN. Conclusions: Though dialysis modality was not an independent factor for overall survival, HD therapy seemed to be more suitable for patients without DN.

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