Patients undergoing assisted peritoneal dialysis show a better technique survival: a competing risk analysis

Objective: The nutritional status of patients on peritoneal dialysis (PD) is influenced by patient- and disease-related factors and lifestyle. This analysis evaluated the association of PD prescription with body composition and patient outcomes in the prospective incident Initiative for Patient Outcomes in Dialysis–Peritoneal Dialysis (IPOD-PD) patient cohort.Design and Methods: In this observational, international cohort study with longitudinal follow-up of 1,054 incident PD patients, the association of PD prescription with body composition was analyzed by using the linear mixed models, and the association of body composition with death and change to hemodialysis (HD) by means of a competing risk analysis combined with a spline analysis. Body composition was regularly assessed with the body composition monitor, a device applying bioimpedance spectroscopy.Results: Age, time on PD, and the use of hypertonic and polyglucose solutions were significantly associated with a decrease in lean tissue index (LTI) and an increase in fat tissue index (FTI) over time. Competing risk analysis revealed a U-shaped association of body mass index (BMI) with the subdistributional hazard ratio (HR) for risk of death. High LTI was associated with a lower subdistributional HR, whereas low LTI was associated with an increased subdistributional HR when compared with the median LTI as a reference. High FTI was associated with a higher subdistributional HR when compared with the median as a reference. Subdistributional HR for risk of change to HD was not associated with any of the body composition parameters. The use of polyglucose or hypertonic PD solutions was predictive of an increased probability of change to HD, and the use of biocompatible solutions was predictive of a decreased probability of change to HD.Conclusion: Body composition is associated with non-modifiable patient-specific and modifiable treatment-related factors. The association between lean tissue and fat tissue mass and death and change to HD in patients on PD suggests developing interventions and patient counseling to improve nutritional markers and, ultimately, patient outcomes.Study Registration: The study has been registered at Clinicaltrials.gov (NCT01285726).

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Bayesian competing risk analysis: An application to nasopharyngeal carcinoma patients data

Computational and Systems Oncology ◽

10.1002/cso2.1006 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Rakesh Kumar Saroj ◽

K. Narasimha Murthy ◽

Mukesh Kumar ◽

Atanu Bhattacharjee ◽

Kamalesh Kumar Patel

Keyword(s):

Nasopharyngeal Carcinoma ◽

Risk Analysis ◽

Competing Risk ◽

Competing Risk Analysis

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Self-employment duration during the COVID-19 pandemic: A competing risk analysis

Journal of Business Venturing Insights ◽

10.1016/j.jbvi.2021.e00241 ◽

2021 ◽

pp. e00241

Author(s):

Jasper Grashuis

Keyword(s):

Risk Analysis ◽

Competing Risk ◽

Competing Risk Analysis ◽

Self Employment ◽

Employment Duration

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Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

American Journal of Nephrology ◽

10.1159/000494664 ◽

2018 ◽

Vol 48 (6) ◽

pp. 425-433 ◽

Cited By ~ 7

Author(s):

Solène Guilloteau ◽

Thierry Lobbedez ◽

Sonia Guillouët ◽

Christian Verger ◽

Maxence Ficheux ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Lower Risk ◽

Regression Models ◽

Cox Regression ◽

French Language ◽

Dialysis Modality ◽

Technique Survival ◽

Hazard Ratios ◽

Effect Of Pd ◽

Assisted Peritoneal Dialysis

Background: Patients on peritoneal dialysis (PD) can be assisted by a nurse or a family member and treated either by automated PD (APD) or continuous ambulatory PD (CAPD). The aim of this study was to evaluate the effect of PD modality and type of assistance on the risk of transfer to haemodialysis (HD) and on the peritonitis risk in assisted PD patients. Method: This was a retrospective study based on data from the French Language PD Registry. All adults starting assisted PD in France between 2006 and 2015 were included. Events of interest were transfer to HD, peritonitis and death. Cox regression models were used for statistical analysis. Results: Among the 12,144 incident patients who started PD in France during the study period, 6,167 were assisted. There were 5,060 nurse-assisted and 1,095 family-assisted PD patients. Overall, 5,171 were treated by CAPD and 996 by APD. In multivariate analysis, CAPD, compared to APD, was not associated with the risk of transfer to HD (cause specific hazard ratios [cs-HR] 0.96 [95% CI 0.84–1.09]). Patients on nurse-assisted PD had a lower risk of transfer to HD than family assisted PD patients (cs-HR 0.85 [95% CI 0.75–0.97]). Neither PD modality nor type of assistance were associated with peritonitis risk. Conclusions: In assisted PD, technique survival was not associated with PD modality. Nurse-assisted patients had a lower risk of transfer to HD than family assisted patients. Peritonitis risk was not influenced either by PD modality, or by type of assistance. Both APD and CAPD should be offered to assisted-PD patients.

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Standard and competing risk analysis of the effect of albuminuria on cardiovascular and cancer mortality in patients with type 2 diabetes mellitus

Diagnostic and Prognostic Research ◽

10.1186/s41512-018-0035-4 ◽

2018 ◽

Vol 2 (1) ◽

Cited By ~ 7

Author(s):

Benjamin G. Feakins ◽

Emily C. McFadden ◽

Andrew J. Farmer ◽

Richard J. Stevens

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Analysis ◽

Cancer Mortality ◽

Competing Risk ◽

Competing Risk Analysis

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A Scoring System For Predicting Hepatocellular Carcinoma Risk In Alcoholic Cirrhosis: A Competing Risk Analysis

10.21203/rs.3.rs-970975/v1 ◽

2021 ◽

Author(s):

Kyunghan Lee ◽

Gwang Hyeon Choi ◽

Eun Sun Jang ◽

Sook-Hyang Jeong ◽

Jin–Wook Kim

Keyword(s):

Hepatocellular Carcinoma ◽

Risk Analysis ◽

Viral Hepatitis ◽

Validation Cohort ◽

Alcoholic Cirrhosis ◽

Competing Risk ◽

Competing Risk Analysis ◽

Hazards Model ◽

B Virus

Abstract Background & Aims: The role of hepatocellular carcinoma (HCC) surveillance is being questioned in alcoholic cirrhosis because of the relative low HCC risk. Comorbid viral hepatitis may synergistically increase the HCC risk in alcoholic cirrhosis. This study aimed to assess the risk and predictors of HCC in patients with alcoholic cirrhosis by using competing risk analysis in an area with intermediate prevalence for hepatitis B virus.Methods: A total of 965 patients with alcoholic cirrhosis were recruited at a university-affiliated hospital in Korea and randomly assigned to either the derivation (n=643) and validation (n=322) cohort. Subdistribution hazards model of Fine and Gray was used with deaths and liver transplantation treated as competing risks. Death records were confirmed from Korean government databases. A nomogram was developed to calculate the Alcohol-associated Liver Cancer Estimation (ALICE) score.Results: Markers for viral hepatitis were positive in 21.0 % and 25.8 % of patients in derivation and validation cohort, respectively. The cumulative incidence of HCC was 13.5 and 14.9 % at 10 years for derivation and validation cohort, respectively. Age, positivity for viral hepatitis markers, alpha-fetoprotein level, and platelet count were identified as independent predictors of HCC and incorporated in the ALICE score, which discriminated low, intermediate, and high risk for HCC in alcoholic cirrhosis at the cut-off of 120 and 180. Conclusions: HCC risk can be stratified by using clinical parameters including viral markers in alcoholic cirrhosis in an area where the prevalence of viral hepatitis is substantial.

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