Uptake of next‐generation sequencing in children with end‐stage renal disease secondary to focal segmental glomerulosclerosis and parental decision for kidney transplantation—Experience from a low resource setting: A Retrospective Cohort Study

Background: The effect of dialysis modality on the survival of end-stage renal disease patients is a major public health interest. Methods: In this retrospective cohort study, all adult end-stage renal disease patients receiving dialysis treatment in Sabah between January 1, 2007 and December 31, 2017 as identified from the Malaysian Dialysis and Transplant Registry were evaluated and followed up through December 31, 2018. The endpoint was all-cause mortality. The observation time was defined as the time from the date of dialysis initiation after the onset of end-stage renal disease to whichever of the following that came first: date of death, date of transplantation, date of last follow-up, date of recovered kidney function, or December 31, 2018. Weighted Cox regression was used to estimate the effect of dialysis modality. Analyses were restricted to patients with complete data on all variables. Results: 1,837 patients began hemodialysis and 156 patients started with peritoneal dialysis, yielding 7,548.10 (potential median 5.48 years/person) and 747.98 (potential median 5.68 years/person) person-years of observation. 3.1% of patients were lost to follow-up. The median survival time was 5.8 years (95% confidence interval: 5.4, 6.3) among patients who started on hemodialysis and 7.0 years (95% confidence interval: 5.9, indeterminate) among those who started on peritoneal dialysis. The effect of dialysis modality was not significant after controlling for confounders. The average hazard ratio was 0.80 (95% confidence interval: 0.61, 1.05) with hemodialysis as a reference. Conclusion: There was no evidence of a difference in mortality between hemodialysis and peritoneal dialysis.

Download Full-text

Infantile Nephropathic Cystinosis in Sulaimani Pediatric Teaching Hospital: A Retrospective Cohort Study

Kurdistan Journal of Applied Research ◽

10.24017/science.2018.1.2 ◽

2018 ◽

Vol 3 (1) ◽

pp. 5-8

Author(s):

Hunar Jamal Hussein ◽

Khalid Hama Salih ◽

Adnan Mohammed Hasan

Keyword(s):

Cohort Study ◽

End Stage Renal Disease ◽

Retrospective Cohort ◽

Positive Family History ◽

The Other ◽

P Value ◽

History Of ◽

Infantile Cystinosis ◽

Stage Renal Disease ◽

End Stage

Cystinosis is a rare metabolic autosomal recessive disorder which characterized by intralysosomal accumulation of cystine. There are three forms; infantile nephropathic is the commonest forms. to evaluate clinical presentations and outcome of infantile cystinosis. A retrospective cohort study conducted in Sulaimani Pediatric Teaching Hospital on 25 patients with infantile cystinosis during May 1, 2014, to June 1, 2017. This study has depended on clinical symptoms and signs, and corneal crystallization for the diagnosis of cystinosis. Gender of the patients was 13 (52%) females and 12 (48%) males. The ages were ranged between (1-12 years) with a mean age of (6.25 years). Eight (32%) patients were from Sulaimani city, but the other 17 (68%) patients were from outside of Sulaimani. Moreover, a 17 (68%) of them were Arabic and the other eight (32%) were Kurdish ethnic groups. The study showed a 20 (80%) positive consanguinity with 19 (76%) positive family history of infantile cystinosis. Additionally, the age of first presentations was between (0.25-2 years) with a mean of (0.8 years). Clinical features included a 100% for polyuria, polydipsia, and failure to thrive. Furthermore, 10 (40%) presented with constipation, 23 (92%) photophobia and 5 (20%) blond hair. Complications included 24 (96%) rickets, 14 (56%) renal insufficiency, 5 (20%) hypothyroidism, 4 (16%) genu valgum, 3 (12%) growth hormone deficiency, and 3 (12%) developed end-stage renal disease. Subsequently, two patients died (8%) due to end-stage renal disease. Finally, there was a statistically significant relationship between both renal insufficiency (P-value = 0.042) and hypothyroidism (P-value < 0.001) with Kurdish ethnicity. Conclusion: Incidence of cystinosis was high among consanguineous parents and those patients who had a positive family history of cystinosis. Furthermore, the delay in diagnosis was due to atypical presentations and unavailability of specific investigations.

Download Full-text

End-Stage Renal Disease Patients on Chronic Hemodialysis Fare Better With COVID-19: A Retrospective Cohort Study From the New York Metropolitan Region

Cureus ◽

10.7759/cureus.10373 ◽

2020 ◽

Author(s):

Ashutossh Naaraayan ◽

Abhishek Nimkar ◽

Amrah Hasan ◽

Sushil Pant ◽

Momcilo Durdevic ◽

...

Keyword(s):

New York ◽

Cohort Study ◽

Renal Disease ◽

Retrospective Cohort Study ◽

End Stage Renal Disease ◽

Retrospective Cohort ◽

Chronic Hemodialysis ◽

Metropolitan Region ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Effects of dialysis modality choice on the survival of end-stage renal disease patients in southern China: a retrospective cohort study

BMC Nephrology ◽

10.1186/s12882-020-02070-7 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Zhiren He ◽

Haijing Hou ◽

Difei Zhang ◽

Yenan Mo ◽

La Zhang ◽

...

Keyword(s):

Cohort Study ◽

Renal Disease ◽

Retrospective Cohort Study ◽

End Stage Renal Disease ◽

Older Patients ◽

Retrospective Cohort ◽

Risk Of Death ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is still controversial. Only a few studies comparing HD and PD have been conducted in China, which has the largest number of dialysis patients in the world. Methods A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics. Results A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-year-old), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (> 70-year-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age at dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of all-cause mortality in the younger subgroup, while PD was risk factor in the older subgroup. Conclusion PD may be a better choice for younger ESRD patients, and HD for the older patients.

Download Full-text

Complications and outcomes of urgent-start peritoneal dialysis in elderly patients with end-stage renal disease in China: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2019-032849 ◽

2020 ◽

Vol 10 (3) ◽

pp. e032849

Author(s):

Xiujuan Zang ◽

Xiu Du ◽

Lin Li ◽

Changlin Mei

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Elderly Patients ◽

Renal Disease ◽

Retrospective Cohort Study ◽

End Stage Renal Disease ◽

Retrospective Cohort ◽

Dialysis Method ◽

Stage Renal Disease ◽

End Stage

ObjectivesTo investigate the complications and survival of elderly patients with end-stage renal disease (ESRD) who received urgent-start peritoneal dialysis (USPD) or urgent-start haemodialysis (USHD), and to explore the value of peritoneal dialysis (PD) as the emergent dialysis method for elderly patients with ESRD.DesignRetrospective cohort study.SettingTwo tertiary care hospitals in Shanghai, China.ParticipantsChinese patients (n=542) >65 years of age with estimated glomerular filtration rate ≤15 mL/min/m2who received urgent-start dialysis between 1 January 2005 and 31 December 2015, and with at least 3 months of treatment. Patients who converted to other dialysis methods, regardless of the initial dialysis method, were excluded, as well as those with comorbidities that could significantly affect their dialysis outcomes.Primary and secondary outcome measuresDialysis-related complications and survival were compared. Patients were followed until death, stopped PD, transfer to other dialysis centres, loss to follow-up or 31 December 2016.ResultsThere were 309 patients in the USPD group and 233 in the USHD group. The rate of dialysis-related complications within 30 days after catheter implantation was significantly lower in the USPD group compared with the USHD group (4.5% vs 10.7%, p=0.031). The 6-month and 1, 2 and 3-year survival rates were 95.3%, 91.4%, 86.6% and 64.8% in the USPD group, and 92.2%, 85.7%, 70.2% and 57.8% in the USHD group, respectively (p=0.023). The multivariable Cox regression analysis showed that USHD (HR=2.220, 95% CI 1.298 to 3.790; p=0.004), age (HR=1.025, 95% CI 1.013 to 1.043, p<0.001) and hypokalaemia (HR=0.678, 95% CI 0.487 to 0.970; p=0.032) were independently associated with death.ConclusionsUSPD was associated with slightly better survival compared with USHD. USPD was associated with fewer complications and better survival than USHD in elderly patients with ESRD.

Download Full-text

Do Bacteremic Patients with End-Stage Renal Disease Have a Fever When Presenting to The Emergency Department? A Paired, Retrospective Cohort Study.

10.21203/rs.2.16382/v1 ◽

2019 ◽

Author(s):

Leonard Mermel ◽

Sarah L. Weatherall ◽

Alison B. Chambers

Keyword(s):

Diabetes Mellitus ◽

Emergency Department ◽

Cohort Study ◽

Renal Disease ◽

Retrospective Cohort Study ◽

End Stage Renal Disease ◽

Emergency Departments ◽

Retrospective Cohort ◽

Stage Renal Disease ◽

End Stage

Abstract Background Fever is a common symptom when patients present to Emergency Departments. It is unclear if the febrile response of bacteremic hemodialysis-dependent patients differs from bacteremic patients not receiving hemodialysis. The objective of this study was to compare Emergency Departments triage temperatures of patients with and without hemodialysis-dependent end-stage rental disease who have Staphylococcus aureus bacteremia and determine the incidence of afebrile S. aureus bacteremia.Methods Paired, retrospective cohort study of 37 patients with and 37 patients without hemodialysis hospitalized with Methicillin-resistant or Methicillin-susceptible S. aureus bacteremia. Emergency Department triage temperatures were reviewed for all patients, as were potential confounding variables.Results 54% (95% CI, 38-70%) and 82% (95% CI 65-91%) of hemodialysis and non-hemodialysis patients did not have a detectable fever (<100.4°F) at triage. Triage temperatures were 100.5°F (95% CI 99.9-101.2°F) and 99.0°F (95% CI 98.4-99.6°F) in the hemodialysis and non-hemodialysis cohorts, respectively (p<0.001). Triage temperature in patients with and without diabetes mellitus was 99.2°F (95% CI 98.4-99.9°F) and 100.4°F (95% CI 99.7-101.0°F), respectively (p=0.03). We were unable to detect a significant effect of diabetes mellitus and other potential confounding variables on differences in temperature between the hemodialysis and non-hemodialysis cohorts (all interactions p > 0.19).Conclusions Hemodialysis-dependent patients with S. aureus bacteremia had significantly higher temperatures than non- hemodialysis-dependent end stage renal disease patients but more than half of patients were without detectable fever at triage, possibly reflecting use of insensitive methods for measuring temperature. Absence of fever at presentation to the Emergency Department should not delay blood culture acquisition in patients who are at increased risk of S. aureus bacteremia.

Download Full-text