O26-3 Metalworking fluid exposure and risk of end-stage renal disease: analyses using standard cox proportional hazards regression and competing risk analyses

2016 ◽  
Author(s):  
Katie Applebaum ◽  
Deepika Shrestha ◽  
Michael LaValley ◽  
Daniel Weiner ◽  
Ellen Eisen
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Competing Risk ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Metalworking Fluid ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Erythropoietin Use and the Risk of Stroke in Patients on Hemodialysis: A Retrospective Cohort Study in Taiwan

2021 ◽  
Author(s):  
Peir‐Haur Hung ◽  
Chih‐Ching Yeh ◽  
Chih‐Yen Hsiao ◽  
Chih‐Hsin Muo ◽  
Kuan‐Yu Hung ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Defined Daily Doses ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

Background Targeting higher hemoglobin levels with erythropoietin to treat anemia in patients with chronic kidney disease is associated with increased cardiovascular risk, including that of stroke. The risks of the subtypes of stroke, ischemic, hemorrhagic, and unspecified, following the administration of erythropoietin in patients with end‐stage renal disease receiving hemodialysis remain unclear. Methods and results Overall, 12 948 adult patients with end‐stage renal disease treated during 1999 to 2010 who had undergone hemodialysis were included. The study end points were the incidences of stroke and its subtypes. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) of stroke and its subtypes in erythropoietin recipients compared with nonrecipients. Patients in the erythropoietin cohort did not have an increased risk of stroke compared with those in the nonerythropoietin cohort (adjusted HR, 1.03; 95% CI, 0.92–1.15). Compared with patients in the nonerythropoietin cohort, the risks of ischemic, hemorrhagic, or unspecified stroke were not higher in patients in the erythropoietin cohort (adjusted HRs, 1.08 [95% CI, 0.93–1.26], 0.96 [95% CI, 0.78–1.18], and 1.03 [95% CI, 0.80–1.32], respectively). Increased risks of stroke and its subtypes were not observed with even large annual defined daily doses of erythropoietin (>201). Conclusions Erythropoietin in patients receiving hemodialysis is not associated with increased risk of stroke or any of its subtypes.

Increased risk of tuberculosis in patients with end-stage renal disease: a population-based cohort study in Taiwan, a country of high incidence of end-stage renal disease

2013 ◽  
Vol 142 (1) ◽  
pp. 191-199 ◽  
Author(s):  
H. Y. HU ◽  
C. Y. WU ◽  
N. HUANG ◽  
Y. J. CHOU ◽  
Y. C. CHANG ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

SUMMARYThis nationwide population-based cohort study investigated the risk of tuberculosis (TB) in patients with end-stage renal disease (ESRD) and receiving dialysis. The evaluations included 4131 incident ESRD patients receiving dialysis and 16 524 age- and gender-matched controls, recruited between 1998 and 2009. We used Cox proportional hazards regression analysis to measure the association between TB and ESRD. Compared to the controls, the ESRD cohort had a significantly higher risk of TB within 1 year [incident rate ratio (IRR) 4·13], and 1–2 years (IRR 2·12), of occurrence of ESRD. The Cox proportional hazards model revealed that ESRD [hazard ratio (HR) 2·40], age >65 years (HR 2·41), male sex (HR 1·94), diabetes mellitus (HR 1·36), silicosis (HR 7·70) and chronic obstructive pulmonary disease (HR 1·61) are independent risk factors for TB. Patients with ESRD are associated with an increased risk of TB, and should thus be monitored more carefully for TB, especially within 2 years of onset of ESRD.

scholarly journals Competing Risk Analyses of Patients with End-Stage Renal Disease

10.19082/1458 ◽  
2015 ◽  
pp. 1458-1463 ◽  
Author(s):  
Reza Tabrizi ◽  
Mahmood Moosazadeh ◽  
Eghbal Sekhavati ◽  
Maryam Jalali ◽  
Mahdi Afshari ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Competing Risk ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Pre-End-Stage Renal Disease Hemoglobin Variability Predicts Post-End-Stage Renal Disease Mortality in Patients Transitioning to Dialysis

2017 ◽  
Vol 46 (5) ◽  
pp. 397-407 ◽  
Author(s):  
Keiichi Sumida ◽  
Charles Dyer Diskin ◽  
Miklos Z. Molnar ◽  
Praveen K. Potukuchi ◽  
Fridtjof Thomas ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Proportional Hazards ◽  
Dialysis Initiation ◽  
Linear Regression Models ◽  
Hemoglobin Variability ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Related Mortality

Background: Hemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown. Methods: Among 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles. Outcomes included post-transition all-cause, cardiovascular, and infection-related mortality, assessed in Cox proportional hazards models and adjusted for demographics, comorbidities, length of hospitalization, medications, estimated glomerular filtration rate (eGFR), type of vascular access, Hb parameters (baseline Hb [i.e., intercept] and change in Hb [i.e., slope]), and number of Hb measurements. Results: Higher prelude Hb-var was associated with use of iron and antiplatelet agents, tunneled dialysis catheter use, higher levels of baseline Hb, change in Hb, eGFR, and serum ferritin. After multivariable adjustment, higher prelude Hb-var was associated with higher post-ESRD all-cause and infection-related mortality, but not cardiovascular mortality (adjusted hazard ratios [95% CI] for the highest [vs. lowest] quartile of Hb-var, 1.10 [1.02–1.19], 1.28 [0.93–1.75], and 0.93 [0.79–1.10], respectively). Conclusions: High pre-ESRD Hb-var is associated with higher mortality, particularly from infectious causes rather than cardiovascular causes. Further research is required to clarify the underlying mechanisms and true causal nature of the observed association.

scholarly journals End-stage renal disease versus death in a Portuguese cohort of elderly patients: an approach using competing event analysis

2017 ◽  
Vol 65 (7) ◽  
pp. 1041-1048 ◽  
Author(s):  
Josefina Santos ◽  
Isabel Fonseca ◽  
Jorge Malheiro ◽  
Idalina Beirao ◽  
Luisa Lobato ◽  
...  
Keyword(s):  
Risk Analysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Laboratory Data ◽  
Competing Risk ◽  
Event Analysis ◽  
Competing Risk Analysis ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease (CKD) is higher in elderly, but mortality outweighs the risk of end-stage renal disease (ESRD). Our aim was to identify prognostic markers for ESRD or death in elderly CKD, within a competing-risk analysis. This is a longitudinal study of consecutive newly referred patients with CKD ages 65 years, followed until the time of the first event (ESRD or death), using a competing-risk analysis. A modified Charlson Comorbidity Index (mCCI) was subdivided into subgroups (0-2, 3-4, ≥5). Patients were followed for hospitalizations that occurred prior to the outcomes. Among 416 patients, age 76±8 years, 52% male, median estimated glomerular filtration rate of 32 mL/min per 1.73 m2, 50% had diabetes, and 67% cardiovascular disease. Over a median follow-up of 3.6 years, 36 patients progressed to ESRD (8.7%) and 103 died (24.8%). Older age (subdistribution HR (sHR)=1. 06; p<0.001), creatinine≥1.6 mg/dL (sHR=2.03, p=0.004), hemoglobin <11 g/dL (sHR=1.91, p=0.003), mCCI score≥5 (sHR=3.01, p<0.001) and having one or more hospitalizations (sHR=1.73, p<0.001) were associated with death before ESRD. The independent predictors for ESRD with competing risk of death were: lower age (sHR=0.94; p=0.009), creatinine≥1.6 mg/dL (sHR=3.26, p=0.006), hemoglobin <11 g/dL (sHR=2.15, p=0.027), peripheral vascular disease (sHR=3.45, p=0.001) and having one or more hospitalizations (sHR=1.56, p=0.031). Elderly referred patients with CKD are near threefold more likely to die than progress to ESRD. A competing-risk framework based on available clinical and laboratory data may discriminate between those outcomes and could be used as a decision-making tool.

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