scholarly journals Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Fang-Ting Chen ◽  
Fu-Chao Liu ◽  
Chih-Wen Cheng ◽  
Jr-Rung Lin ◽  
Huang-Ping Yu

The aim of this population-based cohort study was to explore postoperative renal outcomes of patients receiving pyelolithotomy versus percutaneous nephrolithotomy (PCNL). Data were retrieved from the Taiwan National Health Insurance Research Database. During the period from Jan 1, 1998, to Dec 31, 2012, there were 2549 and 21654 patients who underwent pyelolithotomy and PCNL, respectively. The postoperative incidence of new diagnosed end stage renal disease (ESRD) was statistically analyzed and compared between the pyelolithotomy and PCNL groups. The perioperative complications of two groups were also analyzed. In comparison to pyelolithotomy, PCNL achieved lower new diagnosed ESRD (1.38% versus 2.28%, p=0.0004). Patients receiving PCNL had significantly higher rates of preoperative hypertension, diabetes mellitus, pulmonary disease, cerebrovascular disease, and coronary artery disease. The hospital stay was shorter in PCNL groups compared with pyelolithotomy groups (8.31 days versus 12.59 days, p=0.0006). In conclusion, PCNL contributed to lower rates of new diagnosed ESRD and hospital stay when compared to pyelolithotomy.

2021 ◽  
Vol 10 (4) ◽  
pp. 817
Author(s):  
Jur-Shan Cheng ◽  
Yu-Sheng Lin ◽  
Jing-Hong Hu ◽  
Ming-Yu Chang ◽  
Hsin-Ping Ku ◽  
...  

Whether hepatitis C virus (HCV) infection-associated risk of rheumatic diseases is reversed by anti-HCV therapy remain elusive. A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database was conducted. Of 19,298,735 subjects, 3 cohorts (1:4:4, propensity score-matched), including HCV-treated (6919 HCV-infected subjects with interferon and ribavirin therapy ≥ 6 months), HCV-untreated (n = 27,676) and HCV-uninfected (n = 27,676) cohorts, were enrolled and followed (2003–2015). The HCV-uninfected cohort had the lowest cumulative incidence of rheumatic diseases (95% confidence interval (CI): 8.416–10.734%), while HCV-treated (12.417–17.704%) and HCV-untreated (13.585–16.479%) cohorts showed no difference in the cumulative incidences. Multivariate analyses showed that HCV infection (95% CI hazard ratio (HR): 1.54–1.765), female sex (1.57–1.789), age ≥ 49 years (1.091–1.257), Charlson comorbidity index ≥ 1 (1.075–1.245), liver cirrhosis (0.655–0.916), chronic obstruction pulmonary disease (1.130–1.360), end-stage renal disease (0.553–0.98), diabetes mellitus (0.834–0.991) and dyslipidemia (1.102–1.304) were associated with incident rheumatic diseases. Among the 3 cohorts, the untreated cohort had the highest cumulative incidence of overall mortality, while the treated and un-infected cohorts had indifferent mortalities. Conclusions: HCV infection, baseline demographics and comorbidities were associated with rheumatic diseases. Although HCV-associated risk of rheumatic diseases might not be reversed by interferon-based therapy, which reduced the overall mortality in HCV-infected patients.


2020 ◽  
Author(s):  
Jur-Shan Cheng ◽  
Jing-Hong Hu ◽  
Yu-sheng Lin ◽  
Ming-Shyan Lin ◽  
Hsin-Ping Ku ◽  
...  

Abstract BackgroundWhether hepatitis C virus (HCV) infection increases the risk of rheumatic disorders and whether the associated risk is reversed by anti-HCV therapy remain elusive. We aimed to investigate these topics. MethodsA nationwide population-based cohort study of Taiwan National Health Insurance Research Database (TNHIRD) was conducted. ResultsOf 19,298,735 subjects, 3 TNHIRD cohorts (1:4:4, propensity score-matched), including HCV-treated (6,919 HCV-infected subjects with interferon and ribavirin therapy > 6 months), HCV-untreated (n=27,676) and HCV-uninfected (n=27,676) cohorts, were enrolled and had been followed since 2003 to 2015. HCV-uninfected cohort had the lowest 11-year cumulative incidence of rheumatic disorders [9.535%; 95% confidence interval (CI): 8.416~10.734%] (p<0.0001), while HCV-treated (14.95%; 12.417~17.704%) and HCV-untreated (14.999%; 13.585~16.479%) cohorts showed no difference in the cumulative incidences of rheumatic disorders (p=0.8316). Multivariate analyses showed, HCV infection [hazard ratio (HR):1.671; 95% CI HR: 1.562-1.788, p<0.0001], female sex (1.67; 1.565-1.782, p<0.0001), age> 49 years (1.168; 1.088-1.253, p<0.0001), Charlson comorbidity index > 1 (1.156; 1.074-1.245, p=0.0001), liver cirrhosis (0.795; 0.674-0.937, p=0.0062), chronic obstruction pulmonary disease (1.244; 1.134-1.364, p<0.0001), end stage renal disease (0.732; 0.549-0.974, p=0.0326), diabetes mellitus (0.91; 0.835-0.993, p=0.0333) and dyslipidemia (1.205; 1.108-1.31, p<0.0001) were associated with incident rheumatic disorders. Among the 3 cohorts, the untreated cohort had the highest cumulative incidence of overall mortality (29.163%; 27.218-31.133%, p<0.0001), while the treated (13.662%; 11.389-16.140%) and un-infected (9.99%; 8.548-11.559%) cohorts had indifferent mortalities (p=0.1796). ConclusionsHCV infection, baseline demographics and comorbidities were associated with the risks of rheumatic disorders. Although HCV-associated risk of rheumatic disorders might not be reversed by interferon-based anti-HCV therapy, which reduced the overall mortality in HCV-infected patients.


Author(s):  
Chin-Kai Yen ◽  
Tian-Hoe Tan ◽  
I-Jung Feng ◽  
Chung-Han Ho ◽  
Chien-Chin Hsu ◽  
...  

Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESRD risk between physicians and the general population and among physician subgroups was compared by following up their medical histories until 2012. We also compared the treatments between both cohorts with ESRD. Physicians had a lower ESRD risk than the general population (adjusted odds ratio (AOR): 0.5; 95% confidence interval (CI): 0.4–0.7), particularly in the middle-age subgroup (35–64 years) (AOR: 0.4; 95% CI: 0.3–0.7); however, there was no difference in the older age subgroup (≥65 years) (AOR: 1.0; 95% CI: 0.6–1.7). More physicians received peritoneal dialysis (63.0% vs. 11.1%) and renal transplantation (5.6% vs. 1.7%) than the general population after being diagnosed with ESRD. Compared with the general population, physicians had a lower ESRD risk and higher treatment selection for peritoneal dialysis and renal transplantation after being diagnosed with ESRD. Better medical knowledge, a greater awareness of diseases and their risk factors, more rigorous implementation of preventive measures, and easy access to medical care may play a role in this aspect. Further studies are warranted for elucidating the associated mechanisms.


2020 ◽  
Vol 75 (1) ◽  
Author(s):  
Shih‐Yi Lin ◽  
Cheng‐Li Lin ◽  
Wu‐Huei Hsu ◽  
Cheng‐Chieh Lin ◽  
Sui‐Foon Lo ◽  
...  

Nephrology ◽  
2018 ◽  
Vol 23 (2) ◽  
pp. 139-147 ◽  
Author(s):  
Tsung Liang Ma ◽  
Rei Yeuh Chang ◽  
Hsuan Ju Chen ◽  
Chun Yi Liu ◽  
Chih Cheng Hsu ◽  
...  

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