Abstract 347: End-Stage Renal Disease (ESRD) Patients Undergoing Hemodialysis Have Higher Possibility of Return of Spontaneous Circulation (ROSC) During Out-Hospital Cardiac Arrest (OHCA) and Non-Inferior Short-Term Survival: A Nationwide Population Cohort Study in Taiwan

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ming-Shun Hsieh ◽  
Chorng-Kuang How ◽  
Pau-Chung Chen
Keyword(s):  
Incidence Rate ◽  
End Stage Renal Disease ◽  
Spontaneous Circulation ◽  
Rank Test ◽  
Short Term ◽  
Log Rank Test ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Hospital Cardiac Arrest

Objective: To compare the incidence rate of return of spontaneous circulation (ROSC) between end-stage renal disease (ESRD) patients undergoing hemodialysis and non-ESRD patients after out-hospital cardiac arrest (OHCA) and subsequent hospital outcomes. Participants and Methods: We enrolled a cohort of 101,876 ESRD patients undergoing hemodialysis between 2000 and 2010 years. After matching for age and gender, an equal number of non-ESRD patients were enrolled to serve as the comparison cohort. We compared the incidence rate of OHCA and subsequent ROSC between the two cohorts. Hazard ratios (HRs) with 95% confidence interval (CI) of OHCA incidence rate were calculated using the Cox proportional hazards regression model. Chi-square test was conducted to compare the incidence rate of ROSC between the two cohorts. Multi-variate analysis with logistic regression was conducted to calculate the odds ratio (OR) of ROSC for different variables. Kaplan-Meier analysis with log-rank test was conducted to determine the difference of survival rate after ROSC between the two cohorts. Results: During the median follow-up of 3.71 and 5.65 years for ESRD and non-ESRD patients, there were 2563 (2.51%) and 1125 (1.10%) OHCA events, respectively. The condition of ESRD undergoing hemodialysis presented as an risk factor to develop OHCA compared with non-ESRD patients (adjusted HR = 2.11, 95% CI 1.89-2.36, P <0.0001 ). Within these OHCA patients with ESRD and non-ESRD, 1085 of 2563 (42.33%) and 202 of 1125 (17.96%) patients got ROSC. In the multivariate analysis with logistic regression, ESRD under hemodialysis presented to be a protective factor for ROSC (adjusted OR = 2.47, 95% CI 1.90-3.21, P <0.0001). In the further Kaplain-Meier analysis with log-rank test, the ESRD patients with OHCA and subsequent ROSC had a better 30-day hospital survival rate compared with the non-ESRD patients. Conclusion: Although, ESRD patients undergoing hemodialysis had a higher incidence rate of OHCA compared with non-ESRD patients. They had a higher possibility to get ROSC and had a better short-term hospital outcome. This observation may be explained by the training of vascular compliance during regular hemodialysis.

Characteristics and Clinical Outcomes of End-Stage Renal Disease Patients on Peritoneal Dialysis for over 15 Years: A Single-Center Experience

2017 ◽  
Vol 37 (5) ◽  
pp. 535-541 ◽  
Author(s):  
Youn Kyung Kee ◽  
Jung Tak Park ◽  
Chang-Yun Yoon ◽  
Hyoungnae Kim ◽  
Seohyun Park ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
End Stage Renal Disease ◽  
Short Term ◽  
Factors Associated ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background Maintaining peritoneal dialysis (PD) for a long time is problematic owing to a number of factors. This study aimed to clarify the characteristics and examine the clinical outcomes of patients who received PD as a long-term dialysis modality. Methods All end-stage renal disease (ESRD) patients who initiated PD at Yonsei University Health System between 1987 and 2000 were screened. Patients who maintained PD for over 15 years were classified as the long-term PD group and those who were treated with PD for less than 5 years were included in the short-term PD group. Demographic and biochemical data and clinical outcomes were compared between the groups. Independent factors associated with long-term PD maintenance were ascertained using multivariate logistic regression analysis. Results Among 1,116 study patients, 87 (7.8%) were included in the long-term group and 293 (26.3%) were included in the short-term group. In the long-term group, the mean patient age at PD initiation was 39.6 ± 11.5 years, 35 patients (40.2%) were male, and the mean PD duration was 205.3 ± 32.7 months. Patients were younger, body weight was lower, the proportion of patients with diabetes or cardiovascular diseases was lower, and the proportion of low to low-average transporters was higher in the long-term group than in the short-term group ( p < 0.001). Multiple logistic regression analysis revealed that age, body mass index (BMI), serum creatinine, type of PD solution, and diabetes were significant independent factors associated with long-term PD maintenance. Conclusion Peritoneal dialysis can be considered as a long-term renal replacement therapy option, especially in non-diabetic, not overweight, and young ESRD patients.

scholarly journals Thyroid Hormone Abnormalities in Hemodialyzed Patients: Low Triiodothyronine As Well As High Reverse Triiodothyronine Are Associated With Increased Mortality

2012 ◽  
pp. 495-501 ◽  
Author(s):  
J. HORÁČEK ◽  
S. DUSILOVÁ SULKOVÁ ◽  
M. KUBIŠOVÁ ◽  
R. ŠAFRÁNEK ◽  
E. MALÍŘOVÁ ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Reference Range ◽  
Rank Test ◽  
Nonthyroidal Illness ◽  
Log Rank Test ◽  
Low T3 ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Esrd Patients

Numerous abnormalities of thyroid hormones in end-stage renal disease (ESRD) have been described. Our aim was to analyze the impact of these abnormalities on survival. In 167 hemodialyzed ESRD patients, TSH and thyroid hormone levels (T4, fT4, T3, fT3, rT3) were determined. The patients were then prospectively followed up for up to 5 years and the possible impact of any observed abnormalities on their mortality was studied. Only 16.8 % patients had all six tests within the reference range. The pattern of nonthyroidal illness syndrome was found in 56.3 %. Low T3 was particularly common (44.3 %), and clearly associated with increased 6- and 12-month mortality and decreased overall survival (log rank test, P=0.007). Independent of T3 levels (Spearman correlation, NS), increased rT3 was more frequently observed (9.9 %) than expected from the literature, and was also related to increased mortality and decreased survival (log rank test, P=0.021). Increased rT3 may be more common in ESRD patients than previously described, and together with decreased T3 it may serve as an indicator of poor prognosis in subsequent months.

Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus

2018 ◽  
Vol 47 (1-3) ◽  
pp. 52-57 ◽  
Author(s):  
Haijiao Jin ◽  
Zhaohui Ni ◽  
Xiajing Che ◽  
Leyi Gu ◽  
Mingli Zhu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Short Term ◽  
Patients With Diabetes ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Aims: This study aimed to compare the short-term complications and long-term prognosis between urgent-start peritoneal dialysis (PD) and hemodialysis (HD), and explore the safety and feasibility of PD in end-stage renal disease (ESRD) patients with diabetes. Methods: This retrospective study enrolled ESRD patients with diabetes who required urgent-start dialysis at a single center from January 2011 to December 2014. Short-term (30-day) dialysis-related complications and patient survival trends were compared between patients receiving PD and HD. Results: Eighty patients were included in the study, including 50 (62.5%) who underwent PD. The incidence of dialysis-related complications and complications requiring reinsertion during the first 30 days was significantly lower in PD patients. Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD. The patient survival rate was higher in the PD compared to that in the HD group. Conclusions: PD may be acceptable, safe, and feasible for urgent-start dialysis in ESRD patients with diabetes.

Iron Chelation Therapy in CAPD: A New and Effective Treatment of Iron Overload Disease in Esrd Patients

1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Overload ◽  
End Stage Renal Disease ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelation Therapy ◽  
Peritoneal Dialysate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

Adipokines and Gut Hormones in End-Stage Renal Disease

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peptide Yy ◽  
Gut Hormones ◽  
Poor Quality ◽  
Mortality And Morbidity ◽  
Novel Therapeutic Strategies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

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