Survival analysis in the incident dialysis patients by different modalities

Background: To analysis survival in onset uremic patients who initiating HD or PD dialysis in our dialysis center. Methods: Between Jan. 2015 and June. 2018, patients with onset uremia and initiating planned-start dialysis were retrospectively enrolled in this study and followed up to January, 2019. The relationships between the types of dialysis modality and patient prognosis were assessed. Results: A total of 460 patients were included in the final analysis. Of which, 213 patient (46.30%) undergoing PD and 247 patients (53.70%) undergoing HD with arteriovenous fistula. The average follow-up time was 27.9 months. Eighty-seven (18.91%) patients died during the study period. The all-cause mortality was 127 per 1000 person-year. It was 102 per 1000 person-year in the HD group and 171 per 1000 person-year in the PD group ( p < 0.01). However, dialysis modality was not an independent predictor for survival. During the first year after dialysis initiation, patient survival was comparable between the PD and HD groups (log-rank p = 0.14). As the dialysis age increased over 1 year, HD patients seemed to have a better survival as compared to that of PD patient (log-rank p < 0.05), especially those older than 65 years and without DN. Conclusions: Though dialysis modality was not an independent factor for overall survival, HD therapy seemed to be more suitable for patients without DN.

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Calcium Channel Autoantibodies Predicted Sudden Cardiac Death and All-Cause Mortality in Patients with Ischemic and Nonischemic Chronic Heart Failure

Disease Markers ◽

10.1155/2014/796075 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Haiyun Yu ◽

Juanhui Pei ◽

Xiaoyan Liu ◽

Jingzhou Chen ◽

Xian Li ◽

...

Keyword(s):

Heart Failure ◽

Multivariate Analysis ◽

Sudden Cardiac Death ◽

Chronic Heart Failure ◽

Cardiac Death ◽

Independent Predictor ◽

All Cause Mortality ◽

Patient Prognosis ◽

The Relationship

The purpose of this study was to evaluate whether CC-AAbs levels could predict prognosis in CHF patients. A total of 2096 patients with CHF (841 DCM patients and 1255 ICM patients) and 834 control subjects were recruited. CC-AAbs were detected and the relationship between CC-AAbs and patient prognosis was analyzed. During a median follow-up time of 52 months, there were 578 deaths. Of these, sudden cardiac death (SCD) occurred in 102 cases of DCM and 121 cases of ICM. The presence of CC-AAbs in patients was significantly higher than that of controls (bothP<0.001). Multivariate analysis revealed that positive CC-AAbs could predict SCD (HR 3.191, 95% CI 1.598–6.369 for DCM; HR 2.805, 95% CI 1.488–5.288 for ICM) and all-cause mortality (HR 1.733, 95% CI 1.042–2.883 for DCM; HR 2.219, 95% CI 1.461–3.371 for ICM) in CHF patients. A significant association between CC-AAbs and non-SCD (NSCD) was found in ICM patients (HR = 1.887, 95% CI 1.081–3.293). Our results demonstrated that the presence of CC-AAbs was higher in CHF patients versus controls and corresponds to a higher incidence of all-cause death and SCD. Positive CC-AAbs may serve as an independent predictor for SCD and all-cause death in these patients.

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Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00259 ◽

2015 ◽

Vol 35 (2) ◽

pp. 206-215 ◽

Cited By ~ 21

Author(s):

Hong Xu ◽

Makoto Watanabe ◽

Abdul Rashid Qureshi ◽

Olof Heimbürger ◽

Peter Bárány ◽

...

Keyword(s):

Oxidative Stress ◽

Body Mass Index ◽

Peritoneal Dialysis ◽

Body Mass ◽

Dialysis Modality ◽

Dialysis Patients ◽

Comorbidity Score ◽

Dialysis Vintage ◽

All Cause Mortality

Background and Aims Increased oxidative stress in dialysis patients is thought to contribute to increased mortality; however, confirmatory data are scarce. We analyzed the serum concentration of 8-hydroxy-2'–deoxyguanosine (8-OHdG), a marker of oxidative stress, in relation to mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods Serum 8-OHdG, interleukin 6 (IL-6), other biochemical markers, Davies comorbidity score, and protein-energy wasting (PEW) were assessed in 303 prevalent patients treated with HD (n = 220; age: 63 ± 14 years) or PD (n = 83; age: 64 ± 14 years). Mortality was assessed after a median follow-up of 31 months. Results The median (25th - 75th percentile) concentration of 8-OHdG was higher in HD than in PD patients: 1.3 ng/mL (0.9 - 1.8 ng/mL) versus 0.5 ng/mL (0.4 - 0.6 ng/mL), p < 0.001. The HD modality (standard β = 0.57, p < 0.001) and dialysis vintage (standard β3 = 0.12, p = 0.02) were independent predictors of serum 8-OHdG in a multivariable linear regression model including age, sex, body mass index, dialysis modality (HD or PD), preceding time on dialysis (dialysis vintage), PEW, comorbidity score, IL-6, and use of angiotensin converting-enzyme inhibitors or angiotensin II receptor blockers or statins. During follow-up, 107 patients died. In multivariable Cox regression models including all 303 patients and adjusted for age, sex, body mass index, dialysis modality, dialysis vintage, and comorbidity score, 8-OHdG was significantly associated with all-cause mortality (adjusted hazard ratio: 1.40; 95% confidence limits: 1.05, 1.87 for 1 standard deviation increase of 8-OHdG). In subgroup analyses according to dialysis modality, 8-OHdG was associated with mortality in HD patients but not in PD patients. Conclusions Oxidative stress as assessed by 8-OHdG is an independent predictor of all-cause mortality in dialysis patients. This association was seen in HD patients, but no such association could be demonstrated for PD patients.

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Prognostic impact of SYNTAX II score in patients with cardiogenic shock complicating ST-elevation myocardial infarction: analysis of an 10-year all-comers registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.1789 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Juskova ◽

P Tasende Rey ◽

B Cid Alvarez ◽

B Alvarez Alvarez ◽

J.M Garcia Acuna ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiogenic Shock ◽

Independent Predictor ◽

Coronary Intervention ◽

Prognostic Impact ◽

Cardiac Events ◽

Prognostic Information ◽

St Segment Elevation ◽

All Cause Mortality

Abstract Background The SYNTAX II score (SS-II) can predict 4-year outcomes in patients with complex coronary artery disease and ST-segment elevation myocardial infarction (STEMI). Nonetheless, the prognostic value of SS-II for a cardiogenic shock (CS) in the setting of STEMI has not been assessed. Purpose This study aimed to investigate the predictive impact of SS-II in patients with CS complicating STEMI undergoing primary percutaneous coronary intervention, and whether SS-II adds prognostic information to predict major adverse cardiac events (MACE) and all-cause death in this population. Methods This prospective cohort study included 1965 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2017. The cohort of patients with CS (n=153) was identified and divided into three groups based on SS-II tertiles [SS-II low tertile <38 (n=51), ≥38 SS-II intermediate tertile <47 (n=51), and SS-II high tertile ≥48 (n=51)]. Results Amongst the cohort of patients with CS mean age was 68.4±14.0 years, 69.2% were male and 51.6% presented with anterior STEMI (mean SSII was 45.1±14). In-hospital mortality was significantly higher in the high SS-II tertile (85.7% vs. 38.9% vs 24.4%, p≤0.001) compared with SS-II intermediate and low tertiles. During follow-up (median 2.5 years), SS-II was positively correlated with MACE (89.3% (high SS-II) vs. 52.8% (int SS-II) vs. 42.2% (low SS-II), p≤0.001), and with all-cause mortality (89.3% vs 44.4% vs 26.7%, p≤0.001). The SS-II was also an independent predictor of MACE (HR=1.042, 95% CI: 1.020–1.063, p=0.000) and all-cause mortality during follow-up (HR=1.056, 95% CI: 1.033–1.079, p=0.000) Conclusion In a real-world cohort of patients with STEMI related CS, the SS-II added important prognostic information, being an independent predictor of MACE and all-cause mortality during follow-up. Image 1 Funding Acknowledgement Type of funding source: None

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High Incidence of Arterial and Venous Thrombosis in Antineutrophil Cytoplasmic Antibody–associated Vasculitis

The Journal of Rheumatology ◽

10.3899/jrheum.170896 ◽

2018 ◽

Vol 46 (3) ◽

pp. 285-293 ◽

Cited By ~ 18

Author(s):

Amy Kang ◽

Marilina Antonelou ◽

Nikki L. Wong ◽

Anisha Tanna ◽

Nishkantha Arulkumaran ◽

...

Keyword(s):

Ischemic Stroke ◽

Venous Thrombosis ◽

Independent Predictor ◽

Antineutrophil Cytoplasmic Antibody ◽

First Year ◽

High Incidence ◽

All Cause Mortality ◽

Coronary Events ◽

The Uk ◽

Event Rates

Objective.To determine the incidence of arterial thrombotic events (ATE) and venous thromboembolism (VTE) in antineutrophil cytoplasmic antibody–associated vasculitis (AAV).Methods.This is a retrospective cohort study presenting the incidence of ATE (coronary events or ischemic stroke) and VTE [pulmonary embolism (PE) or deep venous thrombosis (DVT)] in patients diagnosed with AAV between 2005 and 2014.Results.There were 204 patients with AAV who were identified. Median followup for surviving patients was 5.8 (range 1–10) years, accounting for 1088 person-years (PY). The incidence of ATE was 2.67/100 PY (1.56 for coronary events and 1.10 for ischemic stroke) and for VTE was 1.47/100 PY (0.83 for DVT only and 0.64 for PE with/without DVT). On multivariate analysis, prior ischemic heart disease (IHD) and advancing age were the only independent predictors of ATE. Among patients without prior IHD or stroke, the incidence of ATE remained elevated at 2.32/100 PY (1.26 for coronary events and 1.06 for ischemic stroke). ATE, but not VTE, was an independent predictor of all-cause mortality. Event rates for both ATE and VTE were highest in the first year after diagnosis of AAV but remained above the population incidence during the 10-year followup period. In comparison to reported rates for the UK population, the event rates in our AAV patients were 15-times higher for coronary events, 11-times higher for incident stroke, and 20-times higher for VTE.Conclusion.Patients with AAV have a high incidence of arterial and venous thrombosis, particularly in the first year after diagnosis.

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Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

Peritoneal Dialysis International ◽

10.3747/pdi.2008.00277 ◽

2010 ◽

Vol 30 (2) ◽

pp. 170-177 ◽

Cited By ~ 87

Author(s):

Inna Kolesnyk ◽

Friedo W. Dekker ◽

Elisabeth W. Boeschoten ◽

Raymond T. Krediet

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Peritoneal Dialysis ◽

The Netherlands ◽

Patient Survival ◽

Time Dependent ◽

First Year ◽

Technique Survival ◽

Technique Failure

BackgroundPeritoneal dialysis (PD) technique failure is high compared to hemodialysis (HD). There is a lack of data on the impact of duration of PD treatment on technique survival and on whether there is a difference in risk factors with respect to early and late failure. The aim of this study was to clarify these issues by performing a time-dependent analysis of PD technique and patient survival in a large cohort of incident PD patients.MethodsWe analyzed 709 incident PD patients participating in the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), who started their treatment between 1997 and 2007. We compared technique and patient survival on PD in 4 periods of follow-up: within the first 3 months, and after 3 – 12 months, 12 – 24 months, and 24 – 36 months of treatment. Cox proportional hazards model was used to analyze survival on PD and technique failure. Risk factors were also identified by comparing patients that were transferred to HD with those that remained on PD. Incidence rates for every cause of dropout for each period of follow-up were calculated to establish their trends with respect to PD treatment duration.ResultsThere was a significant increase in transplantation rate after the first year of treatment. The rate of switching to HD was highest during the first 3 months and decreased afterward. One-, 2- and 3-year technique survival was 87%, 76%, and 66%, respectively. Age, diabetes, and cardiovascular disease appeared to be risk factors for death on PD or switch to HD: a 1-year increase in age was associated with a relative risk (RR) of PD failure of 1.04 [95% confidence interval (CI) 1.003 – 1.06]; for diabetes, RR of stopping PD after 3 months of treatment increased from 1.8 (95% CI 1.1 – 3) during the first year to 2.2 (95% CI 1.3 – 4) after the second year; cardiovascular disease had a major impact in the earliest period (RR 2.5, 95% CI 1.2 – 5) and had a stable influence further on (RR 2, 95% CI 1.1 – 3.5). Loss of 1 mL/minute residual glomerular filtration rate (rGFR) appeared to be a significant predictor of PD failure after 3 months of treatment, but within the first 2 years, RR was 1.1 (95% CI 1.04 – 1.25).ConclusionsIn The Netherlands, transplantation is a main reason to stop PD treatment. The incidence of PD technique failure is at its highest during the earliest months after treatment initiation and decreases later due to fewer catheter and abdominal complications as well as less influence of psychosocial factors. Risk factors for PD discontinuation are those responsible for patient survival: age, cardiovascular disease, diabetes, and rGFR.

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Male childlessness as independent predictor of risk of cardiovascular and all-cause mortality: A population-based cohort study with more than 30 years follow-up

PLoS ONE ◽

10.1371/journal.pone.0237422 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0237422

Author(s):

Angel Elenkov ◽

Aleksander Giwercman ◽

Sandra Søgaard Tøttenborg ◽

Jens Peter Ellekilde Bonde ◽

Clara Helene Glazer ◽

...

Keyword(s):

Cohort Study ◽

Independent Predictor ◽

Population Based ◽

All Cause Mortality

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Significant Decreasing Incidence of Encapsulating Peritoneal Sclerosis in the Dutch Population of Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00109 ◽

2017 ◽

Vol 37 (2) ◽

pp. 230-234 ◽

Cited By ~ 11

Author(s):

Michiel G.H. Betjes ◽

Sayed M. Habib ◽

Els W. Boeschoten ◽

Aline C. Hemke ◽

Dick G. Struijk ◽

...

Keyword(s):

Peritoneal Dialysis ◽

The Netherlands ◽

Patient Survival ◽

Average Duration ◽

Dutch Population ◽

Dialysis Patients ◽

Post Transplantation ◽

Surgical Interventions ◽

Yearly Incidence

The Dutch Encapsulating Peritoneal Sclerosis (EPS) Registry was started in 2009. Cases were identified by contacting all Dutch nephrologists twice yearly. The predefined criteria for EPS allowed for inclusion of patients with diagnosed and suspected EPS. Cases registered between January 2009 and January 2015 were analyzed with follow-up until September 2015. Fifty-three EPS cases were identified, of which 28.3% were post-transplantation EPS cases. Fourteen patients were initially categorized as suspected EPS, of whom 13 developed EPS. A remarkable 6-fold decrease in the yearly incidence of EPS was observed, from 0.85% in 2009 to 0.14% in 2014. This decrease could not be explained by a decrease in the number of PD patients or average duration of PD treatment in this period. Two-year survival of EPS patients was 52%. The use of tamoxifen and surgical interventions increased significantly over the years. Tamoxifen-treated cases showed a trend to better patient survival and post-transplantation EPS had a significantly favorable outcome. In conclusion, the incidence of EPS has declined significantly in the Netherlands from 2009 to 2014.

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Increased orosomucoid in urine is an independent predictor of cardiovascular and all-cause mortality in patients with type 2 diabetes at 10years of follow-up

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2013.05.008 ◽

2013 ◽

Vol 27 (6) ◽

pp. 570-575 ◽

Cited By ~ 5

Author(s):

Mathilde Svendstrup ◽

Merete Skovdal Christiansen ◽

Erik Magid ◽

Eva Hommel ◽

Bo Feldt-Rasmussen

Keyword(s):

Type 2 Diabetes ◽

Independent Predictor ◽

All Cause Mortality

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The influence of gestational age at term on breastfeeding: a cohort study

Revista da Escola de Enfermagem da USP ◽

10.1590/1980-220x-reeusp-2020-0381 ◽

2021 ◽

Vol 55 ◽

Author(s):

Nathallia Seródio Michelin ◽

Hélio Rubens de Carvalho Nunes ◽

Maria Antonieta de Barros Leite Carvalhaes ◽

Cristina Maria Garcia de Lima Parada

Keyword(s):

Gestational Age ◽

Exclusive Breastfeeding ◽

Cox Regression ◽

Final Analysis ◽

Negative Influence ◽

First Year ◽

Baby Bottle ◽

One Year ◽

First Year Of Life

ABSTRACT Objective: To identify the effect of the category gestational age at term on breastfeeding in he first hour of life, the duration of exclusive breastfeeding, and practice of breastfeeding twelve months from birth. Method: Single cohort, with a one-year prospective follow-up of 541 children. A hierarchical analysis was performed, with models adjusted per Cox regression, considering critical p < 0.05. Results: During raw analysis there was a statistical difference on breastfeeding in the first hour of life (RR = 1.54; CI 95% = 1.12–2.12; p = 0.008). However, in the final analysis, there was no association between gestational age at term and breastfeeding in the first hour of life, duration of exclusive breastfeeding, and the practice of breastfeeding twelve months from birth. Secondarily, higher age and education, cesarean section, birth at private services, and the need for resuscitation were observed to have a negative influence. Duration of previous pregnancy favored breastfeeding in the first hour of life. Using baby bottle and pacifier was negative for breastfeeding in the first year of life. Conclusion: There was no association between the category gestational age at term and breastfeeding. The association of outcomes pointed out by the scientific literature have been confirmed.

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First-year mortality in incident dialysis patients: results of the Peridialysis study

10.21203/rs.3.rs-362169/v1 ◽

2021 ◽

Author(s):

James Heaf ◽

Maija Heiro ◽

Aivars Petersons ◽

Baiba Vernere ◽

Johan V Povlsen ◽

...

Keyword(s):

Clinical Symptoms ◽

First Year ◽

Dialysis Modality ◽

C Reactive Protein ◽

Dialysis Patients ◽

Reactive Protein ◽

Actual Choice ◽

High Age ◽

A Prospective Study ◽

Modality Preference

Abstract Background: Controversy surrounds which factors are important for predicting early mortality after dialysis initiation (DI). We investigated associations of predialysis course and circumstances affecting planning and execution of DI with mortality following DI. Methods: Among 1580 patients participating in the Peridialysis study, a prospective study of causes and timing of DI, features of predialysis course, clinical and biochemical data at DI, incidence of unplanned suboptimal DI, contraindications to peritoneal dialysis (PD) or hemodialysis (HD), and modality preference, actual choice, and cause of modality choice were registered. Patients were followed for 12 months or until transplantation.Results: First-year mortality was 20.2%. In addition to age and comorbid factors, independent factors predicting death were: clinical contraindications to PD or HD, a rapidly falling eGFR before DI, suboptimal DI, acidosis, high C-reactive protein, signs of overhydration (pulmonary stasis) and cerebral symptoms at DI while eGFR at DI was not. Among 1061 (67.2%) patients who could select dialysis modality based on personal choice, 654 (61.6%) chose PD, 368 (34.7%) center HD and 39 (3.7%) home HD. The 12-months survival did not differ significantly between patients receiving PD and in-center HD.Conclusions: First-year mortality in incident dialysis patients was associated with high age, comorbidity, worsening of kidney failure and clinical symptoms, acidosis, inflammation, and suboptimal DI while eGFR at DI and dialysis modality did not appear as predictors. These findings support the view that choice of dialysis modality among patients who are able to make an informed decision can be based on patient preference.

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