Incidence and risk factors of peritoneal dialysis-related peritonitis in elderly patients: A retrospective clinical study

2020 ◽  
Vol 40 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Haishan Wu ◽  
Hongjian Ye ◽  
Rong Huang ◽  
Chunyan Yi ◽  
Juan Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Advanced Age ◽  
Retrospective Clinical Study ◽  
Technique Failure ◽  
Related Mortality

Background: This study was to analyze the incidence, risk factors, and clinical outcomes of peritonitis in elderly continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Incident patients undergone CAPD from 1 January 2006 to 30 June 2015 in our center were enrolled and divided into aged < 65 years and ≥ 65 years groups. Risk factors were evaluated using a logistic regression model, and outcome comparison was evaluated using a Cox proportional model. Results: Among 1953 patients, 111(33.2%) in elderly ( n = 334) and 470 (29.0%) in younger ( n = 1619) developed at least one episode of peritonitis. Comparing with younger patients, elderly ones had a higher peritonitis rate (0.203 vs. 0.145 episodes/patient-year, p < 0.05). The multivariate Cox regression showed that advanced age (hazard ratio (HR) = 1.06, 95% confidence interval (CI) = 1.01–1.11, p = 0.015), assistant-assisted peritoneal dialysis (PD; HR = 2.64, 95% CI = 1.23–5.64, p = 0.012), higher body mass index (BMI; HR = 1.11, 95% CI = 1.02–1.20, p = 0.010), and low serum albumin level (HR = 0.94, 95% CI = 0.90–0.98, p = 0.004) were associated with increased peritonitis risk in elderly patients. Compared with younger ones with peritonitis, elderly patients had an approximately fourfold increased risk of peritonitis-related mortality (odd ratio (OR) = 3.57, 95% CI = 1.38–9.28, p = 0.009). During the cohort, peritonitis was the risk factor associated with technique failure (HR = 3.19, 95% CI = 2.33–4.39, p < 0.001) in younger patient but not in the elderly population (HR = 1.82, 95% CI = 0.84–3.94, p = 0.132). Conclusions: Elderly PD patients had higher prevalence for peritonitis and peritonitis-related mortality. Advanced age, assistant-assisted PD, a higher BMI, and lower serum albumin level were independently associated with the first episode of peritonitis in elderly patients. However, peritonitis was not the predictor of death-censored technique failure in elderly ones.

scholarly journals Analysis of risk factors and outcome in peritoneal dialysis patients with early-onset peritonitis: a multicentre, retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e029949 ◽  
Author(s):  
Xiaoyan Ma ◽  
Yingfeng Shi ◽  
Min Tao ◽  
Xiaolu Jiang ◽  
Yi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Retrospective Cohort ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
First Episode ◽  
Lower Serum ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Technique Failure

ObjectivesTo investigate the risk factors associated with early-onset peritonitis (EOP) and their influence on patients’ technique survival and mortality.Study designRetrospective, cohort study.SettingThree peritoneal dialysis (PD) units in Shanghai.ParticipantsPD patients from 1 June 2006 to 1 May 2018 were recruited and followed up until 31 December 2018. According to time-to-first episode of peritonitis, patients were divided into non-peritonitis (n=144), EOP (≤6 months, n=74) and late-onset peritonitis (LOP) (>6 months, n=139).Primary and secondary outcome measuresEOP was defined as the first episode of peritonitis occurring within 6 months after the initiation of PD. The outcomes were all-cause mortality and technique failure.ResultsOf the 357 patients, 74 (20.7%) patients developed their first episode of peritonitis within the first 6 months. Compared with the LOP group, the EOP group had older ages, more female patients, higher Charlson Comorbidity Index (CCI) score, lower serum albumin levels and renal function at the time of initiation of PD, and higher diabetes mellitus and peritonitis rates (p<0.05).Staphylococcuswas the most common Gram-positive organism in both EOP and LOP groups. The multivariate logistic regression analysis showed that factors associated with EOP included a higher CCI score (OR 1.285, p=0.011), lower serum albumin level (OR 0.924, p=0.016) and lower Kt/V (OR 0.600, p=0.018) at start of PD. In the Cox proportional-hazards model, EOP was more likely a predictor of technique failure (HR 1.801, p=0.051). There was no difference between EOP and LOP for all-cause mortality.ConclusionA higher CCI score and lower serum albumin level and Kt/V at PD initiation were significantly associated with EOP. EOP also predicted a high peritonitis rate and poor clinical outcome.

Pulmonary Hypertension in Peritoneal Dialysis Patients: Prevalence and Risk Factors

2009 ◽  
Vol 29 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Aydin Ünal ◽  
Murat Sipahioglu ◽  
Fatih Oguz ◽  
Mehmet Kaya ◽  
Hamit Kucuk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Ejection Fraction ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systolic Pulmonary Artery Pressure ◽  
Ventricular Ejection Fraction

Aim To investigate the prevalence of pulmonary arterial hypertension (PAH) and the possible contributing factors for PAH in patients receiving regular continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods The study included 135 CAPD patients and 15 disease-free controls. Patients that had chronic obstructive pulmonary disease, severe mitral or aortic valve disease, connective tissue disease, history of pulmonary embolism, left ventricular ejection fraction <50%, or chest wall or parenchymal lung disease were excluded. All patients and controls were examined using echocardiography and bioelectrical impedance analysis. PAH was defined as systolic pulmonary artery pressure (PAP) >35 mmHg at rest. Results Mean systolic PAP was higher in the CAPD patients than in the controls (19.66 ± 11.66 vs 14.27 ± 4.55 mmHg, p = 0.001). PAH was detected in 17 (12.6%) of the 135 CAPD patients. Mean systolic PAP was significantly higher in patients with PAH than in those without PAH (42.00 ± 9.13 vs 16.44 ± 7.83 mmHg, p = 0.001). Serum albumin level and ejection fraction were lower in patients with PAH than in those without PAH ( p = 0.001 and 0.003 respectively). The ratio of extracellular water/total body water (ECW/TBW), which can reflect hydration status, was significantly higher in patients with PAH than in those without PAH ( p = 0.008). In the PD group, no patients were hypovolemic; 51 (37.8%) of the 135 PD patients were hypervolemic and 84 (62.2%) were normovolemic. Only 3 of the 17 patients with PAH were normovolemic; the rest were hypervolemic. Mean systolic PAP was significantly higher in hypervolemic PD patients (24.57 ± 14.19 mmHg) than in normovolemic PD patients (16.68 ± 7.61 mmHg) ( p = 0.001). PAP correlated with ECW/TBW ( r=0.317, p = 0.001) and left ventricular mass index (LVMI; r=0.286, p = 0.001). On the other hand, it inversely correlated with serum albumin level ( r = –0.281, p = 0.001), hemoglobin level ( r = –0.165, p = 0.044), and ejection fraction ( r = –0.263, p = 0.001). Serum albumin level, ECW/TBW, and LVMI were found in multivariate analysis to be independent risk factors for PAP. Conclusion PAH is a frequent cardiovascular complication in CAPD patients. Serum albumin level, hypervolemia, and LVMI are major risk factors for PAH. Therefore, strategies for treatment of hypervolemia, left ventricular hypertrophy, and hypoalbuminemia should be enhanced to prevent the development of PAH in CAPD patients.

Subclinical Peripheral Artery Disease in Patients Undergoing Peritoneal Dialysis: Risk Factors and Outcome

2009 ◽  
Vol 29 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Jiung-Hsiun Liu ◽  
Hsin-Hung Lin ◽  
Ya-Fei Yang ◽  
Yao-Lung Liu ◽  
Huey-Liang Kuo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Peripheral Artery Disease ◽  
Serum Triglyceride ◽  
Advanced Age ◽  
Peripheral Artery ◽  
Technique Survival ◽  
Artery Disease ◽  
Highly Correlated

Background Peripheral artery disease (PAD) is highly prevalent among patients in end-stage renal disease. The ankle–brachial index (ABI) is believed to be highly correlated with the subclinical PAD of lower extremities but little is known about the associated risk factors and outcome for PAD and ABI in patients on peritoneal dialysis (PD). Methods We performed a cohort study of 153 patients from a single center receiving stable PD for more than 3 months. These patients were screened for subclinical PAD using the ABI measurement. The ABI was measured and a ratio of <0.9 was considered abnormal. Clinical outcomes included actuarial patient and technique survival in this study. Results 30 patients were classified into a subclinical PAD group. The prevalence of PAD (subclinical and overt) in our PD center was 19.61% (30/153). Advanced age, preexisting diabetes, preexisting cardiovascular and/or cerebrovascular disease (CVD), lower renal Kt/V urea, lower renal creatinine clearance (WCrCl), lower serum albumin level, and higher serum triglyceride level were risk factors for PAD in our PD center. Bivariate analysis showed that ABI was positively correlated with residual renal Kt/V urea and WCrCl, but was not correlated with peritoneal Kt/V urea and WCrCl. Patient and technique survival rates were significantly lower in the low ABI group than in the normal ABI group. Conclusions ABI is highly correlated with advanced age, preexisting diabetes, preexisting CVD, serum albumin, serum triglyceride, and residual renal clearance in PD patients. Also, lower ABI is independently associated with a high risk of patient mortality and PD technique failure.

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

2009 ◽  
Vol 29 (4) ◽  
pp. 450-457 ◽  
Author(s):  
Chih-Chung Shiao ◽  
Tze-Wah Kao ◽  
Kuan-Yu Hung ◽  
Yin-Cheng Chen ◽  
Ming-Shiou Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Survival Rate ◽  
Serum Albumin Level ◽  
Patient Survival ◽  
Survival Rates ◽  
Albumin Level ◽  
Technique Survival ◽  
Technique Failure

Background There are no Taiwanese publications and only a few Asian publications on the long-term outcome of peritoneal dialysis (PD) patients. The aim of this study was to evaluate the outcome of PD patients in Taiwan during a 7-year follow-up period. Patients and Methods This study enrolled 67 patients (23 males, mean age 46.2 ± 14.5 years) on maintenance PD. We administered the Short-Form questionnaire on 30 September 1998 and recorded major events and outcomes until 30 September 2005. We compared differences in initial parameters between groups categorized by PD patient survival and PD technique survival. Causes of mortality and transfer to hemodialysis were determined. PD patient and PD technique survival rates were measured and risk factors for patient mortality and PD technique failure were analyzed. Results Those in patient survival or PD technique survival groups had lower mean age ( p < 0.001 and 0.018 respectively) and higher serum albumin level ( p = 0.015 and 0.041 respectively) compared to those that died or failed PD. The 7-year patient survival rate was 77% and the PD technique survival rate was 58%. The independent predictors for PD technique failure included lower Mental Component Summary scores [hazard ratio (HR) = 0.85, p = 0.031] and diabetes mellitus (HR = 4.63, p < 0.001), whereas lower serum albumin level (HR = 0.22, p = 0.031), lower Physical Component Summary scores (HR = 0.67, p = 0.047), and presence of diabetes mellitus (HR = 5.123, p = 0.009) were the independent predictors for patient mortality. Conclusion For our PD patients, both patient and technique survival rates are good. Better glycemic control, adequate nutrition, and enhancement of health-related quality of life are all of potential prognostic benefit.

scholarly journals Hypoalbuminemia, cardiac morbidity, and mortality in end-stage renal disease.

1996 ◽  
Vol 7 (5) ◽  
pp. 728-736 ◽  
Author(s):  
R N Foley ◽  
P S Parfrey ◽  
J D Harnett ◽  
G M Kent ◽  
D C Murray ◽  
...  
Keyword(s):  
Heart Disease ◽  
Peritoneal Dialysis ◽  
Ischemic Heart Disease ◽  
Serum Albumin ◽  
Cardiac Failure ◽  
Serum Albumin Level ◽  
De Novo ◽  
Albumin Level ◽  
Dialysis Patients ◽  
Overall Mortality

A cohort of 432 ESRD (261 hemodialysis and 171 peritoneal dialysis) patients was followed up prospectively for an average of 41 months. Baseline and annual demographic, clinical, and echocardiographic assessments were performed, as well as serial clinical and laboratory tests measured monthly while patients were on dialysis therapy. Among hemodialysis patients, after adjustment was made for age, diabetes, and ischemic heart disease, as well as hemoglobin and blood pressure levels measured serially, a 10-g/L fall in mean serum albumin level was independently associated with the the development of de novo (relative risk [RR], 2.22; P = 0.001) and recurrent cardiac failure (RR, 3.84; P = 0.003), de novo (RR, 5.29; P = 0.001) and recurrent ischemic heart disease (RR, 4.24; P = 0.005), cardiac mortality (RR, 5.60; P = 0.001), and overall mortality (RR, 4.33; P < 0.001). Among peritoneal dialysis patients, a 10-g/L fall in mean serum albumin level was independently associated with the progression of left ventricular dilation as seen on follow-up echocardiography (beta, 13.4 mL/m2; P = 0.014), the development of de novo cardiac failure (RR, 4.16; P = 0.003), and overall mortality (RR, 2.06; P < 0.001). Hypoalbuminemia, a major adverse prognostic factor in dialysis patients, is strongly associated with cardiac disease.

P0411PREDICTORS OF RENAL AND PATIENT OUTCOME IN PATIENTS WITH IDIOPATHIC MEMBRANOUS NEPHROPATHY: FROM KOGNET DATA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ji-Young Choi ◽  
Ji Hye Kim ◽  
Ga Young Lee ◽  
Hee Won Noh ◽  
Soojee Jeon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Outcome ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Patient Survival ◽  
Albumin Level ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Abstract Background and Aims Idiopathic membranous nephropathy (iMN) is a leading cause of nephrotic syndrome and one of the major causes of end-stage renal disease (ESRD). Various factors can affect renal and patient outcome in patients with iMN. In this study, we analyzed the predictors of renal and patient survival in patients with iMN. Method We analyzed 1,776 patients diagnosed with iMN in Korean GlomeruloNEphritis STudy (KoGNET), a retrospective database of patients with renal biopsy from 1979 to 2018 from 18 centers in Korea. Student t-test for continuous variables and Chi-square test for categorical variables were performed for analyses. Cox proportional hazard regression was used to determine risk factors affecting renal and patient survival. Results The mean age of patients was 53.0 ± 14.7 years old and 1,075 (60.5%) were male. At the time of renal biopsy, 755 (46.0%) and 266 (16.2%) had hypertension and diabetes, respectively. Serum albumin level was 2.7 ± 0.8 g/dL and 871 (49.0%) had nephrotic range of proteinuria. When analyzed by dividing over 65 and under, the hemoglobin and serum albumin level were lower, more patients showed nephrotic ranged proteinuria, and higher prevalence of comorbidities such as hypertension, diabetes, coronary heart disease and cerebrovascular disease in the group over 65 than in the group under 65. Median duration of follow-up was 88.0 (38.0 – 115.1) months. Complete or partial remission rates were 48.5%, 63.8%, and 68.0% at 6 months, 12months after biopsy, and last follow-up, respectively. In Cox proportional hazard regression, high hemoglobin [HR 0.66 (0.47 – 0.93), p=0.017], high serum albumin level [HR 0.41 (0.18 – 0.94), p=0.034], and high estimated GFR by CKD-EPI equation [HR 0.94 (0.91 – 0.96), p&lt;0.001] at biopsy were good predictors for renal outcome, whereas presence of cerebrovascular disease at biopsy [HR 6.45 (1.16 – 35.71), p=0.033] were poor prognostic factors for ESRD. Age 65 and older [HR 3.26 (1.53 – 6.95), p=0.002] and presence of hypertension at biopsy [HR 2.45 (1.09 – 5.54), p=0.031] were significant risk factors for patient survival in multivariate Cox proportional regression analysis. Conclusion High hemoglobin and serum albumin, and good renal function at biopsy were good predictors for renal survival. Older age and hypertension at biopsy were poor prognostic factors for patient survival in iMN patients. Prognostic information of outcomes in this study might be helpful to optimize management in iMN patients.

Increasing Serum Albumin Level Shortly After Gastrostomy Tube Insertion Predicts Longer Survival in Elderly Patients With Dementia

2017 ◽  
Vol 51 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Rachel Gingold-Belfer ◽  
Avraham Weiss ◽  
Alex Geller ◽  
Boris Sapoznikov ◽  
Yichayaou Beloosesky ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Gastrostomy Tube ◽  
Tube Insertion

Prognostic factor of the two-year mortality after revascularization in patients with critical limb ischemia

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Koichi Morisaki ◽  
Takuya Matsumoto ◽  
Yutaka Matsubara ◽  
Kentaro Inoue ◽  
Yukihiko Aoyagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ejection Fraction ◽  
Serum Albumin ◽  
Critical Limb Ischemia ◽  
Serum Albumin Level ◽  
Limb Ischemia ◽  
Albumin Level ◽  
Surgical Revascularization ◽  
Hybrid Therapy

Purposes The aim of this study was to evaluate the risk factors for the two-year survival after revascularization of critical limb ischemia. Methods Between 2008 and 2012, 142 patients underwent revascularization. A retrospective analysis was performed to measure the risk factor. Results A total 85 patients underwent surgical revascularization, 31 patients underwent endovascular therapy while 26 patients underwent hybrid therapy. By multivariate analysis, the following variables were considered to be risk factors: ejection fraction <50 % (HR, 3.14; 95% CI, 1.22–7.95; P = 0.02), serum albumin level <2.5 g/dL (HR, 3.45; 95% CI, 1.01–11.7; P = 0.04) and nonambulatory status (HR, 4.11; 95% CI, 1.79–9.70; P < 0.01). The two-year survival rate of the patients with no risk factors was 85.5%, while the patients with at least one risk factor had an unfavorable prognosis (one; 56.7%, two; 45.4%). Conclusions The nonambulatory status, serum albumin level <2.5 g/dL and ejection fraction <50% were the risk factors for the two-year mortality after revascularization in critical limb ischemia patients. These risk factors may be useful for the treatment strategy of critical limb ischemia patients.

scholarly journals Favored serum albumin level and ICF volume after use of 1.1% aminoacid based peritoneal dialysis(PD) solution

2012 ◽  
Vol 31 (2) ◽  
pp. A87
Author(s):  
Jong-woo Yoon ◽  
Myung-jin Choi ◽  
Ja-ryong Koo ◽  
Young-ki Lee ◽  
Jung-woo Noh
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level

Anemia is Correlated with Malnutrition and Inflammation in Croatian Peritoneal Dialysis Patients: A Multicenter Nationwide Study

2017 ◽  
Vol 37 (4) ◽  
pp. 472-475 ◽  
Author(s):  
Josipa Radić ◽  
Nikolina Bašic-Jukić ◽  
Božidar Vujicić ◽  
Dragan Klarić ◽  
Goran Radulović ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Clinical Laboratory ◽  
Binding Capacity ◽  
Albumin Level ◽  
Weekly Dose ◽  
Anthropometric Parameters ◽  
Reactive Protein ◽  
Anemia Management

Malnutrition, inflammation, and anemia are common in peritoneal dialysis (PD) patients. In this study, correlations between Malnutrition Inflammation Score (MIS), laboratory and anthropometric parameters, and anemia indices in Croatian PD patients were analyzed. One hundred and one PD patients (males/females 54/47, age 58.71 ± 14.68 years, mean PD duration 21.82 ± 21.71 months) were included. Clinical, laboratory, and anthropometric parameters were measured. Statistically significant correlations between MIS and erythropoietin weekly dose per kg of body weight (ESA weekly dose), hemoglobin (Hb), and erythrocytes were found ( r = 0.439, p < 0.001; r = -0.032, p < 0.001; r = -0.435, p < 0.001), respectively. Also, statistically significant correlations were found between MIS and mean corpuscular volume ( r = 0.344, p < 0.001), iron ( r = -0.229, p = 0.021), and total iron binding capacity (TIBC) ( r = -0.362, p < 0.001), respectively. Furthermore, statistically significant correlations between ESA weekly dose and serum albumin level and body mass index (BMI) were found ( r = -0.272, p = 0.006; r = -0.269, p = 0.006), respectively. When we divided PD patients into 2 groups according Hb level (Hb ≥ 11 0 [ N = 60, 59.41 %]) and Hb < 110 [ N = 41, 40.59%]), statistically significant differences were found in MIS score (3.02 ± 2.54 vs 4.54 ± 3.54, p = 0.014), C-reactive protein (CRP) (3.52 ± 6.36 vs 7.85 ± 7.96, p = 0.005), and serum albumin level (44.22 ± 8.54 vs 39.94 ± 8.56, p = 0.003), respectively. Our findings suggest that anemia is correlated with malnutrition and inflammation in Croatian PD patients. Further studies are needed to assess whether modulating inflammatory or nutritional processes can improve anemia management in PD patients.

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