Four steps to standardize reporting of peritoneal dialysis technique failure: A proposed approach

2020 ◽  
pp. 089686082097693
Author(s):  
Alix Clarke ◽  
Pietro Ravani ◽  
Matthew J Oliver ◽  
Mohamed Mahsin ◽  
Ngan N Lam ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Outcome Measure ◽  
Time Window ◽  
Time Windows ◽  
Dialysis Patients ◽  
Data Set ◽  
The Impact ◽  
Technique Failure ◽  
Standardize Reporting ◽  
Dialysis Technique

Background: Technique failure is an important outcome measure in research and quality improvement in peritoneal dialysis (PD) programs, but there is a lack of consistency in how it is reported. Methods: We used data collected about incident dialysis patients from 10 Canadian dialysis programs between 1 January 2004 and 31 December 2018. We identified four main steps that are required when calculating the risk of technique failure. We changed one variable at a time, and then all steps, simultaneously, to determine the impact on the observed risk of technique failure at 24 months. Results: A total of 1448 patients received PD. Selecting different cohorts of PD patients changed the observed risk of technique failure at 24 months by 2%. More than one-third of patients who switched to hemodialysis returned to PD—90% returned within 180 days. The use of different time windows of observation for a return to PD resulted in risks of technique failure that differed by 16%. The way in which exit events were handled during the time window impacted the risk of technique failure by 4% and choice of statistical method changed results by 4%. Overall, the observed risk of technique failure at 24 months differed by 20%, simply by applying different approaches to the same data set. Conclusions: The approach to reporting technique failure has an important impact on the observed results. We present a robust and transparent methodology to track technique failure over time and to compare performance between programs.

The Impact of Strict Volume Control Strategy on Patient Survival and Technique Failure in Peritoneal Dialysis Patients

2011 ◽  
Vol 32 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Fatih Kircelli ◽  
Gulay Asci ◽  
Mumtaz Yilmaz ◽  
Ebru Sevinc Ok ◽  
Meltem Sezis Demirci ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Control Strategy ◽  
Patient Survival ◽  
Volume Control ◽  
Dialysis Patients ◽  
The Impact ◽  
Technique Failure

scholarly journals Impact of COVID-19 pandemic on HIV viremia: a single-center cohort study in northern Italy

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ilaria Izzo ◽  
Canio Carriero ◽  
Giulia Gardini ◽  
Benedetta Fumarola ◽  
Erika Chiari ◽  
...  
Keyword(s):  
Time Window ◽  
Time Windows ◽  
Continuum Of Care ◽  
Northern Italy ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Before And After ◽  
Missed Visits ◽  
Hiv Continuum Of Care ◽  
The Impact

Abstract Background Brescia Province, northern Italy, was one of the worst epicenters of the COVID-19 pandemic. The division of infectious diseases of ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili Hospital of Brescia had to face a great number of inpatients with severe COVID-19 infection and to ensure the continuum of care for almost 4000 outpatients with HIV infection actively followed by us. In a recent manuscript we described the impact of the pandemic on continuum of care in our HIV cohort expressed as number of missed visits, number of new HIV diagnosis, drop in ART (antiretroviral therapy) dispensation and number of hospitalized HIV patients due to SARS-CoV-2 infection. In this short communication, we completed the previous article with data of HIV plasmatic viremia of the same cohort before and during pandemic. Methods We considered all HIV-patients in stable ART for at least 6 months and with at least 1 available HIV viremia in the time window March 01–November 30, 2019, and another group of HIV patients with the same two requisites but in different time windows of the COVID-19 period (March 01–May 31, 2020, and June 01–November 30, 2020). For patients with positive viremia (PV) during COVID-19 period, we reported also the values of viral load (VL) just before and after PV. Results: the percentage of patients with PV during COVID-19 period was lower than the previous year (2.8% vs 7%). Only 1% of our outpatients surely suffered from pandemic in term of loss of previous viral suppression. Conclusions Our efforts to limit the impact of pandemic on our HIV outpatients were effective to ensure HIV continuum of care.

Mortality and Technique Failure in Peritoneal Dialysis Patients Using Advanced Peritoneal Dialysis Solutions

2009 ◽  
Vol 54 (4) ◽  
pp. 711-720 ◽  
Author(s):  
Seung Hyeok Han ◽  
Song Vogue Ahn ◽  
Jee Young Yun ◽  
Anders Tranaeus ◽  
Dae-Suk Han
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Technique Failure ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

scholarly journals Are COVID-19 mitigation measures reducing preterm birth rate in China?

2021 ◽  
Vol 6 (8) ◽  
pp. e006359
Author(s):  
Zheng Bian ◽  
Xiaoxian Qu ◽  
Hao Ying ◽  
Xiaohua Liu
Keyword(s):  
Preterm Birth ◽  
Birth Rate ◽  
Time Window ◽  
Time Windows ◽  
Mitigation Measures ◽  
Late Preterm Birth ◽  
Child Morbidity ◽  
Preterm Birth Rate ◽  
Underlying Mechanisms ◽  
The Impact

ObjectivePreterm birth is the leading cause of child morbidity and mortality globally. We aimed to determine the impact of the COVID-19 mitigation measures implemented in China on 23 January 2020 on the incidence of preterm birth in our institution.DesignLogistic regression analysis was used to investigate the association between the national COVID-19 mitigation measures implemented in China and the incidence of preterm birth.SettingShanghai First Maternity and Infant Hospital, Shanghai China.ParticipantsAll singleton deliveries abstracted from electronic medical record between 1 January 2014 to 31 December 2020.Main outcome measuresPreterm birth rate.ResultsData on 164 107 singleton deliveries were available. COVID-19 mitigation measures were consistently associated with significant reductions in preterm birth in the 2-month, 3-month, 4-month, 5-month time windows after implementation (+2 months, OR 0.80, 95% CI 0.69 to 0.94; +3 months, OR 0.83, 95% CI 0.73 to 0.94; +4 months, OR 0.82, 95% CI 0.73 to 0.92; +5 months, OR 0.84, 95% CI 0.76 to 0.93). These reductions in preterm birth were obvious across various degrees of prematurity, but were statistically significant only in moderate-to-late preterm birth (32 complete weeks to 36 weeks and 6 days) subgroup. The preterm birth difference disappeared gradually after various restrictions were removed (7th–12th month of 2020, OR 1.02, 95% CI 0.94 to 1.11). There was no difference in stillbirth rate across the study time window.ConclusionSubstantial decreases in preterm birth rates were observed following implementation of the national COVID-19 mitigation measures in China. Further study is warranted to explore the underlying mechanisms associated with this observation.

scholarly journals Time Windows Voting Classifier for COVID-19 Mortality Prediction

2021 ◽  
Author(s):  
TIONG GOH ◽  
MengJun Liu
Keyword(s):  
Time Window ◽  
Majority Vote ◽  
Time Windows ◽  
Mortality Prediction ◽  
Data Set ◽  
Risk Of Mortality ◽  
Machine Learning Model ◽  
Partitioned Data ◽  
Considerable Impact ◽  
Extended Duration

The ability to predict COVID-19 patients' level of severity (death or survival) enables clinicians to prioritise treatment. Recently, using three blood biomarkers, an interpretable machine learning model was developed to predict the mortality of COVID-19 patients. The method was reported to be suffering from performance stability because the identified biomarkers are not consistent predictors over an extended duration. To sustain performance, the proposed method partitioned data into three different time windows. For each window, an end-classifier, a mid-classifier and a front-classifier were designed respectively using the XGboost single tree approach. These time window classifiers were integrated into a majority vote classifier and tested with an isolated test data set. The voting classifier strengthens the overall performance of 90% cumulative accuracy from a 14 days window to a 21 days prediction window. An additional 7 days of prediction window can have a considerable impact on a patient's chance of survival. This study validated the feasibility of the time window voting classifier and further support the selection of biomarkers features set for the early prognosis of patients with a higher risk of mortality.

Six-minute walk test predicts all-cause mortality and technique failure in ambulatory peritoneal dialysis patients

Nephrology ◽  
2017 ◽  
Vol 22 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Yuanyuan Shi ◽  
Dongxia Zheng ◽  
Lin Zhang ◽  
Zanzhe Yu ◽  
Hao Yan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Walk Test ◽  
Dialysis Patients ◽  
Six Minute Walk Test ◽  
All Cause Mortality ◽  
Technique Failure ◽  
Minute Walk

Higher Eosinophils Predict Death-Censored Technique Failure in Peritoneal Dialysis Patients

2020 ◽  
Vol 181 (10) ◽  
pp. 765-773
Author(s):  
Jiayi Yang ◽  
Jinjin Fan ◽  
Li Fan ◽  
Chunyan Yi ◽  
Jianxiong Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Technique Failure

Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

2019 ◽  
Vol 39 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Osasuyi Iyasere ◽  
Edwina Brown ◽  
Fabiana Gordon ◽  
Helen Collinson ◽  
Richard Fielding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Mixed Model ◽  
Rating Scale ◽  
Depression Scale ◽  
Dialysis Patients ◽  
The Impact ◽  
Assisted Peritoneal Dialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

scholarly journals Predictors of Peritonitis and the Impact of Peritonitis on Clinical Outcomes of Continuous Ambulatory Peritoneal Dialysis Patients in Taiwan—10 Years’ Experience in a Single Center

2014 ◽  
Vol 34 (1) ◽  
pp. 85-94 ◽  
Author(s):  
Yao-Peng Hsieh ◽  
Chia-Chu Chang ◽  
Yao-Ko Wen ◽  
Ping-Fang Chiu ◽  
Yu Yang
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Drop Out ◽  
Kaplan Meier ◽  
Underlying Mechanisms ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Technique Failure

ObjectivePeritoneal dialysis (PD) has become more prevalent as a treatment modality for end-stage renal disease, and peritonitis remains one of its most devastating complications. The aim of the present investigation was to examine the frequency and predictors of peritonitis and the impact of peritonitis on clinical outcomes.MethodsOur retrospective observational cohort study enrolled 391 patients who had been treated with continuous ambulatory PD (CAPD) for at least 90 days. Relevant demographic, biochemical, and clinical data were collected for an analysis of CAPD-associated peritonitis, technique failure, drop-out from PD, and patient mortality.ResultsThe peritonitis rate was 0.196 episodes per patient–year. Older age (>65 years) was the only identified risk factor associated with peritonitis. A multivariate Cox regression model demonstrated that technique failure occurred more often in patients experiencing peritonitis than in those free of peritonitis ( p < 0.001). Kaplan–Meier analysis revealed that the group experiencing peritonitis tended to survive longer than the group that was peritonitis-free ( p = 0.11). After multivariate adjustment, the survival advantage reached significance (hazard ratio: 0.64; 95% confidence interval: 0.46 to 0.89; p = 0.006). Compared with the peritonitis-free group, the group experiencing peritonitis also had more drop-out from PD ( p = 0.03).ConclusionsThe peritonitis rate was relatively low in the present investigation. Elderly patients were at higher risk of peritonitis episodes. Peritonitis independently predicted technique failure, in agreement with other reports. However, contrary to previous studies, all-cause mortality was better in patients experiencing peritonitis than in those free of peritonitis. The underlying mechanisms of this presumptive “peritonitis paradox” remain to be clarified.

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