scholarly journals Effectiveness comparison of cardio-selective to non-selective β-blockers and their association with mortality and morbidity in end-stage renal disease: a retrospective cohort study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Theresa I. Shireman ◽  
Jonathan D. Mahnken ◽  
Milind A. Phadnis ◽  
Edward F. Ellerbeck
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiren He ◽  
Haijing Hou ◽  
Difei Zhang ◽  
Yenan Mo ◽  
La Zhang ◽  
...  

Abstract Background The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is still controversial. Only a few studies comparing HD and PD have been conducted in China, which has the largest number of dialysis patients in the world. Methods A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics. Results A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-year-old), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (> 70-year-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age at dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of all-cause mortality in the younger subgroup, while PD was risk factor in the older subgroup. Conclusion PD may be a better choice for younger ESRD patients, and HD for the older patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032849
Author(s):  
Xiujuan Zang ◽  
Xiu Du ◽  
Lin Li ◽  
Changlin Mei

ObjectivesTo investigate the complications and survival of elderly patients with end-stage renal disease (ESRD) who received urgent-start peritoneal dialysis (USPD) or urgent-start haemodialysis (USHD), and to explore the value of peritoneal dialysis (PD) as the emergent dialysis method for elderly patients with ESRD.DesignRetrospective cohort study.SettingTwo tertiary care hospitals in Shanghai, China.ParticipantsChinese patients (n=542) >65 years of age with estimated glomerular filtration rate ≤15 mL/min/m2who received urgent-start dialysis between 1 January 2005 and 31 December 2015, and with at least 3 months of treatment. Patients who converted to other dialysis methods, regardless of the initial dialysis method, were excluded, as well as those with comorbidities that could significantly affect their dialysis outcomes.Primary and secondary outcome measuresDialysis-related complications and survival were compared. Patients were followed until death, stopped PD, transfer to other dialysis centres, loss to follow-up or 31 December 2016.ResultsThere were 309 patients in the USPD group and 233 in the USHD group. The rate of dialysis-related complications within 30 days after catheter implantation was significantly lower in the USPD group compared with the USHD group (4.5% vs 10.7%, p=0.031). The 6-month and 1, 2 and 3-year survival rates were 95.3%, 91.4%, 86.6% and 64.8% in the USPD group, and 92.2%, 85.7%, 70.2% and 57.8% in the USHD group, respectively (p=0.023). The multivariable Cox regression analysis showed that USHD (HR=2.220, 95% CI 1.298 to 3.790; p=0.004), age (HR=1.025, 95% CI 1.013 to 1.043, p<0.001) and hypokalaemia (HR=0.678, 95% CI 0.487 to 0.970; p=0.032) were independently associated with death.ConclusionsUSPD was associated with slightly better survival compared with USHD. USPD was associated with fewer complications and better survival than USHD in elderly patients with ESRD.


2019 ◽  
Author(s):  
Leonard Mermel ◽  
Sarah L. Weatherall ◽  
Alison B. Chambers

Abstract Background Fever is a common symptom when patients present to Emergency Departments. It is unclear if the febrile response of bacteremic hemodialysis-dependent patients differs from bacteremic patients not receiving hemodialysis. The objective of this study was to compare Emergency Departments triage temperatures of patients with and without hemodialysis-dependent end-stage rental disease who have Staphylococcus aureus bacteremia and determine the incidence of afebrile S. aureus bacteremia.Methods Paired, retrospective cohort study of 37 patients with and 37 patients without hemodialysis hospitalized with Methicillin-resistant or Methicillin-susceptible S. aureus bacteremia. Emergency Department triage temperatures were reviewed for all patients, as were potential confounding variables.Results 54% (95% CI, 38-70%) and 82% (95% CI 65-91%) of hemodialysis and non-hemodialysis patients did not have a detectable fever (<100.4°F) at triage. Triage temperatures were 100.5°F (95% CI 99.9-101.2°F) and 99.0°F (95% CI 98.4-99.6°F) in the hemodialysis and non-hemodialysis cohorts, respectively (p<0.001). Triage temperature in patients with and without diabetes mellitus was 99.2°F (95% CI 98.4-99.9°F) and 100.4°F (95% CI 99.7-101.0°F), respectively (p=0.03). We were unable to detect a significant effect of diabetes mellitus and other potential confounding variables on differences in temperature between the hemodialysis and non-hemodialysis cohorts (all interactions p > 0.19).Conclusions Hemodialysis-dependent patients with S. aureus bacteremia had significantly higher temperatures than non- hemodialysis-dependent end stage renal disease patients but more than half of patients were without detectable fever at triage, possibly reflecting use of insensitive methods for measuring temperature. Absence of fever at presentation to the Emergency Department should not delay blood culture acquisition in patients who are at increased risk of S. aureus bacteremia.


2020 ◽  
Author(s):  
Zhiren He ◽  
Haijing Hou ◽  
Difei Zhang ◽  
Yenan Mo ◽  
La Zhang ◽  
...  

Abstract Background: The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is yet controversial. Only a few studies comparing HD and PD have been conducted in China with the largest number of dialysis patients in the world.Methods: A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics.Results: A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-years-old), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (>70-years-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age of dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of all-cause mortality in the younger subgroup, while PD was risk factors in the older subgroup.Conclusion: Younger ESRD patients may be suitable for PD, and the older ESRD patients for HD.


2020 ◽  
Author(s):  
Zhiren He ◽  
Haijing Hou ◽  
Difei Zhang ◽  
Yenan Mo ◽  
La Zhang ◽  
...  

Abstract Background: The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is still controversial. Only a few studies comparing HD and PD have been conducted in China, which has the largest number of dialysis patients in the world.Methods: A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics.Results: A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-year-old), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (>70-year-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age at dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of all-cause mortality in the younger subgroup, while PD was risk factor in the older subgroup.Conclusion: PD may be a better choice for younger ESRD patients, and HD for the older patients.


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