scholarly journals The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Hongjian Ye ◽  
Qian Zhou ◽  
Li Fan ◽  
Qunying Guo ◽  
Haiping Mao ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
The Impact

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.

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.

scholarly journals Effects of Erythropoietin Payment Policy on Cardiovascular Outcomes of Peritoneal Dialysis Patients: Observational Study (Preprint)

2020 ◽  
Author(s):  
Ying-Hui Hou ◽  
Feng-Jung Yang ◽  
I-Chun Lai ◽  
Shih-Pi Lin ◽  
Thomas TH Wan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Propensity Scores ◽  
Cardiovascular Outcomes ◽  
Cardiovascular Risks ◽  
Dialysis Patients ◽  
Before And After ◽  
Patients With Diabetes ◽  
Cardiovascular Endpoint ◽  
The Impact

BACKGROUND The change in the reimbursement policy of erythropoietin administration to patients receiving peritoneal dialysis by the Taiwan National Health Insurance (NHI) system provided a natural experimental venue to examine whether cardiovascular risk differs when maintaining the hematocrit (Hct) level below or above 30%. OBJECTIVE The aim of this study was to analyze the impact of loosening the erythropoietin payment criteria for peritoneal dialysis patients on their cardiovascular outcomes. METHODS Two cohorts of incident peritoneal dialysis patients were identified according to the time before and after relaxation of the NHI’s erythropoietin payment criteria, designated cohort 1 (n=1759) and cohort 2 (n=2981), respectively. The cohorts were matched according to propensity scores (1754 patients in each cohort) and then followed up for cardiovascular events, which were analyzed with Cox regressions. RESULTS For the composite cardiovascular endpoint, patients in cohort 2 had a significantly lower risk than those in cohort 1. However, subgroup analysis showed that this risk reduction was observed only in patients with diabetes. CONCLUSIONS After loosening erythropoietin payment criteria, reduced cardiovascular risks were observed, particularly for patients with diabetes. These results indicate that it is crucial to maintain an Hct level above 30% to reduce the cardiovascular risk in patients with diabetes undergoing peritoneal dialysis.

scholarly journals Effects of Erythropoietin Payment Policy on Cardiovascular Outcomes of Peritoneal Dialysis Patients: Observational Study

10.2196/18716 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e18716
Author(s):  
Ying-Hui Hou ◽  
Feng-Jung Yang ◽  
I-Chun Lai ◽  
Shih-Pi Lin ◽  
Thomas TH Wan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Propensity Scores ◽  
Cardiovascular Outcomes ◽  
Cardiovascular Risks ◽  
Dialysis Patients ◽  
Before And After ◽  
Patients With Diabetes ◽  
Cardiovascular Endpoint ◽  
The Impact

Background The change in the reimbursement policy of erythropoietin administration to patients receiving peritoneal dialysis by the Taiwan National Health Insurance (NHI) system provided a natural experimental venue to examine whether cardiovascular risk differs when maintaining the hematocrit (Hct) level below or above 30%. Objective The aim of this study was to analyze the impact of loosening the erythropoietin payment criteria for peritoneal dialysis patients on their cardiovascular outcomes. Methods Two cohorts of incident peritoneal dialysis patients were identified according to the time before and after relaxation of the NHI’s erythropoietin payment criteria, designated cohort 1 (n=1759) and cohort 2 (n=2981), respectively. The cohorts were matched according to propensity scores (1754 patients in each cohort) and then followed up for cardiovascular events, which were analyzed with Cox regressions. Results For the composite cardiovascular endpoint, patients in cohort 2 had a significantly lower risk than those in cohort 1. However, subgroup analysis showed that this risk reduction was observed only in patients with diabetes. Conclusions After loosening erythropoietin payment criteria, reduced cardiovascular risks were observed, particularly for patients with diabetes. These results indicate that it is crucial to maintain an Hct level above 30% to reduce the cardiovascular risk in patients with diabetes undergoing peritoneal dialysis.

scholarly journals How Dialysis Patients Cope with a Curfew? A Comparison of Psychological Status between Hemodialysis and Peritoneal Dialysis Patients During the COVID-19 Pandemic

2021 ◽  
pp. 1-6
Author(s):  
Cebrail Karaca ◽  
Necmi Eren ◽  
Mevlut Tamer Dincer ◽  
Senol Turan ◽  
Hatice Kubra Karaca ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Social Isolation ◽  
Depression Scale ◽  
Psychological Status ◽  
Daily Routine ◽  
Dialysis Patients ◽  
Event Scale ◽  
The Social ◽  
The Impact ◽  
Isolation Period

<b><i>Introduction:</i></b> There are many differences between hemodialysis (HD) and peritoneal dialysis (PD) treatments, including their impact on the psychological status of the patients. In this study, our aim was to compare the psychological statuses of HD and PD patients during the social isolation period due to the COVID-19 pandemic. <b><i>Methods:</i></b> We conducted this cross-sectional study on adult HD and PD patients when the curfew measures were in effect. We used an electronic form composed of 3 sections to collect data. In the first section, we collected data on the demographics and clinical and laboratory parameters of the patients. The second and third sections consisted of the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R) questionnaires, respectively. <b><i>Results:</i></b> The HD (<i>n</i> = 116) and PD (<i>n</i> = 130) groups were similar regarding age and sex, and they had similar HADS anxiety scores. HADS depression scores were higher in PD patients (<i>p</i> = 0.052). IES-R scores were significantly higher in PD patients in comparison to HD patients (<i>p</i> = 0.001). Frequencies of abnormal HADS-anxiety (<i>p</i> = 0.035) and severe psychological impact (<i>p</i> = 0.001) were significantly higher in PD patients. <b><i>Discussion/Conclusion:</i></b> During the social isolation period due to the COVID-19 pandemic, HD patients had better mood profiles than PD patients. A more stable daily routine, an uninterrupted face-to-face contact with health-care workers, and social support among patients in the in-center dialysis environment might be the cause of the favorable mood status. PD patients might need additional psychological support during those periods.

scholarly journals Mortality Rates do not Differ among Patients Prescribed Various Vitamin d Agents

2015 ◽  
Vol 35 (1) ◽  
pp. 62-69 ◽  
Author(s):  
T. Christopher Bond ◽  
Steve Wilson ◽  
John Moran ◽  
Mahesh Krishnan
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Proportional Hazards Model ◽  
Mortality Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Dialysis Patients ◽  
Oral Vitamin ◽  
Significant Difference ◽  
The Impact

BackgroundLimited well-controlled research exists examining the impact of different formulations of oral vitamin D on clinical outcomes in dialysis patients, specifically those on peritoneal dialysis. For this retrospective mortality analysis, we compared mortality rates of patients on 3 of the most commonly prescribed vitamin D agents.MethodsWe examined 2 years (7/1/2008 to 6/30/2010) of oral medication records of peritoneal dialysis patients from a large US dialysis organization. Patients were identified whose physicians prescribed a single form of vitamin D (calcitriol, paricalcitol, or doxercalciferol) for ≥ 90% of all patient-months. We excluded incident patients (< 90 days on dialysis) and patients whose physicians treated < 5 peritoneal dialysis patients at a dialysis facility, and we assessed mortality.ResultsThe analysis inclusion criteria identified 1,707 patients. The subset in this analysis included 12.6% of all prevalent peritoneal dialysis patients and 11.8% of prevalent patient-months. Patients with physicians who predominately prescribed calcitriol had a lower mortality rate: 9.33 (confidence interval (CI) 7.06, 11.60) deaths per 100 patient-years than the doxercalciferol, 12.20 (CI 9.34, 15.06) or paricalcitol, 12.27 (CI 9.27, 15.28) groups. However, these differences were not statistically significant. A Cox proportional hazards model, adjusting for differences in age, vintage, gender, race, body mass index, and comorbidities also showed no significant differences.ConclusionsFor this peritoneal dialysis population, instrumental variable analyses showed no significant difference in mortality in patients taking the most common oral vitamin D formulations (calcitriol, doxercalciferol, paricalcitol).

The impact of gene polymorphisms in angiotensin receptor 1 and aldosterone synthase in peritoneal dialysis patients

2017 ◽  
Vol 88 (S1) ◽  
pp. 73-77 ◽  
Author(s):  
Alijana Trošt Rupnik ◽  
Damjan Kovač ◽  
Jernej Pajek ◽  
Joško Osredkar ◽  
Janja Marc ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Gene Polymorphisms ◽  
Angiotensin Receptor ◽  
Dialysis Patients ◽  
Aldosterone Synthase ◽  
The Impact

The Progression and Impact of Vascular Calcification in Peritoneal Dialysis Patients

2007 ◽  
Vol 27 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Adriano Luiz Ammirati ◽  
Maria Aparecida Dalboni ◽  
Miguel Cendoroglo ◽  
Sérgio Antonio Draibe ◽  
Raul D. Santos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Events ◽  
Mineral Metabolism ◽  
Survival Rates ◽  
Density Lipoprotein ◽  
Calcium Score ◽  
Free Time ◽  
Dialysis Patients ◽  
Markers Of Inflammation ◽  
The Impact

Background Progression of coronary artery calcification (CAC) has been described in hemodialysis patients, and severe CAC has been associated with the occurrence of cardiovascular events in this population. Little information is available regarding peritoneal patients. Aim To prospectively evaluate peritoneal dialysis patients in order to identify the variables associated with the rate of CAC progression, as well as to determine the impact that baseline CAC has on clinical outcomes over a 1-year follow-up period. Methods Using multislice coronary tomography, calcium scores were estimated at baseline and after 12 months in 49 peritoneal dialysis patients. Patients with and without CAC progression were compared with respect to clinical characteristics and biochemical variables, including lipid profile, parameters of mineral metabolism, and markers of inflammation. Cardiovascular events, hospitalizations, and all-cause mortality were recorded. Results At baseline, 29 patients (59%) presented CAC and a median calcium score of 234.7 (range 10.3 – 2351) Agatston units. Progression of CAC was observed in 13 patients (43%) who, in comparison with those presenting no CAC progression, were older, presented higher baseline calcium scores, and had higher mean glucose levels, lower mean high density lipoprotein cholesterol levels, and more months using low calcium peritoneal solution. We also observed a trend toward more often presenting with a history of hypertension, exhibiting more hyperphosphatemic and hyperglycemic events, and having lower albumin levels. In multiple logistic regression, only baseline calcium score was independently associated with progression of CAC. A shorter cardiovascular event-free time and a trend toward lower survival rates were observed in the group with CAC. Hospitalization event-free time did not differ between the groups. Conclusion Determining CAC provides important prognostic data in peritoneal dialysis patients. Baseline calcium score and disturbances in glucose, mineral, and lipid metabolism were indicative of higher risk of CAC progression in this population.

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