scholarly journals Cigarette smoking may accelerate the progression of IgA nephropathy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Siqing Wang ◽  
Aiya Qin ◽  
Gaiqin Pei ◽  
Zheng Jiang ◽  
Lingqiu Dong ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Cigarette Smoking ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Cox Proportional Hazards ◽  
Study Endpoint ◽  
Cox Regression Analysis ◽  
Ckd Stage

Abstract Background Whether cigarette smoking is associated with the progression of immunoglobulin A nephropathy (IgAN) remains uncertain; therefore, we aimed to evaluate the effect of cigarette smoking on the prognosis of IgAN. Methods We divided 1239 IgAN patients from West China Hospital of Sichuan University who met the inclusion criteria into smoker (current or former) and non-smoker groups. The endpoint was end-stage renal disease (ESRD: eGFR < 15 mL/min/1.73 m2 or undergoing renal replacement treatment) and/or eGFR decreased by > 50%. Kaplan–Meier, correlation, logistic regression and Cox proportional hazards analyses were performed. The association between cigarette smoking and IgAN was further verified by propensity-score-matched cohort analysis. Results During the mean follow-up period of 61 months, 19% (40/209) of the smoker group and 11% (110/1030) of the non-smoker group reached the study endpoint (p < 0.001). Multivariate Cox regression analysis revealed that cigarette smoking (hazard ratio (HR) = 1.58; p = 0.043) was an independent risk factor predicting poor renal progression in IgAN, and that IgAN patients with chronic kidney disease (CKD) stage 3–4 were more susceptible to cigarette smoking (p < 0.001). After propensity score matching (PSM), a significant correlation between cigarette smoking and renal outcomes in IgAN patients was seen. Furthermore, Spearman’s correlation test revealed that smoking dose was negatively correlated with eGFR (r = 0.141; p < 0.001) and positively related with proteinuria (r = 0.096; p = 0.001). Conclusions Cigarette smoking is an independent risk factor for IgAN progression, especially for advanced patients.

scholarly journals The Relationship between Cigarette Smoking and IgA Nephropathy

2021 ◽  
Author(s):  
Siqing Wang ◽  
Aiya Qin ◽  
Gaiqin Pei ◽  
Zheng Jiang ◽  
Lingqiu Dong ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Iga Nephropathy ◽  
Cox Regression ◽  
Interstitial Fibrosis ◽  
Cohort Analysis ◽  
Cox Proportional Hazards ◽  
Renal Outcome ◽  
Study Endpoint ◽  
Tubular Atrophy ◽  
Cox Regression Analysis

Abstract Background and aim: Regarding that whether cigarette smoking is associated with the progression of IgA nephropathy (IgAN) remains uncertain, we aimed to evaluate the effect of cigarette smoking on the prognosis of IgAN.Methods: 1239 IgAN patients who meet inclusion criteria from West China Hospital of Sichuan University were divided into smoker and non-smoker group. The endpoint was end stage renal disease (ESRD: eGFR <15 mL/min/1.73 m2 or having renal replacement treatment) and/or eGFR decreased>50%. Kaplan-Meier and Cox proportional hazards analyses were performed. Association of cigarette smoking and IgAN was further verified by propensity-score-matched cohort analysis.Results: During the mean follow-up period of 61 months, 40 out of 209 (19%) patients in smoker group and 110 out of 1030 (11%) in non-smoker group reached study endpoint(p<0.001). Multivariate Cox regression analysis revealed that cigarette smoking (HR=1.58,p=0.043), female gender (HR=2.00,p=0.002), Hypertension (HR=1.50,p=0.029), Serum creatinine (HR=1.01,p<0.001), segmental glomerulosclerosis (HR=1.59,p=0.026), and tubular atrophy/interstitial fibrosis (HR=3.13,p<0.001) were independent risk factors for prediction of poor renal outcome of IgAN. After matching with propensity scores, the significant correlation between cigarette smoking and the renal outcomes of IgAN patients can be seen.Conclusion: Smoking is an independent risk factor for the progression of IgAN, especially for female subjects.

scholarly journals The Association between Homocysteinemia and Mortality in Pre-dialysis CKD patients: A Propensity-Score Matched Analysis Using NHANES-National Death Index Link

2021 ◽  
Author(s):  
Je Hun Song ◽  
Hyuk Huh ◽  
Eunjin Bae ◽  
Jeonghwan Lee ◽  
Jung Pyo Lee ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Mortality Data ◽  
Protein Energy Wasting ◽  
Cox Regression Analysis ◽  
Cox Proportional Hazards Models ◽  
All Cause Mortality

Abstract Background: Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular disease (CVD) including chronic kidney disease (CKD). In this study, we investigated the association between serum homocysteine (Hcy) level and mortality according to the presence of CKD.Methods: Our study included data of 9,895 participants from the 1996–2016 National Health and Nutrition Examination Surveys (NHANES). Moreover, linked mortality data were included and classified into four groups according to the Hcy level. Multivariable-adjusted Cox proportional hazards models using propensity-score were used to examine dose-response associations between Hcy level and mortality.Results: Of 9,895 participants, 1032 (21.2%) participants were diagnosed with CKD. In a multivariate Cox regression analysis including all participants, Hcy level was associated with all-cause mortality, compared with the 1st quartile in Model 3 (2nd quartile: hazard ratio (HR) 1.751, 95% confidence interval (CI) 1.348-2.274, p<0.001; 3rd quartile: HR 2.220, 95% CI 1.726-2.855, p<0.001; 4th quartile: HR 3.776, 95% CI 2.952-4.830, p<0.001). In the non-CKD group, there was a significant association with all-cause mortality; however, this finding was not observed in the CKD group. The observed pattern was similar after propensity score matching. In the non-CKD group, overall mortality increased in proportion to Hcy concentration (2nd quartile: HR 2.195, 95% CI 1.299-3.709, p = 0.003; 3rd quartile: HR 2.607, 95% CI 1.570-4.332, p<0.001; 4th quartile: HR 3.720, 95% CI 2.254-6.139, p<0.001). However, the risk of all-cause mortality according to the quartile of Hcy level did not increase in the CKD groupConclusion: This study found a correlation between the Hcy level and mortality rate only in the non-CKD group. This altered risk factor patterns may be attributed to protein-energy wasting or chronic inflammation status that is accompanied by CKD.

scholarly journals Tertiary Gleason Pattern 5 is An Independent Risk Factor for Prostate Cancer with GS 7: A Retrospective Study from China.

2021 ◽  
Author(s):  
Desheng Cai ◽  
Zixin Wang ◽  
Yu Fan ◽  
Lin Cai ◽  
Kan Gong
Keyword(s):  
Prostate Cancer ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Prostate Volume ◽  
Surgical Margin ◽  
Rank Test ◽  
Positive Surgical Margin ◽  
Cox Regression Analysis ◽  
Gleason Pattern

Abstract Background: Tertiary Gleason pattern 5 (TGP5) was found to be prognostic in prostate cancer (PCa) after radical prostatectomy (RP), but related data from China was rare. Our study was aimed at finding out the effect of TGP5 on PCa with Gleason score (GS) 7 and supplementing data from China in this field.Methods: A total of 229 cases met with inclusion criteria during Jan. 2014 to Dec. 2018 were reviewed. Cases were divided into GS 7 without TGP5 and GS 7 with TGP5. We compared age at diagnosis, preoperative PSA level, prostate volume, PSA density (PSAD), GS variation, clinical T staging, pathological T staging, T staging variation, extra-prostatic extension (EPE), positive surgical margin (PSM) and seminal vesicle invasion (SVI) between the groups. Effects of TGP5 on prognosis of PCa with GS 7 were evaluated using biochemical recurrence (BCR) as the primary end point.Results: TGP5 was related to higher PSM rate (P=0.001) and BCR rate (P=0.009) but not related to higher preoperative PSA level, larger prostate volume, higher PSAD, GS upgrade, poorer clinical/pathological T staging, T upstaging, EPE and SVI (all P>0.05). The median follow-up time was 24 months (interquartile range 17.5-45.5). TGP5 was an independent risk factor to PCa with GS 7 after RP using Kaplan-Meier log-rank test (P=0.018). Both univariable and multivariable cox-regression analysis pointed out that TGP5 increased the incidence of BCR in PCa with GS 7 (P<0.05). Stratified analyses were also done.Conclusion: TGP5 is an independent risk factor predicting of BCR after RP in PCa with GS 7 from China. TGP5 is related to higher PSM rate and BCR incidence. It is time to renew the contemporary Grading Group system with the consideration of TGP.

Recurrent Vascular Access Dysfunction as a Novel Marker of Cardiovascular Outcome and Mortality in Hemodialysis Patients

2016 ◽  
Vol 44 (1) ◽  
pp. 71-80 ◽  
Author(s):  
Hyo Jin Kim ◽  
Hajeong Lee ◽  
Dong Ki Kim ◽  
Kook-Hwan Oh ◽  
Yon Su Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Vascular Access ◽  
Independent Risk Factor ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
De Novo ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Patients Âgés

Background: Vascular access (VA) is essential for hemodialysis (HD) patients, and its dysfunction is a major complication. However, little is known about outcomes in patients with recurrent VA dysfunction. We explored the influence of recurrent VA dysfunction on cardiovascular (CV) events, death and VA abandonment. Methods: This is a single-center, retrospective study conducted in patients who underwent VA surgery between 2009 and 2014. VA dysfunction was defined as VA stenosis or thrombosis requiring intervention after the first successful cannulation. Patients with ≥2 interventions within 180 days were categorized as having recurrent VA dysfunction. Outcomes were analyzed using Cox proportional hazards model before and after propensity score matching. Results: Of 766 patients (ages 59.6 ± 14.3 years, 59.7% male), 10.1% were in the recurrent VA dysfunction group. Most baseline parameters after matching were similar between the recurrent and non-recurrent groups. A total of 213 propensity score-matched patients were followed for 28.7 ± 15.8 months, during which 46 (21.6%), 30 (14.1%) and 14 (6.6%) patients had de novo CV outcomes, died and abandoned VA, respectively. Recurrent VA dysfunction after adjustment remained an independent risk factor for CV events (adjusted hazards ratio (aHR), 2.71; 95% CI 1.48-4.98; p = 0.001). Moreover, recurrent VA dysfunction predicted composite all-cause mortality (ACM)/CV events (aHR 1.99; 95% CI 1.21-3.28; p = 0.007). Conclusions: Recurrent VA dysfunction was a novel independent risk factor for CV and composite ACM/CV events in HD patients, but not for VA abandonment. Patients with recurrent vascular dysfunction should be carefully monitored not only for VA patency but also for CV events.

Elective Cesarean Delivery at Term and the Long-Term Risk for Neurological Morbidity of the Offspring

2018 ◽  
Vol 35 (11) ◽  
pp. 1038-1043 ◽  
Author(s):  
Eyal Sheiner ◽  
Tamar Wainstock ◽  
Idit Segal ◽  
Ruslan Sergienko ◽  
Daniella Landau ◽  
...  
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Cohort Analysis ◽  
Mode Of Delivery ◽  
Cox Proportional Hazards ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Neurological Morbidity ◽  
Elective Cesarean

Objective The study's objective was to determine whether mode of delivery has an impact on the long-term risk for neurologic morbidity of the offspring. Materials and Methods This population-based cohort analysis included all term singleton deliveries between 1991 and 2014. The study population was divided into two study group: elective cesarean deliveries (CD) versus vaginal deliveries (VD). Urgent cesarean deliveries, pregnancy, and delivery complications including preeclampsia and gestational diabetes were excluded. The evaluation of cumulative neurological hospitalization rate over time was performed with a Kaplan–Meier survival analysis and Cox proportional hazards models were used to study the independent association between mode of delivery and neurological morbidity while controlling for potential confounders. Results During the study period 132,054 deliveries met the inclusion criteria, 11,746 CD (8.9%), and 120,308 (91.1%) VD. A total of 3,626 neurological hospitalizations were documented with 2.70% (3,244) in the VD group as compared with 3.25% (382) in the CD group. The survival curves showed higher cumulative hospitalization rates in the CD as compared with the VD group (p ≤ 0.001). The Cox analysis demonstrated CD to be an independent risk factor for pediatric neurological hospitalizations (p < 0.001). Conclusion Term elective CD is an independent risk factor for neurological morbidity of the offspring.

scholarly journals Obesity, an independent risk factor for hepatocellular carcinoma (HCC) in NAFLD non-cirrhotic patients

2013 ◽  
Vol 19 (1) ◽  
pp. 51-56
Author(s):  
Andra-Iulia Suceveanu ◽  
Laura Mazilu ◽  
F. Voinea ◽  
A.P Suceveanu ◽  
Irinel Raluca Parepa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Regression Analysis ◽  
Risk Factor ◽  
Fatty Liver ◽  
Cumulative Incidence ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Developed Countries ◽  
Obese Patients ◽  
Cox Regression Analysis

AbstractHepatocellular carcinoma (HCC) is one of the most common malignancies with increasing incidence in developed countries. Epidemiological studies show that the cause of new discovered HCC cases remains unclear in 15%-50% of cases. Obesity and the subsequent/ underlying nonalcoholic fatty liver disease (NAFLD) can be responsible for most of these cases. The aim of our study was to estimate the risk of HCC in obese patients diagnosed with NAFLD, without clinical or imagistic features of liver cirrhosis, in order to see if HCC can develop in fatty liver in the absence of cirrhosis. Patients with regular/daily alcohol consumption or diagnosed with liver viral infections were excluded. We studied 214 obese patients with NAFLD over a period of 5 years. We evaluated all patients using abdominal ultrasound and serum alpha-fetoprotein every 6 month, in order to detect the HCC occurrence. Kaplan-Meier analysis estimated the cumulative incidence of HCC. Univariate and multivariate Cox regression analysis were used to assess associations between HCC and obesity. The median follow-up was 4.3 years. During the study period, 16 from 118 cirrhotic NFLAD patients (13.5%) and 12 from 96 non-cirrhotic NAFLD patients (12.5 %) developed HCC (p = 0.07, ns). The cumulative incidence of HCC was found to be 2.9% in obese patients with NAFLD-cirrhosis, compared with 2.2% in obese patients without cirrhosis (p = 0.09, ns). Multivariate regression analysis revealed that older age (p = 0.04) was independent variable associated with development of HCC in patients with/without NAFLDcirrhosis. Obesity seems to be an independent risk factor for HCC occurrence, regardless the presence of mild or advanced liver fibrosis in NAFLD patients.

scholarly journals Identification and Validation of DEPDC1B as an Independent Early Diagnostic and Prognostic Biomarker in Liver Hepatocellular Carcinoma

2022 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyan Fan ◽  
Junye Wen ◽  
Lei Bao ◽  
Fei Gao ◽  
You Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Factor ◽  
Early Diagnosis ◽  
Signaling Pathways ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Mapk Signaling ◽  
Cox Regression Analysis ◽  
Liver Hepatocellular Carcinoma ◽  
Early Diagnostic

Liver hepatocellular carcinoma (LIHC) is one of the most lethal tumors worldwide, and while its detailed mechanism of occurrence remains unclear, an early diagnosis of LIHC could significantly improve the 5-years survival of LIHC patients. It is therefore imperative to explore novel molecular markers for the early diagnosis and to develop efficient therapies for LIHC patients. Currently, DEPDC1B has been reported to participate in the regulation of cell mitosis, transcription, and tumorigenesis. To explore the valuable diagnostic and prognostic markers for LIHC and further elucidate the mechanisms underlying DEPDC1B-related LIHC, numerous databases, such as Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, Kaplan-Meier plotter, and The Cancer Genome Atlas (TCGA) were employed to determine the association between the expression of DEPDC1B and prognosis in LIHC patients. Generally, the DEPDC1B mRNA level was highly expressed in LIHC tissues, compared with that in normal tissues (p &lt; 0.01). High DEPDC1B expression was associated with poor overall survival (OS) in LIHC patients, especially in stage II, IV, and grade I, II, III patients (all p &lt; 0.05). The univariate and multivariate Cox regression analysis showed that DEPDC1B was an independent risk factor for OS among LIHC patients (HR = 1.3, 95% CI: 1.08–1.6, p = 0.007). In addition, the protein expression of DEPDC1B was validated using Human Protein Atlas database. Furthermore, the expression of DEPDC1B was confirmed by quantitative real-time polymerase chain reaction (qRT-PCR) assay using five pairs of matched LIHC tissues and their adjacent noncancerous tissues. The KEGG pathway analysis indicated that high expression of DEPDC1B may be associated with several signaling pathways, such as MAPK signaling, the regulation of actin cytoskeleton, p53 signaling, and the Wnt signaling pathways. Furthermore, high DEPDC1B expression may be significantly associated with various cancers. Conclusively, DEPDC1B may be an independent risk factor for OS among LIHC cancer patients and may be used as an early diagnostic marker in patients with LIHC.

scholarly journals MO688CALCIUM PHOSPHATE PRODUCT IN PERITONEAL DIALYSIS: A RISK FACTOR FOR TYPE I MEMBRANE FAILURE?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Berfu Korucu ◽  
Omer Faruk Akcay ◽  
Galip Guz
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
High Glucose ◽  
Cox Regression ◽  
Residual Renal Function ◽  
Study Endpoint ◽  
Type I ◽  
Cox Regression Analysis ◽  
Increased Risk

Abstract Background and Aims Type I membrane failure (T1MF), increased transport status with ultrafiltration, and solute removal inadequacy are among the most challenging issues in peritoneal dialysis (PD) continuity. Although quite common, the causes of T1MF are not fully understood. This study aims to identify risk factors associated with T1MF. Method This is a retrospective, single site, cohort study of incident adult peritoneal dialysis patients sampled between January 2000 and January 2020. Patients were classified as “increased transporters” who had two or more categories of a rise in peritoneal equilibration test (PET), and “stable transporters” who had had a rise of 1 or no categories from their baseline during follow-up. The four-hour dialysate/plasma creatinine ratio was used to classify PET categories. The study endpoint was five years for stable transporters, and at the time of two category rise in the PET test for increased transporters. Results Baseline demographics, diabetes frequency, residual renal function (RRF), non-phosphate baseline laboratory, parathormone levels, and PD modalities were similar between the increased transporters (n=48) and the stable transporters (n=93). Significantly more patients were using renin-angiotensin-aldosterone system (RAAS) blockers in stable transporters and high-glucose dialysates in increased transporters (p=0.03 and p&lt;0.01). Icodextrin, calcitriol, calcium-based phosphate binder use, and the number of peritonitis episodes were similar between the groups. Increased transporters reached the endpoint in 3.9(±0.7) years. Increased transporters had a higher baseline phosphate than stable transporters (p=0.02). The frequency of patients with an RRF and groups’ mean RRF in ml were similar at the endpoint (p=0.37, p=0.13). Increased transporters had a significantly higher baseline and endpoint CaXP than stable transporters (p&lt;0.01 and p=0.02). Baseline weekly peritoneal Kt/V and peritoneal creatinine clearance (PCrCl) were similar at baseline. Increased transporters had significantly lower endpoint peritoneal Kt/V and insignificantly lower endpoint PCrCl than stable transporters (p&lt;0.01 and p=0.05). ΔUF was negative for increased transporters and positive for stable transporters. Age, diabetes, peritonitis episodes, RAAS blocker use, and PD modality were insignificant in Cox regression analysis. A CaXP of &gt;55 was related to 2.51-fold, and high-glucose dialysates were associated with a 2.93-fold increased risk for a rise in transport status (p=0.01 and p&lt;0.01). Mean follow-up was 7.0 (±3.9) years for stable transporters and 5.6 (±2.0) years for increased transporters. Technical survival was significantly higher in stable transporters (p=0.03). Conclusion Our study revealed a CaXP of &gt;55 is a risk factor for a significant increase in transport status, presumably due to peritoneal calcification. The peritoneal Kt/V, PCrCl, and UF rates declined accordingly. The high-glucose dialysates are associated with a high risk in analyses. However, it is not possible to determine whether these solutions are the cause or the result of Type I membrane failure.

scholarly journals Marital status does not affect the cancer-specific survival of patients with upper tract urothelial carcinoma treated with nephroureterectomy: a propensity score matching study

2020 ◽  
Vol 12 ◽  
pp. 175628722098151
Author(s):  
Weipu Mao ◽  
Jianping Wu ◽  
Keyi Wang ◽  
Bin Xu ◽  
Ming Chen
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Urothelial Carcinoma ◽  
Propensity Score Matching ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Upper Tract

Background: The purpose of this study was to investigate the relationship between marital status and the prognosis of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy (NU). Methods: Patients with UTUC who received NU treatment were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Kaplan–Meier curves and Cox regression were used to analyze the effect of marital status on cancer-specific survival (CSS), and 1:1 propensity score matching (PSM) was performed for married and unmarried patients to explore further the effect of marital status on patients with UTUC. Results: Among 1565 eligible patients, 960 (61.3%) were married and 605 (38.7%) were unmarried, of which 146 (9.3%) were divorced/separated, 306 (19.6%) were widowed, and 153 (9.8%) were single. Multivariate Cox regression analysis showed that marital status was not an independent risk factor for patients with UTUC treated with NU. After stratification by grade and SEER stage, multivariate analysis showed that there was no significant difference in 5-year CSS between divorced/separated, widowed, and single patients compared with married patients in different grades and SEER stages. In addition, after PSM analysis, marital status was still not an independent risk factor for patients with UTUC treated with NU. Conclusion: For patients with UTUC treated with NU, marital status has no prognostic effect on CSS.

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