scholarly journals Evaluation of modifiable risk factors for peritoneal dialysis-related peritonitis: a single-center retrospective cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shigeki Kojima ◽  
Shohei Yamada ◽  
Rie Fujishima ◽  
Kenichiro Koitabashi ◽  
Yugo Shibagaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Modifiable Risk Factors ◽  
Channel Blockers ◽  
Clinical Factors ◽  
Oral Vitamin ◽  
History Of ◽  
Ras Blockers ◽  
Device Use

Abstract Background Peritoneal dialysis (PD)-related peritonitis risk factors can be categorized as modifiable and uncorrectable. We aimed to identify modifiable risk factors for PD-related peritonitis in our facility to prevent PD-related peritonitis and continue quality improvement. Methods This retrospective, observational study included 90 patients who started receiving PD after 2008 and who were continued for over 1 year. Twenty-three patients experienced 40 episodes of peritonitis. Several clinical factors identified at peritonitis onset among patients with a peritonitis history were compared with those identified 1 year after PD initiation among patients without a peritonitis history, and a multivariate analysis was performed. Several serum parameter levels were evaluated as time-average concentrations (TACs; from PD initiation to 1 month before peritonitis onset or to 1 year later). The clinical factors to be investigated were selected based on previous studies. Results There were no significant between-group differences in baseline characteristics regarding uncorrectable factors and TAC values for serum parameters. Use of exchange devices was significantly higher (95.7% vs 71.6%; p = 0.054) whereas administration of renin-angiotensin-aldosterone system (RAS) blockers, calcium channel blockers (CCBs), or oral vitamin D was significantly lower (35.0% vs 65.7%, p = 0.002; 55.0% vs 74.6%, p = 0.036; and 55.0% vs 74.6%, p = 0.036, respectively) in the patients with history of peritonitis, although we did not find a factor independently associated with peritonitis in multivariable logistic regression. Conclusions Although hypokalemia, hypoalbuminemia, and exchange device use which are considered as risk factors did not affect peritonitis, administration of RAS blockers, CCBs, and oral vitamin D is significantly larger in patients without peritonitis.

scholarly journals Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1952
Author(s):  
Anna Johansson ◽  
Isabel Drake ◽  
Gunnar Engström ◽  
Stefan Acosta
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Family History ◽  
Diet Quality ◽  
Alcohol Intake ◽  
Modifiable Risk Factors ◽  
History Of ◽  
Diet And Cancer

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

scholarly journals The effects of oral vitamin D supplementation on the prevention of peritoneal dialysis-related peritonitis: study protocol for a randomized controlled clinical trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-hui Zhang ◽  
Xiao Xu ◽  
Hai-chen Pi ◽  
Zhi-kai Yang ◽  
David W. Johnson ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trial ◽  
Peritoneal Dialysis ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Oral Vitamin ◽  
Randomized Controlled ◽  
Randomized Controlled Trail

Abstract Background Vitamin D deficiency has been shown to be closely associated with peritoneal dialysis (PD)-related peritonitis. The aim of this study is to examine the feasibility of conducting a large, powered randomized controlled trial to determine the effects of vitamin D supplementation on the risk of PD-related peritonitis in patients who have already experienced an episode of peritonitis. Methods This prospective, open-label randomized controlled pilot trial with blinded end-points aims to determine the feasibility of oral vitamin D supplementation and to explore its effects on the risk of subsequent PD-related peritonitis among PD patients who have recovered from a recent episode of peritonitis. Eligible patients will be randomized 1:1 to either oral vitamin D supplementation (2000 IU per day; intervention group) or no vitamin D supplementation (control group) in addition to usual care according to International Society for Peritoneal Dialysis guidelines. The sample size will be 30 patients for both groups. All participants will be followed for 12 months. The primary outcome is the assessment of feasibility (recruitment success, retention, adherence, safety) and fidelity (change in serum 25-hydroxyvitamin D level during follow-up) for a large, powered randomized controlled trial to determine the effects of vitamin D on the risk of PD-related peritonitis in the future. Secondary outcomes include time to peritonitis occurrence, recovery of peritonitis, peritonitis-related transition to hemodialysis, and peritonitis-related death (defined as death within 30 days of peritonitis onset). Discussion This is the first randomized controlled trail investigating the effects of vitamin D supplementation on the risk of subsequent PD-related peritonitis among patients on PD. The findings for this pilot study will determine the feasibility of conducting a full-scale randomized controlled trail, which may provide a new strategy for preventing PD-related peritonitis among PD patients. Trial registration Clinicaltrails.gov, NCT03264625. Registered on 29 August 2017.

scholarly journals Associations between Serum-Intact Parathyroid Hormone, Serum 25-Hydroxyvitamin D. Oral Vitamin D Analogs and Metabolic Syndrome in Peritoneal Dialysis Patients: A Multi-Center Cross-Sectional Study

2014 ◽  
Vol 34 (4) ◽  
pp. 447-455 ◽  
Author(s):  
Jie Dong ◽  
Qin Wang ◽  
Meng-Hua Chen ◽  
Hui-Ping Zhao ◽  
Tong-Ying Zhu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Lower Risk ◽  
Intact Parathyroid Hormone ◽  
Oral Vitamin ◽  
Vitamin D Analogs ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Introduction Although previous studies have suggested associations between serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MS) in the general population, these associations are still uncharacterized in peritoneal dialysis (PD) patients. Methods In total, 837 prevalent PD patients from 5 centers in China were enrolled between April 1, 2011 and November 1, 2011. The demographic data, biochemical parameters and medical records were collected, except for serum 25(OH)D which was measured in 347 of 837 patients. The definition of MS was modified from National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATPIII). Results 55.4% of 837 patients were found to have MS. The median concentration of iPTH, 25(OH)D and doses of oral vitamin D analogs for participants with MS was significantly lower than those without MS. The iPTH, 25(OH)D values and doses of vitamin D analogs were all associated with one or more components of MS. After multivariate adjustment, Low serum iPTH values and oral vitamin D analogs, rather than serum 25(OH)D, were significantly associated with the presence of MS, abnormal fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C). Compared to iPTH < 130pg/mL, iPTH 130–585 pg/mL and > 585pg/mL were associated with a lower risk of MS with adjusted odds ratio (OR) of 0.59 and 0.33, respectively. Taking vitamin D analogs was also associated with a lower risk of MS with adjusted OR of 0.55. Conclusions Serum iPTH and the use of active vitamin D supplements rather than serum 25(OH)D were independently associated with the presence of MS in patients on PD.

scholarly journals Assessment of Risk Factors for Chronic Kidney Disease in Djamaa (El Oued, Algeria) Population

2020 ◽  
Author(s):  
Samir Derouiche ◽  
Tissir Cheradid ◽  
Massaouda Guessoum
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Herbal Medicine ◽  
Strong Association ◽  
High Sensitivity ◽  
Clinical Factors ◽  
History Of ◽  
Urinary Problems

Purpose: This study was conducted aiming at evaluating some risk factors in patients with Chronic Kidney Disease (CKD) in Djamaa (El Oued, Algeria) region. Materials and Methods: Our study is based on 77 voluntary individuals divided into healthy man and women reserved as a control with average age of 46.61± 2.84 years old and CKD patients with average age of 46.03± 2.95 years old; their origin covers the whole Djamaa (El Oued, Algeria) region and they were selected from the dialysis service of SAAD DEHLEB hospital Djamaa (El Oued Algeria). Risk of certain socio-clinical factors has been estimated by the determination of the value of Odd Ratio (OR). Results: Our study reports show a strong association between clinical factors such as Diabetes, urinary problems and Arterial hyper pressure (OR= 5.135, 6.60 and 78.276; P ≤0.05) with chronic kidney disease, respectively, but in this study we show that the Renal herbal medicine and History of kidney disease are the most dangerous risk factors, (OR = 20.00, OR =25,45 ; p≤0.001), respectively, for spices and Amount of water (OR ranging from 0.232 to 0.352; P ≤0.032) are important protective factors against this disease. Conclusion: Lifestyle is a contributing factor in CKD attainment in the region of Djamaa (El Oued, Algeria), which requires high sensitivity to modify these behaviors for limited progression of the disease in this region.

The prevention of infection

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 3-9 ◽  
Author(s):  
V. K. Alamanda ◽  
B. D. Springer
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Vitamin D ◽  
Glycaemic Control ◽  
Operating Room ◽  
Joint Infection ◽  
High Morbidity ◽  
Modifiable Risk Factors ◽  
Skin Preparation ◽  
Vitamin D Levels

AimsProsthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI.Materials and MethodsA search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI. An evidence-based review was performed on 12 specific risk factors: glycaemic control, obesity, malnutrition, smoking, vitamin D levels, preoperative Staphylococcus aureus screening, the management of anti-rheumatic medication, perioperative antibiotic prophylaxis, presurgical skin preparation, the operating room environment, irrigant options, and anticoagulation.ResultsPoor glycaemic control, obesity, malnutrition, and smoking are all associated with increased rates of PJI. Vitamin D replacement has been shown in preliminary animal studies to decrease rates of PJI. Preoperative Staphylococcus aureus screening and appropriate treatment results in decreased rates of PJI. Perioperative variables, such as timely and appropriate dosage of prophylactic antibiotics, skin preparation with chlorohexidine-based solution, and irrigation with dilute betadine at the conclusion of the operation, have all been associated with reduced rates of PJI. Similarly, aggressive anticoagulation and increased operating room traffic should be avoided to help minimize risk of PJI.ConclusionPJI remains a serious complication of arthroplasty. Surgeons should be vigilant of the modifiable risk factors that can be addressed in an attempt to reduce the risk of PJI.

scholarly journals Life style factors associated with the risk of type 2 diabetes mellitus

2019 ◽  
Vol 1 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Bikash Shrestha ◽  
Bipin Nepal ◽  
Yagya Laxmi Shakya ◽  
Binaya Regmi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Alcohol Use ◽  
Modifiable Risk Factors ◽  
Cross Sectional ◽  
History Of

 Introduction: Type 2 diabetes mellitus is the commonest form of diabetes affecting more than 90% of the diabetic population worldwide. The prevalence of type 2 diabetes and its complications are increasing in the world, including developing nations like Nepal. This study aimed to determine the association between the lifestyle risk factors and the risk of type 2 diabetes mellitus in Nepalese population. Methods: This is hospital based cross sectional observational study done in the urban area of Nepal. Records of clients coming for the general health checkup in Grande International Hospital were evaluated in this study. Comparisons of the lifestyle factors in participants having and not having type 2 diabetes mellitus were done. Results: Significant associations with diagnosis of diabetes mellitus (DM) type 2 were seen in age (P ≤ 0.001), associated hypertension (P ≤ 0.001), dyslipidemia, family history of DM (P ≤ 0.001), alcohol use (P ≤ 0.001), and tobacco use (P ≤ 0.001). Logistic regression analysis showed that the odds of having diabetes were high in age group above 40 (OR – 6.9, CI 3.82 – 12.47), history of hypertension (OR- 3.84, CI 2.42 – 6.08), tobacco users (OR-2.26, CI 1.12 – 4.53), alcohol users (OR-3.99, CI 2.47 – 6.44), family history of DM (OR-2.44, CI 1.53 – 3.89), and abdominal obesity in both males (OR-3.9, CI 2 – 7.4) and females (OR-9.6, CI 3.78 – 24.35). Conclusions: The modifiable risk factors - obesity, smoking and alcohol use carry significant risks of developing type 2 diabetes. These red flag signs call for urgent attention to look for and rectify the modifiable risk factors in Nepalese population to prevent diabetes.

Risk Factors for Peritoneal Dialysis–Associated Peritonitis: The Role of Oral Active Vitamin D

2010 ◽  
Vol 30 (5) ◽  
pp. 541-548 ◽  
Author(s):  
Michael Rudnicki ◽  
Julia Kerschbaum ◽  
Johann Hausdorfer ◽  
Gert Mayer ◽  
Paul König
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Lower Risk ◽  
Concomitant Medication ◽  
Mortality Data ◽  
Active Vitamin ◽  
Baseline Serum ◽  
Laboratory Parameters ◽  
Active Vitamin D

BackgroundPeritonitis is a major complication of peritoneal dialysis (PD), being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on various risk factors for peritonitis are inconsistent, and no association with concomitant therapy has been shown.MethodsWe performed a retrospective analysis of all incident and prevalent PD patients ( n = 55) treated in Innsbruck, Austria, between 2000 and 2007. Data consisted of 1291 patient–months and 55 episodes of peritonitis. Patient demographic data, comorbidities, concomitant medication, laboratory parameters, and microbiology results were obtained from the medical records and from the hospital's electronic database.ResultsThe mean peritonitis incidence rate was 0.51 episodes/patient–year (range: 0.24 – 0.73 episodes/patient–year) or 1 episode every 23.5 months (range: 16 – 50 months). In a primary analysis including demographic characteristics, comorbidities, laboratory parameters, and concomitant medication, only treatment with oral active vitamin D was associated with a significantly lower risk of peritonitis. Adjusted for time on PD and baseline serum albumin, oral active vitamin D therapy was associated with an 80% reduced relative risk of peritonitis [hazard ratio (HR): 0.20; 95% confidence interval (CI): 0.06 to 0.64; p = 0.007)]. The risk reduction was comparable in patients who received 0.25 μg or more of vitamin D daily (HR: 0.18; 95% CI: 0.05 to 0.65; p = 0.008) and in those who received less than 0.25 μg vitamin D daily (HR: 0.21; 95% CI: 0.06 to 0.77; p = 0.018).ConclusionsTreatment with oral active vitamin D might be associated with a lower risk of peritonitis in PD patients.

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).

scholarly journals Prevalence and Determinants of QuantiFERON-Diagnosed Tuberculosis Infection in 9810 Mongolian Schoolchildren

2018 ◽  
Vol 69 (5) ◽  
pp. 813-819 ◽  
Author(s):  
Davaasambuu Ganmaa ◽  
Polyna Khudyakov ◽  
Uyanga Buyanjargal ◽  
Badamtsetseg Jargalsaikhan ◽  
Delgerekh Baigal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Environmental Tobacco Smoke ◽  
Tobacco Smoke ◽  
Modifiable Risk Factors ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Potential Risk Factors ◽  
Independent Association

Abstract Background There is controversy regarding the potential influence of vitamin D deficiency, exposure to environmental tobacco smoke, BCG vaccination, season, and body habitus on susceptibility to Mycobacterium tuberculosis (MTB) infection. Methods We conducted a cross-sectional analysis to identify determinants of a positive QuantiFERON-TB Gold (QFT) assay result in children aged 6–13 years attending 18 schools in Ulaanbaatar, Mongolia. Data relating to potential risk factors for MTB infection were collected by questionnaire, physical examination, and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios (RRs) were calculated with adjustment for potential confounders, and population attributable fractions (PAFs) were calculated for modifiable risk factors identified. Results Nine hundred forty-six of 9810 (9.6%) participants had a positive QFT result. QFT positivity was independently associated with household exposure to pulmonary tuberculosis (adjusted RR [aRR], 4.75 [95% confidence interval {CI}, 4.13–5.46, P < .001]; PAF, 13.1% [95% CI, 11.1%–15.0%]), vitamin D deficiency (aRR, 1.23 [95% CI, 1.08–1.40], P = .002; PAF, 5.7% [95% CI, 1.9%–9.3%]), exposure to environmental tobacco smoke (1 indoor smoker, aRR, 1.19 [95% CI, 1.04–1.35]; ≥2 indoor smokers, aRR, 1.30 [95% CI, 1.02–1.64]; P for trend = .006; PAF, 7.2% [95% CI, 2.2%–12.0%]), and increasing age (aRR per additional year, 1.14 [95% CI, 1.10–1.19], P < .001). No statistically significant independent association was seen for presence of a BCG scar, season of sampling, or body mass index. Conclusions Vitamin D deficiency and exposure to environmental tobacco smoke are potentially modifiable risk factors for MTB infection.

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