Sex-Specific Differences in Hemodialysis Prevalence and Practices and the Male-to-Female Mortality Rate: The Dialysis Outcomes and Practice Patterns Study (DOPPS)

Abstract Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated.Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage Kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality.Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate COX model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality.Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.

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Mortality Risk Factors in the China Dialysis Outcomes and Practice Patterns Study (DOPPS)

10.21203/rs.3.rs-445338/v2 ◽

2021 ◽

Author(s):

Xinju Zhao ◽

Qingyu Niu ◽

Zhaohui Ni ◽

Xiaonong Chen ◽

Yuqing Chen ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Congestive Heart Failure ◽

Mortality Rate ◽

Mortality Risk ◽

Practice Patterns ◽

Cox Model ◽

Blood Platelets ◽

Cox Proportional Hazards ◽

Dialysis Outcomes

Abstract Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated. Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality. Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate Cox model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality. Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.

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P1482MORTALITY RATE AND RELATED RISK FACTORS IN THE CHINA DIALYSIS OUTCOMES AND PRACTICE PATTERNS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1482 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Xinju Zhao ◽

Qingyu Niu ◽

Liangying Gan ◽

Li Zuo

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Lung Disease ◽

Practice Patterns ◽

Cox Regression ◽

White Blood Count ◽

Maintenance Hemodialysis ◽

Laboratory Values ◽

Related Risk ◽

Dialysis Outcomes

Abstract Background and Aims Mortality risk for maintenance hemodialysis (MHD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from Dialysis Outcomes and Practice Patterns Study (DOPPS) were studied. Method Data from the China DOPPS phase 5 (2012-2015) were used. All included patients were followed to the end of the study. Patients’ demographics, primary cause of end stage renal disease (ESRD), comorbidities, abstracted dialysis prescription, laboratory values, date of death, and causes for death were analyzed. All-cause mortality (per 100 patient-years) was calculated. We examined clinical and laboratory differences between died and survived patients. Cox regression was used to explore risk factors of death, accounting for facility clustering and adjusted for case-mix (age, sex, vintage, and comorbid conditions), and laboratory values (albumin, hemoglobin, white blood count, sodium). Results There were 1427 MHD patients were enrolled. The mean age at dialysis initiation was 59.4±14.9 years (table 1). The median follow-up time was 1.9 years (IQR 1.1-2.1). There were total 205 deaths. The overall mortality rate was 8.8 per 100 patient-years. Death from cardiovascular disease (CVD) occurred in 50.2% of the patients. Compared with survived patients, patients with mortality were older (58.5 Vs. 70.0 y), more likely with diabetes, with lower pre-dialysis albumin level (Pre-ALB) or hemoglobin level (Pre-HGB), with lower pre or post dialysis diastolic blood pressure (DBP), with some comorbidities and less likely with fistula as their blood access (table 2). Cox regression revealed that risk factors for higher mortality were older age, lower Pre-ALB level, higher pre-dialysis DBP and with CHF, hepatitis, hypertension, and lung disease. Conclusion CVD constituted half of the death reasons for Chinese dialysis patients. Our analysis highlighted that there are some modifiable risk factors for patients’ survival. Attention should be paid to patients who were older, with lower Pre-ALB level, higher pre-dialysis DBP and with CHF, hepatitis, hypertension, and lung disease.

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An Integrated Evolutionary Perspective on the Male to Female Mortality Ratio

PsycEXTRA Dataset ◽

10.1037/e416902005-483 ◽

2003 ◽

Author(s):

Daniel J. Kruger ◽

Randolph M. Nesse

Keyword(s):

Evolutionary Perspective ◽

Female Mortality ◽

Mortality Ratio ◽

Male To Female

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Faculty Opinions recommendation of Data from the Dialysis Outcomes and Practice Patterns Study validate an association between high intravenous iron doses and mortality.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718512045.793498300 ◽

2014 ◽

Author(s):

James Kaufman

Keyword(s):

Practice Patterns ◽

Intravenous Iron ◽

Dialysis Outcomes

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Sex-specific deaths in Norway and Sweden during the COVID-19 pandemic: Did mandates make a difference?

Scandinavian Journal of Public Health ◽

10.1177/14034948211010017 ◽

2021 ◽

pp. 140349482110100

Author(s):

Ralph Catalano

Keyword(s):

Sex Ratio ◽

Infection Control ◽

Temporal Variation ◽

Risky Behavior ◽

Control Strategies ◽

Sex Ratios ◽

Female Mortality ◽

All Cause Mortality ◽

Societal Expectations ◽

Male To Female

Aims: To determine whether differences between Norway’s and Sweden’s attempts to contain SARS-CoV-2 infection coincided with detectably different changes in their all-cause mortality sex ratios. Measuring temporal variation in the all-cause mortality sex ratio before and during the pandemic in populations exposed to different constraints on risky behavior would allow us to better anticipate changes in the ratio and to better understand its association with infection control strategies. Methods: I apply time Box–Jenkins modeling to 262 months of pre-pandemic mortality sex ratios to arrive at counterfactual values of 10 intra-pandemic ratios. I compare counterfactual to observed values to determine if intra-pandemic ratios differed detectably from those expected as well as whether the Norwegian and Swedish differences varied from each other. Results: The male to female mortality sex ratio in both Norway and Sweden increased during the pandemic. I, however, find no evidence that the increase differed between the two countries despite their different COVID-19 containment strategies. Conclusion: Societal expectations of who will die during the COVID-19 pandemic will likely be wrong if they assume pre-pandemic mortality sex ratios because the intra-pandemic ratios appear, at least in Norway and Sweden, detectably higher. The contribution of differences in policies to reduce risky behavior to those higher ratios appears, however, small.

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The Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor: Rationale and Methods for an Initiative to Monitor the New US Bundled Dialysis Payment System

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2011.03.001 ◽

2011 ◽

Vol 57 (6) ◽

pp. 822-831 ◽

Cited By ~ 36

Author(s):

Bruce Robinson ◽

Douglas Fuller ◽

Dawn Zinsser ◽

Justin Albert ◽

Brenda Gillespie ◽

...

Keyword(s):

Practice Patterns ◽

Payment System ◽

Dialysis Outcomes

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MO792CONTEMPORARY MINERAL AND BONE DISORDER MARKERS AND TREATMENT AMONG HEMODIALYSIS PATIENTS IN THE EUROPEAN DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY (DOPPS)*

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab096.001 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Brian Bieber ◽

Indranil Dasgupta ◽

Pieter Evenepoel ◽

Stefan H Jacobson ◽

Piergiorgio Messa ◽

...

Keyword(s):

Vitamin D ◽

Practice Patterns ◽

Hemodialysis Patients ◽

Serum Phosphorus ◽

Active Vitamin ◽

Mineral And Bone Disorder ◽

Bone Disorder ◽

Country Differences ◽

Dialysis Outcomes ◽

The Uk

Abstract Background and Aims Chronic kidney disease mineral and bone disorder (CKD-MBD) is characterized by abnormalities in serum calcium, phosphorus, and parathyroid hormone (PTH) and associated with morbidity and mortality. Previous publications from the Dialysis Outcomes and Practice Patterns Study (DOPPS) have demonstrated country differences in the prevalence and treatment of CKD-MBD among hemodialysis patients in participating European countries. We aim to compare the distribution of CKD-MBD related labs and treatments across countries in a contemporary population of European hemodialysis patients. Method DOPPS is an international prospective cohort study of hemodialysis patients ≥18 years of age. Patients are enrolled randomly from a representative sample of dialysis facilities within each nation at the start of each study phase. The current analysis includes n=1,701 patients from 91 facilities in the initial prevalent cross section of Europe DOPPS phase 7 (2019-present; Belgium, Germany, Italy, Spain, Sweden, UK). Results from Belgium should be considered preliminary as initial questionnaire completion is ongoing. Results The % of patients with a high PTH (>600 pg/mL) ranged from 6% in Italy to 24% in the UK, with 12-17% having high PTH in all other countries. Mean serum total calcium ranged from 8.7 in Germany to 9.1 mg/dL in the UK (Table). Mean serum phosphorus varied from 4.5 in Belgium to 5.3 mg/dL in Germany. Dialysate calcium of 2.5 mEq/L was predominant in Germany, Sweden, and the UK while 3.0 mEq/L was the most common prescription in Belgium, Italy, and Spain. Calcimimetic prescription ranged from 13% in the UK to 32% in Spain. Etelcalcetide prescription ranged from 1% in the UK to 12% in Spain and 14% in Italy. Active vitamin D prescription ranged from 27% in Belgium to 75% in Sweden. Nearly all vitamin D prescriptions were administered intravenously in Spain versus about half in Italy; in all other countries, the route of active vitamin D administration was primarily oral. Patient age and dialysis vintage varied by country, potentially contributing to some of the observed country differences in MBD marker levels and treatment practices. Conclusion CKD-MBD related abnormalities in PTH, serum phosphorus and calcium remain common in European dialysis patients, with prevalence varying considerably by country. Substantial international variation in CKD-MBD treatments was also observed in prescription of vitamin D and calcimimetics. Uptake of the relatively new calcimimetic, etelcalcetide, varied considerably by country. A detailed understanding of the effect of treatment variation on CKD-MBD marker levels and patient outcomes is needed to provide important insights for the European HD community in optimizing management of secondary hyperparathyroidism.

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