scholarly journals Association between salt intake and long-term mortality in hemodialysis patients: A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260671
Author(s):  
Naoki Suzuki ◽  
Yasumasa Hitomi ◽  
Hiroya Takata ◽  
Shinji Ushiya ◽  
Masahiro Yamada ◽  
...  
Keyword(s):  
Body Weight ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Salt Intake ◽  
Ideal Body Weight ◽  
Hemodialysis Patients ◽  
Cox Proportional Hazards ◽  
All Cause Mortality ◽  
Ideal Body

Background The association between salt intake and clinical outcomes in hemodialysis patients has been controversial. This study aimed to clarify the association between salt intake and mortality in hemodialysis patients. Method The present study included patients who underwent hemodialysis from June 1st 2016 to May 31st 2020. Corrected salt intake by ideal body weight was the main predictor of outcomes. Ideal body weight was calculated assuming that the ideal body mass index is 22 kg/m2 for the Japanese population. The multivariate Cox proportional hazards model was used to determine the association between corrected salt intake and mortality, adjusting for potential confounders. The outcomes considered were all-cause mortality and cumulative incidence of cardiovascular events at year 4. Result A total of 492 adult patients were enrolled in the study. The mean daily salt intake and corrected salt intake at baseline were 9.5 g/day and 0.17 g/kg/day, respectively. The low corrected salt intake group (< 0.13 g/kg/day) demonstrated the highest 4-year all-cause mortality. No association was observed between corrected salt intake and the cumulative incidence of cardiovascular events. In multivariate Cox proportional hazards analysis, only the group with corrected salt intake of 0.16–0.20 g/kg/day was associated with a decreased hazard risk for all-cause death compared with the low corrected salt intake group. Conclusion The present study found that a low salt intake was associated with high all-cause mortality in hemodialysis patients. Reduced long-term survival may be attributed to malnutrition resulting from excessive salt restriction.

Overweight Patients Achieve Ideal Body Weight Following Curative Gastrectomy Resulting in Better Long-Term Prognosis

2013 ◽  
Vol 23 (5) ◽  
pp. 650-656 ◽  
Author(s):  
Fanming Kong ◽  
Hui Li ◽  
Yongli Fan ◽  
Xinwei Zhang ◽  
Shui Cao ◽  
...  
Keyword(s):  
Body Weight ◽  
Ideal Body Weight ◽  
Curative Gastrectomy ◽  
Ideal Body ◽  
Long Term Prognosis

scholarly journals Urinary Estrogen Metabolites and Long-Term Mortality Following Breast Cancer

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Tengteng Wang ◽  
Hazel B Nichols ◽  
Sarah J Nyante ◽  
Patrick T Bradshaw ◽  
Patricia G Moorman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Confidence Intervals ◽  
Proportional Hazards ◽  
Statistical Tests ◽  
Breast Cancer Mortality ◽  
Cox Proportional Hazards ◽  
Urine Collection ◽  
Estrogen Metabolites ◽  
All Cause Mortality

Abstract Background Estrogen metabolite concentrations of 2-hydroxyestrone (2-OHE1) and 16-hydroxyestrone (16-OHE1) may be associated with breast carcinogenesis. However, no study has investigated their possible impact on mortality after breast cancer. Methods This population-based study was initiated in 1996–1997 with spot urine samples obtained shortly after diagnosis (mean = 96 days) from 683 women newly diagnosed with first primary breast cancer and 434 age-matched women without breast cancer. We measured urinary concentrations of 2-OHE1 and 16-OHE1 using an enzyme-linked immunoassay. Vital status was determined via the National Death Index (n = 244 deaths after a median of 17.7 years of follow-up). We used multivariable-adjusted Cox proportional hazards to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the estrogen metabolites-mortality association. We evaluated effect modification using likelihood ratio tests. All statistical tests were two-sided. Results Urinary concentrations of the 2-OHE1 to 16-OHE1 ratio (&gt;median of 1.8 vs ≤median) were inversely associated with all-cause mortality (HR = 0.74, 95% CI = 0.56 to 0.98) among women with breast cancer. Reduced hazard was also observed for breast cancer mortality (HR = 0.73, 95% CI = 0.45 to 1.17) and cardiovascular diseases mortality (HR = 0.76, 95% CI = 0.47 to 1.23), although the 95% confidence intervals included the null. Similar findings were also observed for women without breast cancer. The association with all-cause mortality was more pronounced among breast cancer participants who began chemotherapy before urine collection (n = 118, HR = 0.42, 95% CI = 0.22 to 0.81) than among those who had not (n = 559, HR = 0.98, 95% CI = 0.72 to 1.34; Pinteraction = .008). Conclusions The urinary 2-OHE1 to 16-OHE1 ratio may be inversely associated with long-term all-cause mortality, which may depend on cancer treatment status at the time of urine collection.

scholarly journals Efficiency of post-dilution online hemodiafiltration therapy in combination with ketoanalogues of amino acid in the correction of protein-energy malnutrition in hemodialysis patients

2018 ◽  
pp. 174-178 ◽  
Author(s):  
A. A. Yakovenko
Keyword(s):  
Body Weight ◽  
Amino Acid ◽  
Protein Energy Malnutrition ◽  
Ideal Body Weight ◽  
Hemodialysis Patients ◽  
Adequate Intake ◽  
Essential Nutrients ◽  
Protein Energy ◽  
Ideal Body ◽  
Keto Analogues

Purpose of the study. Evaluate the efficiency of permanent post-dilution online hemodiafiltration therapy in combination with the prescription of keto analogues of amino acid at a dose of 0,2 g/kg of ideal body weight/day to correct protein-energy malnutrition in hemodialysis patients with adequate intake of essential nutrients. Patients and methods. A total of 645 patients with terminal renal failure received programmed hemodialysis, of which there were 300 men and 345 women aged 58,8 ± 6,9 years. All patients received treatment with programmed GD for 6,9 ± 2,1 years. All patients underwent a comprehensive assessment of nutritional status. The level of leptin and interleukin-6 serum was determined. Patients with signs of protein-energy malnutritian (PEM) were divided into three groups, depending on the method of PEM correction. Results. The study showed the efficiency of postdilution online hemodiafiltration therapy on an ongoing basis in combination with keto-analogues of amino acids at a dose of 0,2 g/kg of ideal body weight/day for correction of PEM in hemodialysis patients. Conclusion. The post-dilution online hemodiafiltration therapy combined with keto-analogues of amino acid at a dose of 0.2 g /kg of ideal body weight/day can be considered one of the pathogenetically grounded methods for correcting PEM in patients receiving programmed hemodialysis with adequate intake of essential nutrients. 

Hostility predicts mortality but not recurrent acute coronary syndrome

2020 ◽  
pp. 147451512095091
Author(s):  
Tracey K Vitori ◽  
Susan K Frazier ◽  
Martha J Biddle ◽  
Gia Mudd-Martin ◽  
Michele M Pelter ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Proportional Hazards ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
All Cause Mortality ◽  
Large Randomized Clinical Trial ◽  
The Relationship

Background: Hostility is associated with greater risk for cardiac disease, cardiac events and dysrhythmias. Investigators have reported equivocal findings regarding the association of hostility with acute coronary syndrome (ACS) recurrence and mortality. Given mixed results on the relationship between hostility and cardiovascular outcomes, further research is critical. Aims: The aim of our study was to determine whether hostility was a predictor of ACS recurrence and mortality. Methods: We performed a secondary analysis of data ( N = 2321) from a large randomized clinical trial of an intervention designed to reduce pre-hospital delay among patients who were experiencing ACS. Hostility was measured at baseline with the Multiple Adjective Affect Checklist (MAACL) and patients were followed for 24 months for evaluation of ACS recurrence and all-cause mortality. We used Cox proportional hazards modeling to determine whether hostility was predictive of time to ACS recurrence or all-cause mortality. Results: The majority of patients were married (73%), Caucasian (97%), men (68%), and had a mean age of 67 ± 11 years. Fifty-seven percent of participants scored as hostile based on the established MAACL cut point (mean score = 7.56 ± 3.8). Hostility was an independent predictor of all-cause mortality ( p = < 0.039), but was not a predictor of ACS recurrence ( p = 0.792). Conclusion: Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality.

scholarly journals The U-Shape Relationship Between Glycated Hemoglobin Level and Long-Term All-Cause Mortality Among Patients With Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Liwei Liu ◽  
Jianfeng Ye ◽  
Ming Ying ◽  
Qiang Li ◽  
Shiqun Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Proportional Hazards ◽  
Glycated Hemoglobin ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Models ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Artery Disease

Background: Although glycated hemoglobin (HbA1c) was considered as a prognostic factor in some subgroup of coronary artery disease (CAD), the specific relationship between HbA1c and the long-term all-cause death remains controversial in patients with CAD.Methods: The study enrolled 37,596 CAD patients and measured HbAlc at admission in Guangdong Provincial People's Hospital. The patients were divided into 4 groups according to HbAlc level (Quartile 1: HbA1c ≤ 5.7%; Quartile 2: 5.7% &lt; HbA1c ≤ 6.1%; Quartile 3: 6.1% &lt; HbA1c ≤ 6.7%; Quartile 4: HbA1c &gt; 6.7%). The study endpoint was all-cause death. The restricted cubic splines and cox proportional hazards models were used to investigate the association between baseline HbAlc levels and long-term all-cause mortality.Results: The median follow-up was 4 years. The cox proportional hazards models revealed that HbAlc is an independent risk factor in the long-term all-cause mortality. We also found an approximate U-shape association between HbA1c and the risk of mortality, including increased risk of mortality when HbA1c ≤ 5.7% and HbA1c &gt; 6.7% [Compared with Quartile 2, Quartile 1 (HbA1c ≤ 5.7), aHR = 1.13, 95% CI:1.01–1.26, P &lt; 0.05; Quartile 3 (6.1% &lt; HbA1c ≤ 6.7%), aHR = 1.04, 95% CI:0.93–1.17, P =0.49; Quartile 4 (HbA1c &gt; 6.7%), aHR = 1.32, 95% CI:1.19–1.47, P &lt; 0.05].Conclusions: Our study indicated a U-shape relationship between HbA1c and long-term all-cause mortality in CAD patients.

scholarly journals Depression and long-term prognostic outcomes following peripheral endovascular interventions in the VA Healthcare System

2018 ◽  
Vol 23 (5) ◽  
pp. 454-460 ◽  
Author(s):  
Kim G Smolderen ◽  
Mary E Plomondon ◽  
Ehrin J Armstrong ◽  
Edward Hess ◽  
Stephen Waldo ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Vascular Intervention ◽  
Endovascular Interventions ◽  
Increased Risk ◽  
Peripheral Vascular Intervention ◽  
Artery Disease

The association between depression and peripheral artery disease (PAD) outcomes remains widely understudied. In patients with PAD undergoing a peripheral vascular intervention (PVI) who have a recent diagnosis of depression, it is unknown what their long-term outcomes are and what factors may mediate an adverse risk. We therefore studied 797 consecutive patients undergoing PVI across 33 Veterans Affairs (VA) centers. Depression and outcomes were documented from patients’ medical records. Outcomes included: (1) all-cause death; (2) non-fatal cardiovascular events (myocardial infarction, stroke); and (3) PAD-related events (including repeat PVI or amputation). Cox proportional hazards frailty models were constructed, adjusting for age. Additional covariates were selected if they resulted in at least 5% change in the age-adjusted hazard ratio (HR) for depression on outcomes. Overall, 265 (33%) patients had a diagnosis of depression. After a median follow-up of 955 days (range 1–6.25 years), 52 (6.5%) patients died, 30 (3.8%) experienced non-fatal cardiovascular events, and 176 (22.1%) had PAD-related events. Compared to patients without depression, depressed patients had higher rates of non-fatal cardiovascular events (6.4% vs 2.4%, p-value 0.0055). No differences for the other outcomes were noted. Higher risk for non-fatal cardiovascular events persisted after adjustment for age (HR 1.6, 95% CI 1.05–2.47). The only additional covariate that met our selection criteria was hypertension. After adjusting for hypertension, the association between depression and non-fatal cardiovascular outcomes attenuated (HR 1.53, 95% CI 0.99–2.35). In conclusion, a diagnosis of depression in veterans undergoing PVI was associated with increased risk of non-fatal cardiovascular events, mediated by age and hypertension.

scholarly journals Endothelin-1 Measurement in Patients Undergoing Diagnostic Coronary Angiography—Results from the Catheter Sampled Blood Archive in Cardiovascular Diseases (CASABLANCA) Study

2018 ◽  
Vol 64 (11) ◽  
pp. 1617-1625 ◽  
Author(s):  
Nasrien E Ibrahim ◽  
Rajat Gupta ◽  
Asya Lyass ◽  
Yiwei Li ◽  
Shreya Shrestha ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Cardiovascular Mortality ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Vascular Endothelial Cells ◽  
Cox Proportional Hazards ◽  
Biologically Active ◽  
Cross Sectional ◽  
Endothelin 1 ◽  
All Cause Mortality

Abstract BACKGROUND Endothelin-1 (ET-1) is a vasoconstrictor produced by vascular endothelial cells and may play a role in risk for development of coronary artery disease (CAD) and heart failure (HF). In a cohort of 1084 patients referred for coronary angiography, we investigated cross-sectional associations between ET-1 concentrations and prevalent CAD, as well as value of ET-1 for prognostication of future cardiovascular events. METHODS Associations between ET-1 and presence/severity of CAD were assessed. Patients were followed for a median of 4 years for outcomes including incident HF, myocardial infarction (MI), cardiovascular mortality, and all-cause mortality. RESULTS The median concentration of ET-1 was 2.57 ng/L. Patients with ET-1 concentrations above the median were more likely to have higher risk clinical features. Among those without prevalent MI at presentation, ET-1 concentrations were not associated with presence or severity of CAD. In adjusted Cox proportional hazards analyses, log-transformed ET-1 concentrations predicted incident HF [hazard ratio (HR) = 1.51 per increase in log-SD; 95% CI, 1.06–2.15; P = 0.02] and all-cause mortality (HR = 1.61 per increase in log-SD; 95% CI, 1.03–2.53; P = 0.04). Concentrations of ET-1 above the median were associated with shorter time to incident HF, MI, cardiovascular mortality, all-cause mortality, and the composite of incident HF/MI/cardiovascular mortality (all log-rank P &lt; 0.001). CONCLUSIONS Despite epidemiologic links to CAD, we found no cross-sectional association between biologically active ET-1 and prevalent coronary atherosclerosis in an at-risk population referred for coronary angiography. Increased ET-1 concentrations independently predict incident HF and death and are associated with more near-term cardiovascular events.

scholarly journals Serum Potassium Levels and Mortality in Hemodialysis Patients: A Retrospective Cohort Study

2016 ◽  
Vol 44 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Akeem A. Yusuf ◽  
Yan Hu ◽  
Bhupinder Singh ◽  
José A. Menoyo ◽  
James B. Wetmore
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Proportional Hazards ◽  
Serum Potassium Level ◽  
Short Interval ◽  
Hemodialysis Patients ◽  
Cox Proportional Hazards ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
The Impact

Background: Hyperkalemia is common in patients receiving maintenance hemodialysis. However, few studies have examined the association between serum potassium level and mortality. Methods: This study used annual cohorts of hemodialysis patients during 2007-2010. To determine hyperkalemia prevalence, monthly hyperkalemia was defined as serum potassium level ≥5.5 mEq/l; prevalence was calculated as a ratio of hyperkalemia episodes to follow-up time, reported separately by long and short interdialytic interval. To determine the impact of hyperkalemia on mortality, patients in the 2010 cohort were followed from first potassium measurement until death or a censoring event; hyperkalemia was defined, sequentially, by potassium levels 5.5-6.0 mEq/l at 0.1 mEq/l intervals. Time-dependent Cox proportional hazards modeling was used to estimate the association between hyperkalemia and mortality. Results: The 4 annual cohorts ranged from 28,774 to 36,888 patients. Mean age was approximately 63 years, about 56% were men, 51% were white and 44% had end-stage renal disease caused by diabetes. Hyperkalemia prevalence was consistently estimated at 16.3-16.8 events per 100 patient-months. Prevalence on the day after the long interdialytic interval was 2.0-2.4 times as high as on the day after the short interval. Hyperkalemia, when defined as serum potassium ≥5.7 mEq/l, was associated with all-cause mortality (adjusted hazards ratio (AHR) 1.13, 95% CI 1.01-1.28, p = 0.037, vs. <5.7 mEq/l) after adjustment. AHRs increased progressively as the hyperkalemia threshold increased, reaching 1.37 (95% CI 1.16-1.62, p < 0.0001) for ≥6.0 mEq/l. Conclusions: The long interdialytic interval was associated with increased likelihood of hyperkalemia. Hyperkalemia was associated with all-cause mortality beginning at serum potassium ≥5.7 mEq/l; mortality risk estimates increased ordinally through ≥6.0 mEq/l, suggesting a threshold at which serum potassium becomes substantially more dangerous.

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