scholarly journals Brazilian Dialysis Census: analysis of data from the 2009-2018 decade

2020 ◽  
Vol 42 (2) ◽  
pp. 191-200 ◽  
Author(s):  
Precil Diego Miranda de Menezes Neves ◽  
Ricardo de Castro Cintra Sesso ◽  
Fernando Saldanha Thomé ◽  
Jocemir Ronaldo Lugon ◽  
Marcelo Mazza Nasicmento
Keyword(s):  
Hepatitis C ◽  
Absolute Number ◽  
Incidence Rates ◽  
Chronic Dialysis ◽  
Patient Treatment ◽  
Positive Serology ◽  
Online Questionnaire ◽  
Dialysis Treatment ◽  
Number Of Patients ◽  
Treatment Objective

ABSTRACT Introduction: National data on chronic dialysis treatment are essential for the development of health policies that aim to improve patient treatment. Objective: To present data from the Brazilian Society of Nephrology on patients with chronic dialysis for kidney disease in July 2018, making a comparative analysis of the past 10 years. Methods: Data collection from dialysis units, with filling in an online questionnaire for 2018. Data from 2009, 2013 and 2018 were compared. Results: 288 (36.6%) centers answered the questionnaire. In July 2018, the estimated total number of patients on dialysis was 133,464. Estimates of the prevalence and incidence rates of patients undergoing dialysis treatment per million of the population (pmp) were 640 and 204, respectively, with average annual increases of 23.5 pmp and 6 pmp for prevalence and incidence, respectively. The annual gross mortality rate was 19.5%. Of the prevalent patients, 92.3% were on hemodialysis and 7.7% on peritoneal dialysis, with 29,545 (22.1%) on the waiting list for transplantation. Median bicarbonate concentration in the hemodialysis bath was 32 mEq/L. Venous catheters were used as access in 23.6% of the hemodialysis patients. The prevalence rate of positive serology for hepatitis C showed a progressive reduction (3.2%). Conclusion: The absolute number of patients and rates of incidence and prevalence in dialysis in the country increased substantially in the period, although there are considerable differences in rates by state. There has been a persistent increase in the use of venous catheters as an access for dialysis; and reduction in the number of patients with positive serology for hepatitis C.

scholarly journals Brazilian chronic dialysis survey 2017

2019 ◽  
Vol 41 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Fernando Saldanha Thomé ◽  
Ricardo Cintra Sesso ◽  
Antonio Alberto Lopes ◽  
Jocemir Ronaldo Lugon ◽  
Carmen Tzanno Martins
Keyword(s):  
Mortality Rate ◽  
Venous Catheter ◽  
Absolute Number ◽  
Incidence Rates ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Positive Serology ◽  
The North ◽  
Number Of Patients ◽  
National Estimates

Abstract Introduction: Having national data on chronic dialysis is essential in treatment planning. Objective: To present data of the survey from the Brazilian Society of Nephrology on patients with chronic kidney disease on dialysis in July 2017. Methods: Data was collected from dialysis units in Brazil. The data collection was done using a questionnaire completed online by the dialysis units. Results: Two hundred and ninety-one centers (38.4%) answered the questionnaire. In July 2017, the estimated total number of dialysis patients was 126,583. National estimates of prevalence and incidence rates of dialysis patients per million population (pmp) were 610 (range: 473 in the North region and 710 in the Midwest) and 194, respectively. The incidence rate of new dialysis patients with diagnosis of diabetic nephropathy was 77 pmp. The annual gross mortality rate was 19.9%. Of the prevalent patients, 93.1% were on hemodialysis and 6.9% on peritoneal dialysis, with 31,226 (24%) on the waiting list for renal transplantation. Venous catheter was used as access in 22.6% of patients on hemodialysis. The prevalence rate of positive serology for hepatitis C continued with a tendency to decrease (3.3%). Conclusion: The absolute number of patients and rates of incidence and prevalence on dialysis continued to increase; the mortality rate tended to rise. There were obvious regional and state discrepancies in these rates.

scholarly journals Brazilian dialysis survey 2019

2021 ◽  
Author(s):  
Precil Diego Miranda de Menezes Neves ◽  
Ricardo de Castro Cintra Sesso ◽  
Fernando Saldanha Thomé ◽  
Jocemir Ronaldo Lugon ◽  
Marcelo Mazza Nascimento
Keyword(s):  
Peritoneal Dialysis ◽  
Venous Catheter ◽  
Serum Levels ◽  
Absolute Number ◽  
Incidence Rates ◽  
Red Blood Cell Transfusion ◽  
Dialysis Access ◽  
Online Questionnaire ◽  
Dialysis Treatment ◽  
Number Of Patients

Abstract Introduction: National data on chronic dialysis treatment are essential for the development of health policies that aim to improve the treatment of patients. Objective: To present data from the Brazilian Dialysis Survey 2019, promoted by the Brazilian Society of Nephrology. Methods: Data collection from dialysis units in the country through a completed online questionnaire for 2019. Results: 314 (39%) centers responded the questionnaire. In July 2019, the estimated total number of patients on dialysis was 139,691. Estimates of the prevalence and incidence rates of patients undergoing dialysis treatment per million of the population (pmp) were 665 and 218, respectively, with mean annual increases of 25 pmp and 14 pmp for prevalence and incidence, respectively. The annual gross mortality rate was 18.2%. Of the prevalent patients, 93.2% were on hemodialysis and 6.8% on peritoneal dialysis; and 33,015 (23.6%) on the waiting list for transplantation. 55% of THE centers offered treatment with peritoneal dialysis. Venous catheters were used as access in 24.8% of THE patients on hemodialysis. 17% of the patients had K ≥ 6.0mEq/L; 2.5% required red blood cell transfusion in July 2019 and 10.8% of the patients had serum levels of 25-OH vitamin D < 20 ng/mL. Conclusion: The absolute number of patients, the incidence and prevalence rates in dialysis in the country continue to increase, as well as the percentage of patients using venous catheter as dialysis access. There was an increase in the number of patients on the list for transplantation and a tendency to reduce gross mortality.

Recent epidemiological trends in extrapulmonary TB in Galicia, Spain

2021 ◽  
Vol 25 (5) ◽  
pp. 373-381
Author(s):  
L. Ferreiro ◽  
A. Ruano-Raviña ◽  
R. Otero-Mallo ◽  
C. Pou-Álvarez ◽  
V. Riveiro-Blanco ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Prevention And Control ◽  
Extrapulmonary Tuberculosis ◽  
Absolute Number ◽  
Incidence Rates ◽  
Age Group ◽  
Number Of Patients ◽  
Epidemiological Trends ◽  
And Control ◽  
Epidemiological Characteristics

OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66–4.07). The most frequent age group was 15–44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0–14 years), 75% (15–44 years), 44% (45–64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.

Comorbidities, Hospitalization, and Living Status of Dialysis Patients Over 80 Years

2016 ◽  
Vol 42 (4) ◽  
pp. 282-286
Author(s):  
Til Leimbach ◽  
Joachim Kron ◽  
Wolfgang Pommer ◽  
Birgit Urbach ◽  
Susanne Kron
Keyword(s):  
Quality Of Life ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Dialysis Treatment ◽  
Younger Patients ◽  
Number Of Patients ◽  
Age Range ◽  
Hospital Days ◽  
Satisfactory Quality

Background: An increasing number of patients start dialysis when they are over 80 years or reaches their eighties on dialysis. The burden of dialysis can affect their quality of life. Methods: Clinical and social data of all patients aged 80 years or older who underwent chronic dialysis treatment in a single center were analyzed. Results: Fifty-nine patients aged between 80 and 92 years were in chronic dialysis treatment on December 31, 2015. Median time on dialysis was 57 months (3-330 months). Hospitalization rate and days in hospital were lower in this group than in younger patients (1.05 vs. 1.34 hospitalizations; 8.3 vs. 9.0 hospital days per patient and year) despite the presence of many comorbidities. The median patency of the currently used arteriovenous shunt was 70 months (6-194 months). Social status was comparable with the population of the rest of the same average age range. Conclusion: Dialysis patients aged ≥80 years have a satisfactory quality of life with no more complications than younger patients.

scholarly journals Diabetes mellitus was not associated with lower amputation-free survival after open revascularization for chronic limb-threatening ischemia – A nationwide propensity score adjusted analysis

2021 ◽  
pp. 1358863X2110082
Author(s):  
Erika Lilja ◽  
Anders Gottsäter ◽  
Mervete Miftaraj ◽  
Jan Ekelund ◽  
Björn Eliasson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Propensity Score ◽  
Vascular Surgery ◽  
Incidence Rate ◽  
Cox Regression ◽  
Major Amputation ◽  
Incidence Rates ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis ◽  
Number Of Patients

The risk of major amputation is higher after urgently planned endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients with diabetes mellitus (DM). The aim of this nationwide cohort study was to compare outcomes between patients with and without DM following urgently planned open revascularization for CLTI from 2010 to 2014. Out of 1537 individuals registered in the Swedish Vascular Registry, 569 were registered in the National Diabetes Register. A propensity score adjusted Cox regression analysis was conducted to compare outcome between the groups with and without DM. Median follow-up was 4.3 years and 4.5 years for patients with and without DM, respectively. Patients with DM more often had foot ulcers ( p = 0.034) and had undergone more previous amputations ( p = 0.001) at baseline. No differences in mortality, cardiovascular death, major adverse cardiovascular events (MACE), or major amputation were observed between groups. The incidence rate of stroke was 70% higher (95% CI: 1.11–2.59; p = 0.0137) and the incidence rate of acute myocardial infarction (AMI) 39% higher (95% CI: 1.00–1.92; p = 0.0472) among patients with DM in comparison to those without. Open vascular surgery remains a first-line option for a substantial number of patients with CLTI, especially for limb salvage in patients with DM. The higher incidence rates of stroke and AMI among patients with DM following open vascular surgery for infrainguinal CLTI require specific consideration preoperatively with the aim of optimizing medical treatment to improve cardiovascular outcome postoperatively.

Risk of death among chronic dialysis patients infected with hepatitis C virus

1998 ◽  
Vol 32 (4) ◽  
pp. 629-634 ◽  
Author(s):  
CO Stehman-Breen ◽  
S Emerson ◽  
D Gretch ◽  
RJ Johnson
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Risk Of Death

scholarly journals Characterization of Resistance to the Nonnucleoside NS5B Inhibitor Filibuvir in Hepatitis C Virus-Infected Patients

2011 ◽  
Vol 56 (3) ◽  
pp. 1331-1341 ◽  
Author(s):  
Philip J. F. Troke ◽  
Marilyn Lewis ◽  
Paul Simpson ◽  
Katrina Gore ◽  
Jennifer Hammond ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Amino Acid ◽  
Site Directed Mutagenesis ◽  
Phenotypic Resistance ◽  
Number Of Patients ◽  
Chronic Hcv ◽  
Selection Of

ABSTRACTFilibuvir (PF-00868554) is an investigational nonnucleoside inhibitor of the hepatitis C virus (HCV) nonstructural 5B (NS5B) RNA-dependent RNA polymerase currently in development for treating chronic HCV infection. The aim of this study was to characterize the selection of filibuvir-resistant variants in HCV-infected individuals receiving filibuvir as short (3- to 10-day) monotherapy. We identified amino acid M423 as the primary site of mutation arising upon filibuvir dosing. Through bulk cloning of clinical NS5B sequences into a transient-replicon system, and supported by site-directed mutagenesis of the Con1 replicon, we confirmed that mutations M423I/T/V mediate phenotypic resistance. Selection in patients of an NS5B mutation at M423 was associated with a reduced replicative capacityin vitrorelative to the pretherapy sequence; consistent with this, reversion to wild-type M423 was observed in the majority of patients following therapy cessation. Mutations at NS5B residues R422 and M426 were detected in a small number of patients at baseline or the end of therapy and also mediate reductions in filibuvir susceptibility, suggesting these are rare but clinically relevant alternative resistance pathways. Amino acid variants at position M423 in HCV NS5B polymerase are the preferred pathway for selection of viral resistance to filibuvirin vivo.

Inhibitor development in haemophilia according to concentrate

2015 ◽  
Vol 113 (05) ◽  
pp. 968-975 ◽  
Author(s):  
Riita Lassila ◽  
Flora Peyvandi ◽  
Gabriele Calizzani ◽  
Alex Gatt ◽  
Thierry Lambert ◽  
...  
Keyword(s):  
Calculated Data ◽  
Incidence Rates ◽  
Clotting Factor ◽  
Haemophilia A ◽  
Severe Haemophilia ◽  
Inhibitor Development ◽  
Haemophilia B ◽  
Number Of Patients ◽  
Recombinant Fviii ◽  
Set Up

SummaryInhibitor development represents the most serious side effect of haemophilia treatment. Any difference in risk of inhibitor formation depending on the product used might be of clinical relevance. It was this study’s objective to assess inhibitor development according to clotting factor concentrate in severe haemophilia A and B. The European Haemophilia Safety Surveillance (EUHASS) was set up as a study monitoring adverse events overall and according to concentrate. Since October 2008, inhibitors were reported at least quarterly. Number of treated patients was reported annually, specifying the number of patients completing 50 exposure days (Previously Untreated Patients, PUPs) without inhibitor development. Cumulative incidence, incidence rates and 95 % confidence intervals (CI) were calculated. Data from October 1, 2008 to December 31, 2012 were analysed for 68 centres that validated their data. Inhibitors developed in 108/417 (26 %; CI 22–30 %) PUPs with severe haemophilia A and 5/72 (7 %; CI 2–16%) PUPs with severe haemophilia B. For Previously Treated Patients (PTPs), 26 inhibitors developed in 17,667 treatment years [0.15/100 treatment years; CI 0.10–0.22) for severe haemophilia A and 1/2836 (0.04/100; (CI 0.00–0.20) for severe haemophilia B. Differences between plasma-derived and recombinant concentrates, or among the different recombinant FVIII concentrates were investigated. In conclusion, while confirming the expected rates of inhibitors in PUPs and PTPs, no class or brand related differences were observed.

scholarly journals Effect of conversion from calcineurin inhibitors to everolimus on hepatitis C viremia in adult kidney transplant recipients

2018 ◽  
Vol 40 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Larissa Sgaria Pacheco ◽  
Valter Duro Garcia ◽  
Ronivan Luis Dal Prá ◽  
Bruna Doleys Cardoso ◽  
Mariana Ferras Rodrigues ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Controlled Trial ◽  
Calcineurin Inhibitors ◽  
Control Group ◽  
P Value ◽  
Kidney Transplant Recipients ◽  
Positive Serology ◽  
Open Label ◽  
Adult Kidney ◽  
Group 1

ABSTRACT Introduction: Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. Method: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors. Results: Thirty patients were randomized and 28 were followed-up for 12 months (conversion group, Group 1 =15 and control group, Group 2 =13). RT-PCR HCV levels reported in log values were comparable in both groups and among patients in the same group. The statistical analysis showed no interaction effect between time and group (p value G*M= 0.852), overtime intra-groups (p-value M=0.889) and between group (p-value G=0.286). Group 1 showed a higher incidence of dyslipidemia (p=0.03) and proteinuria events (p=0.01), while no difference was observed in the incidence of anemia (p=0.17), new onset of post-transplant diabetes mellitus (p=1.00) or urinary tract infection (p=0.60). The mean eGFR was similar in both groups. Conclusion: Our study did not show viral load decrease after conversion to EVR with maintenance of antiproliferative therapy.

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