scholarly journals Center-effect of incident hemodialysis vascular access use: Analysis of a bi-national registry

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0005742020
Author(s):  
Samantha Ng ◽  
Elaine M. Pascoe ◽  
David W. Johnson ◽  
Carmel M. Hawley ◽  
Kevan R. Polkinghorne ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
New Zealand ◽  
Kidney Disease ◽  
Smoking Status ◽  
Venous Catheter ◽  
National Registry ◽  
Factors Associated ◽  
Patient Level ◽  
Number Of Patients ◽  
Arteriovenous Access

Background: Commencing hemodialysis (HD) with an arteriovenous access is associated with superior patient outcomes compared to a catheter but the majority of patients in Australia and New Zealand (ANZ) initiate HD with a central venous catheter. This study examined patient and center factors associated with arteriovenous fistula/graft access use at HD commencement. Methods: All adult patients starting chronic HD in Australia and New Zealand between 2004 and 2015 were included. Access type at HD initiation was analyzed using logistic regression. Patient-level factors included sex, age, race, body mass index (BMI), smoking status, primary kidney disease, late nephrologist referral, comorbidities and prior kidney replacement therapy (KRT). Center-level factors included size, transplant capability, home HD proportion, incident peritoneal dialysis (average number of patients commencing KRT with peritoneal dialysis per year), mean weekly HD hours, average blood flow and achievement of phosphate, hemoglobin and weekly Kt/V targets. The study included 27,123 patients from 61 centers. Results: Arteriovenous access use at HD commencement varied 4-fold from 15% to 62% (median 39%) across centers. Incident arteriovenous access use was more likely in patients aged 51-72 years, males and patients with BMI >25kg/m2 and polycystic kidney disease but less likely in patients with BMI<18.5kg/m2, late nephrologist referral, diabetes mellitus, cardiovascular disease, chronic lung disease and prior KRT. Starting HD with an arteriovenous access was less likely in centers with the highest proportion of home HD and no center factor was associated with higher arteriovenous access use. Adjustment for center-level characteristics resulted in a 25% reduction in observed inter-center variability of arteriovenous access use at hemodialysis initiation compared to the model adjusted for only patient-level characteristics. Conclusions: This study identified several patient- and center-factors associated with incident hemodialysis access use, yet these factors did not fully explain the substantial variability in arteriovenous access use across centers.

scholarly journals МОДИФІКАЦІЯ ФАКТОРІВ РИЗИКУ СЕРЦЕВО-СУДИННИХ УСКЛАДНЕНЬ В ПЛАНІ ОПТИМІЗАЦІЇ ЛІКУВАННЯ ХВОРИХ ІЗ ХРОНІЧНОЮ ХВОРОБОЮ НИРОК СЕАНСАМИ ПРОГРАМНОГО ГЕМОДІАЛІЗУ

2014 ◽  
Author(s):  
I. L. Kuchma
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Complications ◽  
National Registry ◽  
Treatment Programs ◽  
Number Of Patients ◽  
Class 1 ◽  
Therapy Sessions

<p class="1">The number of patients with chronic kidney disease (CKD) in substitution therapy sessions dialysis program in Ukraine is growing. Improvement of methods of renal replacement therapy (RRT), chronic kidney disease, in particular, the use of modern dialysis technology has led to a significant increase in the life expectancy of patients. However, the mortality of the disease remains high. In its structure heavily reliant on cardiovascular disease, according to the National registry of patients with chronic kidney disease in 2011 it was 72 %. In this regard, there is actual determination of risk factors for these complications and the search for new methods to ensure their prevention. The author studied the effect of individually tailored and standard hemodialysis treatment programs on the risk factors of cardiovascular complications in patients with CKD. It is concluded that the custom-fitted options at the time of hemodialysis and ultrafiltration properties klirensovyh dialyzer electrolyte composition of the dialysate can achieve better results in the management of risk factors in patients with CKD.</p>

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.

Factors Associated With Anthropometric Indicators of Nutritional Status in Children With Chronic Kidney Disease Undergoing Peritoneal Dialysis, Hemodialysis, and After Kidney Transplant

2018 ◽  
Vol 28 (5) ◽  
pp. 352-358 ◽  
Author(s):  
Julieta García De Alba Verduzco ◽  
Erika Fabiola Hurtado López ◽  
Consuelo Pontón Vázquez ◽  
Adriana de la Torre Serrano ◽  
Enrique Romero Velarde ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Kidney Transplant ◽  
Factors Associated ◽  
Anthropometric Indicators

Planning Vascular Access in Peritoneal Dialysis—Defining High-Risk Patients

2018 ◽  
Vol 38 (4) ◽  
pp. 271-277 ◽  
Author(s):  
Hugo Ferreira ◽  
Ana Nunes ◽  
Ana Oliveira ◽  
Ana Beco ◽  
Joana Santos ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
High Risk ◽  
Residual Renal Function ◽  
Number Of Patients ◽  
Replacement Technique ◽  
Risk Patients ◽  
Arteriovenous Access ◽  
Control Study

BackgroundPeritoneal dialysis (PD) is an effective renal replacement technique. However, every year a considerable number of patients are transferred to hemodialysis (HD). Our aim was to identify those at risk, in order to place an arteriovenous fistula (AVF).MethodsCase-control study enrolling all prevalent patients in 2014 and 2015 in our clinic. Groups: 72 case patients who were transferred definitively to HD, 111 control patients (remaining on PD, transplanted, recovered renal function, or deceased).ResultsA total of 183 patients were eligible, with a mean age of 55.2 ± 14.8 years, 56.3% male, 31.1% diabetic, and 49.7% on continuous ambulatory PD. The mean follow-up time was 42.1 ± 25.6 months. Eighty-five patients had an AVF. The groups differed in diabetic nephropathy etiology, and in some PD-related characteristics (Kt/V, creatinine clearance, residual renal function, mean ultrafiltration, natriuretic peptide, peritonitis, hospitalizations, and hypervolemia). In multivariate analysis, Kt/V < 1.7 (odds ratio [OR] 3.00, 95% confidence interval [CI]: 1.20 – 7.50], albumin < 35 g/L (OR 4.03, 95% CI: 1.26 – 12.92), number of hospitalizations 1 to 3 (OR 2.74, 95% CI: 1.15 – 6.53) and 4 or more (OR 10.48, 95% CI: 3.62 – 30.36), and 2 or more peritonitis episodes (OR 2.50, 95% CI: 1.03 – 6.07) were predictors of PD transfer to HD. In those patients who were transferred to HD, 34 initiated HD by AVF, 2 needed a catheter due to a non-functioning AVF, and 36 did not have an AVF needing catheter placement.ConclusionsLow Kt/V, low albumin, higher number of hospitalizations, and peritonitis were factors associated with PD transfer to HD, probably indicative of a high-risk PD population where arteriovenous access should be weighed.

Clinical Factors Associated with Progression to AIDS in the Italian Cohort of HIV-Positive Hemophiliacs

1994 ◽  
Vol 72 (01) ◽  
pp. 033-038 ◽  
Author(s):  
N Schinaia ◽  
A M G Ghirardini ◽  
M G Mazzucconi ◽  
G Tagariello ◽  
M Morfini ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
National Registry ◽  
Factor Ix ◽  
Clotting Factor ◽  
Coagulation Disorders ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Congenital Coagulation Disorders ◽  
Clotting Factor Concentrates

SummaryThis study updates estimates of the cumulative incidence of AIDS among Italian patients with congenital coagulation disorders (mostly hemophiliacs), and elucidates the role of age at seroconversion, type and amount of replacement therapy, and HBV co-infection in progression. Information was collected both retrospectively and prospectively on 767 HIV-1 positive patients enrolled in the on-going national registry of patients with congenital coagulation disorders. The seroconversion date was estimated as the median point of each patient’s seroconversion interval, under a Weibull distribution applied to the overall interval. The independence of factors associated to faster progression was assessed by multivariate analysis. The cumulative incidence of AIDS was estimated using the Kaplan-Meier survival analysis at 17.0% (95% Cl = 14.1-19.9%) over an 8-year period for Italian hemophiliacs. Patients with age greater than or equal to 35 years exhibited the highest cumulative incidence of AIDS over the same time period, 32.5% (95% Cl = 22.2-42.8%). Factor IX recipients (i.e. severe B hemophiliacs) had higher cumulative incidence of AIDS (23.3% vs 14.2%, p = 0.01) than factor VIII recipients (i.e. severe A hemophiliacs), as did severe A hemophiliacs on less-than-20,000 IU/yearly of plasma-derived clotting factor concentrates, as opposed to A hemophiliacs using an average of more than 20,000 IU (18.8% vs 10.9%, p = 0.02). No statistically significant difference in progression was observed between HBsAg-positive vs HBsAg-negative hemophiliacs (10.5% vs 16.4%, p = 0.10). Virological, immunological or both reasons can account for such findings, and should be investigated from the laboratory standpoint.

scholarly journals Determinants of waterpipe smoking among high school students in Jakarta, Indonesia

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ridhwan Fauzi ◽  
Chitlada Areesantichai
Keyword(s):  
High School ◽  
High School Students ◽  
Smoking Status ◽  
Waterpipe Smoking ◽  
School Students ◽  
Factors Associated ◽  
The Past ◽  
Logistic Regressions ◽  
Peer Use ◽  
Waterpipe Use

AbstractObjectivesThe study aimed to examine factors associated with past 30 days waterpipe use among high school students in Jakarta, Indonesia.MethodsWe surveyed a multistage cluster random sample of 1,318 students of grade 10th and 11th from 14 schools in Jakarta. Multiple logistic regressions were employed to examine the association between past 30 days waterpipe use with sociodemographic characteristics, cigarettes smoking status, parental and peer use, availability and affordability.ResultsOf 1,318 participants, 3.3% of female and 8.4% of male currently smoked waterpipe. Multivariate analysis revealed that current waterpipe use was significantly associated with family use (AOR: 4.844, 95% CI: 1.225–19.151), friend use (AOR: 2.554, 95% CI: 1.424–4.582), and availability (AOR: 2.143, 95% CI: 1.127–4.076). Being current smokers were six times more likely (AOR: 6.055, 95% CI: 3.123–11.739) to use waterpipe in the past 30 days.ConclusionsThe finding suggests that smoking by a family member, friends, use of conventional cigarettes, and availability are significantly associated with increased probability of current waterpipe used among adolescents.

scholarly journals Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daiki Watanabe ◽  
Tsukasa Yoshida ◽  
Takashi Nakagata ◽  
Naomi Sawada ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Older Adults ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Middle Aged ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mail Surveys ◽  
Osaka Prefecture ◽  
Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

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