scholarly journals Comorbidities in Chronic Pediatric Peritoneal Dialysis Patients: A Report of the International Pediatric Peritoneal Dialysis Network

2012 ◽  
Vol 32 (4) ◽  
pp. 410-418 ◽  
Author(s):  
Alicia M. Neu ◽  
Anja Sander ◽  
Dagmara Borzych–Dużałka ◽  
Alan R. Watson ◽  
Patricia G. Vallés ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Initiation ◽  
Dialysis Patients ◽  
Pediatric Dialysis ◽  
Hospitalization Rates ◽  
Ocular Abnormality ◽  
International Pediatric ◽  
The Impact ◽  
Pediatric Dialysis Patients

Background, Objectives, and Methods Hospitalization and mortality rates in pediatric dialysis patients remain unacceptably high. Although studies have associated the presence of comorbidities with an increased risk for death in a relatively small number of pediatric dialysis patients, no large-scale study had set out to describe the comorbidities seen in pediatric dialysis patients or to evaluate the impact of those comorbidities on outcomes beyond the newborn period. In the present study, we evaluated the prevalence of comorbidities in a large international cohort of pediatric chronic peritoneal dialysis (CPD) patients from the International Pediatric Peritoneal Dialysis Network registry and began to assess potential associations between those comorbidities and hospitalization rates and mortality. Results Information on comorbidities was available for 1830 patients 0 – 19 years of age at dialysis initiation. Median age at dialysis initiation was 9.1 years [interquartile range (IQR): 10.9], median follow-up for calculation of hospitalization rates was 15.2 months (range: 0.2 – 80.9 months), and total follow-up time in the registry was 2095 patient–years. At least 1 comorbidity had been reported for 602 of the patients (32.9%), with 283 (15.5%) having cognitive impairment; 230 (12.6%), motor impairment; 167 (9.1%), cardiac abnormality; 76 (4.2%), pulmonary abnormality; 212 (11.6%), ocular abnormality; and 101 (5.5%), hearing impairment. Of the 150 patients (8.2%) that had a defined syndrome, 85% had at least 1 nonrenal comorbidity, and 64% had multiple comorbidities. The presence of at least 1 comorbidity was associated with a higher hospitalization rate [hospital days per 100 observation days: 1.7 (IQR: 5.8) vs 1.2 (IQR: 3.9), p = 0.001] and decreased patient survival (4-year survival rate: 73% vs 90%, p < 0.0001). Conclusions Nearly one third of pediatric CPD patients in a large international cohort had at least 1 comorbidity, and multiple comorbidities were frequently reported among patients with a defined syndrome. Preliminary analysis suggests an association between comorbidity and poor outcome in those patients. As this powerful international registry matures, further multivariate analyses will be important to more clearly define the impact of comorbidities on hospital-ization rates and mortality in pediatric CPD patients.

Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

2019 ◽  
Vol 39 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Osasuyi Iyasere ◽  
Edwina Brown ◽  
Fabiana Gordon ◽  
Helen Collinson ◽  
Richard Fielding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Mixed Model ◽  
Rating Scale ◽  
Depression Scale ◽  
Dialysis Patients ◽  
The Impact ◽  
Assisted Peritoneal Dialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

MO700EPIDEMIOLOGICAL ADMISSIONS IN PERITONEAL DIALYSIS IN A SINGLE DIALYSIS CENTER

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vincenzo Antonio Panuccio ◽  
Silvia Lucisano ◽  
Rocco Tripepi ◽  
Giovanni Luigi Tripepi ◽  
Francesca Mallamaci
Keyword(s):  
Peritoneal Dialysis ◽  
Hospital Admissions ◽  
Older Age ◽  
Risk Category ◽  
Historical Cohort ◽  
Hospitalization Rates ◽  
High Risk Category ◽  
The Impact ◽  
Residual Diuresis

Abstract Background and Aims The knowledge of the impact of peritoneal dialysis (PD) program in terms of hospitalization rate can provide solid guidance for nephrologists for management purpose. In a historical cohort of adult PD patients, we examined the hospitalization rates and causes of hospital admissions. Method One hundred ninety-one consecutive PD patients between January 1st 2000 to December 31st 2018 were enrolled. The maximum follow up was 194 months. Their mean age was 65±15 years, 110 were males, 56 had co-morbidities and 67 were diabetics. The median PD vintage was 35 months (interquartile range 20-63 months). Results During the follow-up, 163 out of 191 patients (85%) underwent hospital admission for a total of 356 hospitalizations [57 hospitalizations per 100-person-years]. The most frequent cause of admission was infection (20 hospitalizations per 100-person-years) mainly due to peritonitis (12 hospitalizations per 100-person-years) followed by cardiovascular diseases (17 hospitalizations per 100-person-years). Hospitalizations due to miscellaneous causes were 21 per 100-person-years. In the whole group, high NYHA score [Incidence Rate Ratio (IRR): 1.52, 95%CI 1.21-1.89, P&lt;0.001], residual diuresis &lt;500 ml/die (IRR: 1.43, 95%CI 1.13-1.82, P=0.002), malnutrition (IRR: 1.47, 95%CI 1.08-1.99, P=0.01) and older age (&gt;65 years) (IRR 1.26, 95%CI 1.02-1.56, P=0.03) and were associated to all-cause hospitalizations. In an analysis by hospitalization type, the factors related to admission for infection diseases was malnutrition (IRR: 1.91, 95%CI 1.16-3.03, P=0.005) and high NYHA score (IRR: 1.52, 95%CI 1.03-2.22, P=0.02). As expected, hospitalizations due to cardiovascular causes were strongly related to older age (&gt;65 years) (IRR 2.02, 95%CI 1.35-3.03, P&lt;0.001), diabetes (IRR 2.13, 95%CI 1.43-3.18, P&lt;0.001), high NYHA score (IR 2.14, 95%CI 1.43-3.21, P=0.001], residual diuresis &lt;500 ml/die (IRR: 1.65, 95%CI 1.06-2.55, P=0.02) and previous cardiovascular events (IRR: 1.50, 95%CI 0.98-2.25, P=0.05). Conclusion Analyzing the causes and the rate of hospitalization in PD patients allows more accurate management of these high risk category of patients and contributes to a more efficient organization of a renal department.

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Association between left ventricular mass index and cardiac function in pediatric dialysis patients

2011 ◽  
Vol 27 (5) ◽  
pp. 835-841 ◽  
Author(s):  
Pirouz Shamszad ◽  
Timothy C. Slesnick ◽  
E. O’Brian Smith ◽  
Michael D. Taylor ◽  
Daniel I. Feig
Keyword(s):  
Cardiac Function ◽  
Left Ventricular Mass ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
Dialysis Patients ◽  
Pediatric Dialysis ◽  
Ventricular Mass Index ◽  
Ventricular Mass ◽  
Pediatric Dialysis Patients

Heptavax-B in pediatric dialysis patients: effect of systemic lupus erythematosus

1990 ◽  
Vol 4 (2) ◽  
pp. 171-173 ◽  
Author(s):  
Marva M. Moxey-Mims ◽  
Karen Preston ◽  
Barbara Fivush ◽  
Fredrick McCurdy ◽  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Dialysis Patients ◽  
Systemic Lupus ◽  
Pediatric Dialysis ◽  
Pediatric Dialysis Patients

High prevalence of elevated lead levels in pediatric dialysis patients

2012 ◽  
Vol 27 (9) ◽  
pp. 1551-1556 ◽  
Author(s):  
Guido Filler ◽  
Elizabeth Roach ◽  
Abeer Yasin ◽  
Ajay P. Sharma ◽  
Peter G. Blake ◽  
...  
Keyword(s):  
Dialysis Patients ◽  
Pediatric Dialysis ◽  
High Prevalence ◽  
Lead Levels ◽  
Pediatric Dialysis Patients

Sustained Increase in Peritoneal Dialysis Prevalence through a Structured PD Initiation Service

2018 ◽  
Vol 38 (5) ◽  
pp. 374-376 ◽  
Author(s):  
Muhammad Masoom Javaid ◽  
Behram Ali Khan ◽  
Emily Xe Yeo ◽  
Boon Wee Teo ◽  
Srinivas Subramanian
Keyword(s):  
Peritoneal Dialysis ◽  
Rapid Expansion ◽  
Dialysis Initiation ◽  
Coordinated Care ◽  
Timely Initiation ◽  
Initiation Of Dialysis ◽  
Patient Selection Criteria ◽  
Dedicated Team ◽  
Sustained Increase

A structured peritoneal dialysis (PD) initiation service provided by a dedicated team of nephrologists, interventionists, and PD nurses, taking patients through the stages of predialysis education and monitoring, dialysis catheter insertion, dialysis initiation, and follow-up in the immediate post-dialysis initiation period, can go a long way in expanding PD prevalence. The authors noticed a rapid expansion of their PD program following the introduction of such a service, and they share their experience in this article. A multidisciplinary team providing 1-stop coordinated care may help in alleviating the differences in patient selection criteria, minimize delays in PD catheter insertions, ensure timely initiation of dialysis, reduce the need to start dialysis urgently, actively identify and sort any teething issues, enhance patients’ confidence, and reduce technique failures.

Four steps to standardize reporting of peritoneal dialysis technique failure: A proposed approach

2020 ◽  
pp. 089686082097693
Author(s):  
Alix Clarke ◽  
Pietro Ravani ◽  
Matthew J Oliver ◽  
Mohamed Mahsin ◽  
Ngan N Lam ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Outcome Measure ◽  
Time Window ◽  
Time Windows ◽  
Dialysis Patients ◽  
Data Set ◽  
The Impact ◽  
Technique Failure ◽  
Standardize Reporting ◽  
Dialysis Technique

Background: Technique failure is an important outcome measure in research and quality improvement in peritoneal dialysis (PD) programs, but there is a lack of consistency in how it is reported. Methods: We used data collected about incident dialysis patients from 10 Canadian dialysis programs between 1 January 2004 and 31 December 2018. We identified four main steps that are required when calculating the risk of technique failure. We changed one variable at a time, and then all steps, simultaneously, to determine the impact on the observed risk of technique failure at 24 months. Results: A total of 1448 patients received PD. Selecting different cohorts of PD patients changed the observed risk of technique failure at 24 months by 2%. More than one-third of patients who switched to hemodialysis returned to PD—90% returned within 180 days. The use of different time windows of observation for a return to PD resulted in risks of technique failure that differed by 16%. The way in which exit events were handled during the time window impacted the risk of technique failure by 4% and choice of statistical method changed results by 4%. Overall, the observed risk of technique failure at 24 months differed by 20%, simply by applying different approaches to the same data set. Conclusions: The approach to reporting technique failure has an important impact on the observed results. We present a robust and transparent methodology to track technique failure over time and to compare performance between programs.

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