Comorbidity, urea kinetics, and appetite in continuous ambulatory peritoneal dialysis patients: Their interrelationship and prediction of survival

Davies, Simon; Russell, Lesley; Bryan, Janet; Phillips, Louise Elizabeth; Russell, Ginny

doi:10.1016/0272-6386(95)90657-6

Cited by 266 publications

(179 citation statements)

References 16 publications

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“…Comorbidities were more common in Czech patients; only 16% had no comorbidities compared with 47% and 40% of the Swedish and English patients, respectively (P,0.001). Median BVAS was 12 (IQR, 9-12) in patients with renal-limited disease and 16 (IQR, [13][14][15][16][17][18][19] in patients with more than one organ system involved (P,0.001).…”

Section: Baseline Patient Characteristicsmentioning

confidence: 99%

Outcome and Treatment of Elderly Patients with ANCA-Associated Vasculitis

Weiner¹,

Goh

Mohammad

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives ANCA-associated vasculitis is commonly found in elderly patients, but there are few data concerning outcome and treatment in the highest age groups.Design, setting, participants, & measurements Consecutive patients (N=151) presenting between 1997 and 2009 were retrospectively included from local registries in six centers in Sweden, the United Kingdom, and the Czech Republic if diagnosed with microscopic polyangiitis or granulomatosis with polyangiitis at age $75 years during the study period. Patients were followed until 2 years from diagnosis or death. Data on survival and renal function were analyzed with respect to age, sex, ANCA specificity, renal function, C-reactive protein, comorbidities, and Birmingham Vasculitis Activity Score at diagnosis as well as treatment during the first month.Results Median follow-up was 730 days (interquartile range, 244-730). Overall 1-year survival was 71.5% and 2-year survival was 64.6%. Older age, higher creatinine, and lower Birmingham Vasculitis Activity Score were associated with higher mortality in multivariable analysis. Patients who were not treated with standard immunosuppressive therapy had significantly worse survival. Renal survival was 74.8% at 1 year. No new cases of ESRD occurred during the second year. High creatinine at diagnosis was the only significant predictor of renal survival in multivariable analysis.Conclusions ANCA-associated vasculitis is a disease with substantial mortality and morbidity among elderly patients. This study showed a better prognosis for those who received immunosuppressive treatment and those who were diagnosed before having developed advanced renal insufficiency.

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Section: Baseline Patient Characteristicsmentioning

confidence: 99%

Outcome and Treatment of Elderly Patients with ANCA-Associated Vasculitis

Weiner¹,

Goh

Mohammad

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…On the basis of the number of comorbid conditions, a patient was classified according to the Davies' comorbidity index as having no, intermediate, or severe comorbidity (25,26).…”

Section: Data Collection Proceduresmentioning

confidence: 99%

Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients

Termorshuizen

Dekker²,

Manen³

et al. 2004

Journal of the American Society of Nephrology

320

273

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Abstract.A high delivered Kt/V urea (dKt/V urea ) is advocated in the U.S. National Kidney Foundation Dialysis Outcomes Quality Initiative guidelines on hemodialysis (HD) adequacy, irrespective of the presence of residual renal function. The contribution of treatment adequacy and residual renal function to patient survival was investigated. The Netherlands Cooperative Study on the Adequacy of Dialysis is a prospective multicenter study that includes incident ESRD patients older than 18 yr. The longitudinal data on residual renal function and dialysis adequacy of patients who were treated with HD 3 mo after the initiation of dialysis (n ϭ 740) were analyzed. The mean renal Kt/V urea (rKt/V urea ) at 3 mo was 0.7/wk (SD 0.6) and the dKt/V urea at 3 mo was 2.7/wk (SD 0.8). Both components of urea clearance were associated with a better survival (for each increase of 1/wk in rKt/V urea , relative risk of death ϭ 0.44 [P Ͻ 0.0001]; dKt/V urea , relative risk of death ϭ 0.76 [P Ͻ 0.01]). However, the effect of dKt/V urea on mortality was strongly dependent on the presence of rKt/V urea , low values for dKt/ V urea of Ͻ2.9/wk being associated with a significantly higher mortality in anuric patients only. Furthermore, an excess of ultrafiltration in relation to interdialytic weight gain was associated with an increase in mortality independent of dKt/V urea . In conclusion, residual renal clearance seems to be an important predictor of survival in HD patients, and the dKt/V urea should be tuned appropriately to the presence of renal function. Further studies are required to substantiate the important role of fluid balance in HD adequacy.

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“…Birtay T et al: Vascular Access Type Body Fat and MIAC in Hemodialysis infarction, angina, or ischemic changes on EKG), left ventricular dysfunction (defined as clinical evidence of pulmonary edema not due to errors in fluid balance, or history of congestive heart failure), peripheral vascular disease (includes distal aortic, lower extremity, and cerebrovascular disease), malignancy, diabetes, collagen vascular disease, and other significant pathology (e.g., chronic obstructive pulmonary disease) (25). This Score is designed for peritoneal dialysis patients and commonly used in Europe for adjusting co-morbidity.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nementioning

confidence: 99%

Untitled

2018

Turk Neph Dial Transpl

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OBJECTIVE: Central venous catheters (CVCs) are preferred when a patent arteriovenous fistula (AVF) cannot be created. CVCs have been shown to be associated with increased inflammation and mortality. In the present study, we aimed to investigate a probable association between the vascular access type and BMI, total body fat, truncal fat, muscle mass, visceral (periaortic) fat, and the malnutrition inflammation atherosclerosis and calcification score (MIAC) in hemodialysis patients. MATERIAL and METHODS:A total of 119 patients were involved. Ninety patients had patent AVF and 29 patients were undergoing hemodialysis via permanent jugular catheter. Two-dimensional echocardiography was performed to detect valvular calcification. Computed tomography was performed in all patients to detect the amount of thoracic periaortic fat tissue (T-PAFT). Biochemical analyses were performed using c8000 Architect. MIAC scores were calculated using valvular calcification, albumin, and CRP. Total body fat and truncal fat were detected using the bio impedance analysis method. Aortic calcification score (AoCS) was calculated using routine chest x-rays. RESULTS:MIAC and AoCS was higher in patients with CVC (p=0.02 and 0.032). T-PAFT was higher in patients with AVF (1631.5±645 vs 1112.2±606.8; p=0.035). CRP was higher in patients with CVC (p=0.04). Hemodialysis vintage, calcium and albumin were lower in patients with CVC (p=0.01). Truncal fat (%), cholesterol and 25-OH vitamin D levels were lower in patients with CVC (p=0.04, p=0.02, p=0.03). T-PAFT was a significant predictor of vascular access type in favour of AVF (t=-2.17; p=0.04). CONCLUSION:The present study revealed that HD patients with CVC had increased inflammation and decreased nutrition, visceral and truncal fat. Further prospective studies are needed to illuminate the relationship between vascular access type, nutritional parameters and body composition in HD patients.

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Comorbidity, urea kinetics, and appetite in continuous ambulatory peritoneal dialysis patients: Their interrelationship and prediction of survival

Cited by 266 publications

References 16 publications

Outcome and Treatment of Elderly Patients with ANCA-Associated Vasculitis

Outcome and Treatment of Elderly Patients with ANCA-Associated Vasculitis

Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients

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