Impact of the initial levels of laboratory variables on survival in chronic dialysis patients

Iseki, Kunitoshi; Uehara, Hajime; Nishime, Keizo; Tokuyama, Kiyoyuki; Yoshihara, Kunio; Kinjo, Kazutoshi; Shiohira, Yoshiki; Fukiyama, Koshiro

doi:10.1016/s0272-6386(96)90465-5

Cited by 122 publications

(88 citation statements)

References 20 publications

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“…Thus, our findings build upon and extend those from the previous report. Given the large sample size used in our study and that the cohort was derived from centers distributed over most of the states in the United States, our findings also have considerable external validity (21,22).…”

Section: Discussionmentioning

confidence: 88%

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

Torlén

Kalantar-Zadeh

Molnar

et al. 2012

Clinical Journal of the American Society of Nephrology

126

134

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SummaryBackground and objectives Unlike hemodialysis (HD), peritoneal dialysis (PD) is a continuous therapy and does not induce myocardial stunning. Yet, the death risk in HD and PD patients is similar. This study tested the hypothesis that serum potassium abnormalities contribute more to the death risk in PD patients than in HD patients.Design, setting, participants, & measurements Data from patients treated in DaVita facilities between July 1, 2001 and June 30, 2006 (n=10,468 PD patients; n=111,651 HD patients) were used to determine association of serum potassium with mortality.Results PD patients were significantly more likely to have serum potassium ,4 mEq/L, with an adjusted odds ratio of 3.30 (95% confidence interval [95% CI], 3.05, 3.56). There was a U-shaped relationship between timeaveraged serum potassium and all-cause and cardiovascular mortality of PD patients, with adjusted hazards ratios of 1.51 for all-cause mortality for potassium ,3.5 mEq/L (95% CI, 1.29, 1.76) and 1.52 for potassium $5.5 mEq/L (95% CI, 1.32, 1.75). The population-attributable risks for all-cause mortality for serum potassium ,4.0 and $5.5 mEq/L were 3.6% and 1.9%, respectively, in PD patients, and 0.8% and 1.5%, respectively, in HD patients.Conclusions Abnormalities in serum potassium contribute disproportionately to the high death risk in PD patients. This may, in part, account for the equivalent cardiac risk seen with the two therapies.

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Section: Discussionmentioning

confidence: 88%

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

Torlén

Kalantar-Zadeh

Molnar

et al. 2012

Clinical Journal of the American Society of Nephrology

126

134

View full text Add to dashboard Cite

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“…Traditionally this risk has been ascribed to underlying co-morbidity, such as congestive cardiac failure, cirrhosis and tumour induced inappropriate ADH syndrome. The situation for patients with chronic kidney disease may be somewhat more complex, with reports of both hyponatraemia and also hypernatraemia associated with increased mortality [10], and although there are reports of increased risk for mortality in hyponatraemic haemodialysis patients [4,5], these reports are biased towards more co-morbid patients because they censored patients who were transplanted from the analyses. Our analyses were more conservative -if we had censored the patients who were transplanted we would have biased our sample to the more ill population, and similarly if we had removed all patients with technique failure from the mortality outcome analysis we would have biased our sample to a more healthy population.…”

Section: Discussionmentioning

confidence: 99%

“…As with the general population there are several large observational studies reporting that pre-haemodialysis hyponatraemia is independently associated with increased risk of mortality for haemodialysis patients [4,5]. Whether this risk for mortality is directly attributable to hyponatraemia, and reduced body sodium stores, or whether hyponatraemia is acting as a surrogate for an inflammatory state and increased endothelial permeability remains to be determined.…”

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confidence: 99%

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

2017

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“…They also require additional medication such as iron supplements, phosphate binders, and antihypertensive drugs. Despite the advent of dialysis, most people with advanced kidney failure die within 5 to 10 years [16][17][18][19][20][21].…”

Section: Determination and Modelling Of Clinical Laboratory Data Of Hmentioning

confidence: 99%

Determination and modelling of clinical laboratory data of healthy individuals and patients with end-stage renal failure

et al. 2009

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AbstractThe analyses of 18 biochemical parameters (alanine aminotransferase, albumin, aspartate aminotransferase, calcium, cholesterol, chloride, creatinine, iron, glucose, γ- glutamyl transferase, alkaline phosphatase, phosphorus, potassium, sodium, total protein, triglycerides, uric acid, and urea nitrogen) were performed for 166 healthy individuals and 108 patients with end-stage renal failure (ESRF). The application of cluster analysis proved that there were points of similarity among all 18 biochemical parameters that formed major groups; these groups corresponded to the authors’ assumption of the existence of several overall patterns of biochemical parameters that may be termed “enzyme-specific”; “general health indicator”; “major component excretion”; “blood-specific indicator”; and “protein-specific”. These patterns also appear in the subsets of males and females that were obtained by separation of the general dataset. In addition, the performance of factor analysis similarly proved the validity of this assumption. This projection and modelling method indicated the existence of seven latent factors, which explained 70.05% of the total variance in the system for healthy individuals and more than 72% of the total variance in the system for patients with ESRF. All these results support the probability that a general health indicator could be constructed by taking into account the existing classification groups in the list of biochemical parameters.

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Impact of the initial levels of laboratory variables on survival in chronic dialysis patients

Cited by 122 publications

References 20 publications

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

Serum Potassium and Cause-Specific Mortality in a Large Peritoneal Dialysis Cohort

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

Determination and modelling of clinical laboratory data of healthy individuals and patients with end-stage renal failure

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