Increased Risk of Acute Pancreatitis in Patients with Chronic Hemodialysis: A 4-Year Follow-Up Study

Hou, Sheng-Wen; Lee, Yi-Kung; Hsu, Chung-Ping; Lee, Ching‐Chih; Su, Yung-Cheng

doi:10.1371/journal.pone.0071801

Cited by 35 publications

(33 citation statements)

References 17 publications

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“…Longitudinal Health Insurance Database 2005, which has records of 1 million individuals, is a randomly chosen representative cohort from the larger database of all beneficiaries in the NHI program. There were no statistically significant differences between our study cohort and the larger cohort with respect to age, gender, or health care costs, according to the Taiwan National Health Research Institute [17]. …”

Section: Methodsmentioning

confidence: 99%

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Liu

Hung²,

Lee³

et al. 2017

Am J Nephrol

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Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age- and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age- and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs). Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group. Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment.

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Section: Methodsmentioning

confidence: 99%

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Liu

Hung²,

Lee³

et al. 2017

Am J Nephrol

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“…These selection processes have been well-validated with high positive predictive values. 4,23 After excluding patients with diabetes and AP before January 1, 2005, 42,080 patients were included in the diabetic group and 672,146 in the unexposed group. Diabetes with poor compliance was defined as a hospitalization with the diagnosis of a hyperglycemic crisis episode (HCE) (ICD-9-CM codes: diabetic ketoacidosis, 250.1 or hyperosmolar hyperglycemic state, 250.2).…”

Section: Analysis Of the Association Between Diabetes And Risk Of Acumentioning

confidence: 99%

“…The detailed ICD-9-CM codes for comorbidities are described elsewhere, and the processes for selecting comorbidities are widely used and accepted. 4,18,23,25 Statistical Analysis…”

Section: Covariatesmentioning

confidence: 99%

“…However, the definitions of exposures and outcomes in this study are wellaccepted in the administrative database, and previous studies focusing on either AP or diabetes and using similar enrollment criteria from the same database revealed good validities. 4,23,38,39 Second, laboratory findings relevant to the severity of diabetes, including HbA1c and blood glucose values, were unavailable in the database. Alternatively, since uncontrolled diabetes is the most common factor precipitating HCE, 24 diabetes with poor compliance was defined as diabetes with at least one episode of HCE.…”

Section: Limitationsmentioning

confidence: 99%

“…1,2 The etiology of AP is multifactorial, with factors such as alcohol consumption, gallstones, certain drugs, renal insufficiency, and hypertriglyceridemia reported to increase the risk of this condition. [3][4][5] Additionally, recent findings of several large cohort studies reveal that patients with diabetes mellitus are at increased risk of AP. [6][7][8] Despite this well-supported linkage, no study has yet been performed to examine the possibility that the risk of AP increases with the severity of diabetes.…”

Section: Introductionmentioning

confidence: 99%

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330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

Su¹

2015

Annals of Emergency Medicine

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The proposed bidirectional relationship between acute pancreatitis (AP) and diabetes has never been examined with the same source of data. Furthermore, the effects of disease severity on this relationship have not been fully evaluated. The present study employed the findings from a single database to measure the strength of the association between AP and diabetes.Findings from 1 million National Health Insurance beneficiaries were utilized. Two cohort studies with this database were selected to evaluate the linkage between diabetes and AP. The first cohort analysis addressed the risk of AP among diabetic patients and was comprised of 42,080 diabetic patients and 672,146 unexposed subjects. The second cohort analysis considered the risk of diabetes among patients with AP and enrolled 3187 patients with AP and 709259 unexposed subjects. All adult beneficiaries were followed from January 1, 2005 to December 31, 2012 to identify outcomes of interest. Cox regression models were applied to compare hazards adjusted for potential confounders.For the first cohort, the adjusted hazard ratio (HR) of AP was significantly increased by the presence of diabetes (1.72; 95% confidence interval [CI], 1.52-1.96). In diabetic patients with a history of hyperglycemic crisis episodes (HCEs), the HR was even higher (6.32; 95% CI, 4.54-8.81). For the second cohort, the adjusted HR of diabetes in patients with AP was increased compared to the general population (2.15; 95% CI, 1.92-2.41). For patients with severe AP, the HR was also higher (2.22; 95% CI, 1.50-3.29) but did not differ significantly from that for patients with nonsevere AP.The 2 cohort studies provided evidence for the bidirectional relationship between diabetes and AP. Moreover, diabetic patients with history of HCEs may be associated with higher risk of AP.

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Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography

et al. 2019

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Background The risk of post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) could be related to technical or patient‐related factors. The aim of this study was to assess whether clinical variables and co‐morbidities influence the risk of developing PEP. Methods Data were retrieved from the Swedish GallRiks registry, including all ERCP procedures performed in 2006–2014 for common bile duct stones. A total of 15 800 procedures were identified and cross‐checked. Univariable and multivariable logistic regression analyses were conducted with the endpoint of PEP using the following co‐variables: age, sex, ASA grade, previous history of acute pancreatitis, diabetes, hyperlipidaemia, hypercalcaemia, kidney disease and liver cirrhosis. Results Women (odds ratio (OR) 1·33, 95 per cent c.i. 1·14 to 1·55), patients aged less than 65 years (OR 1·68, 1·45 to 1·94), patients with hyperlipidaemia (OR 1·32, 1·02 to 1·70) and those with a previous history of acute pancreatitis (OR 5·44, 4·68 to 6·31) had a significantly increased risk of PEP. In a subgroup analysis of patients with a previous history of acute pancreatitis, the mean time from previous pancreatitis to ERCP was 4423 days in patients who developed PEP versus 6990 days in patients who did not (P = 0·037). However, when the previous episode of pancreatitis had occurred more than 30 days before ERCP, this association was no longer significant (P = 0·858). Patients with diabetes had a decreased risk of PEP (OR 0·64, 0·48 to 0·85). Conclusion Age, sex, hyperlipidaemia and previous history of recent acute pancreatitis increase the risk of PEP. The reduced risk of PEP in patients with diabetes should be explored in future studies.

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Increased Risk of Acute Pancreatitis in Patients with Chronic Hemodialysis: A 4-Year Follow-Up Study

Cited by 35 publications

References 17 publications

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography

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