Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Marsenić, Olivera; Anderson, Michael P.; Couloures, Kevin

doi:10.1155/2016/5972930

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Fluid removal in terms of UFR (mL/kg/h) and total ultrafiltration (UF, % per kg dry weight per session) was derived for each treatment from pre- and postdialytic weight and treatment duration. Interdialytic weight gain (IDWG) was derived from post- and predialytic weight difference of subsequent treatments and was expressed as %increase per kg dry weight over 2 days [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…Total ultrafiltration (%) = V UF (L)/target dry weight (kg), with V UF = ultrafiltration volume (L) calculated as predialytic weight (kg) – postdialytic weight (kg). Interdialytic weight gain (IDWG, %) = IDWG (kg)/target weight (kg), with IDWG (kg) = predialytic weight – weight aſter preceding HD (Marsenic et al [ 17 ])…”

Section: Methodsmentioning

confidence: 99%

“…High UFR is not uncommon in children [ 14 ] and is driven by nutritional needs of growing pediatric HD patients. This may be worrisome [ 15 ] given that prescribed UFR is closely related to interdialytic weight gain (IDWG), which has been associated with left ventricular hypertrophy at IDWG > 4% [ 16 ] and pre-HD hypertension [ 17 ] in children. Yet, there are no studies of the UFR effect on outcomes in this population.…”

Section: Introductionmentioning

confidence: 99%

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Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

et al. 2021

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Background Hemodialysis (HD) dose targets and ultrafiltration rate (UFR) limits for pediatric patients on chronic HD are not known and are derived from adults (spKt/V>1.4 and <13 ml/kg/h). We aimed to characterize how delivered HD dose and UFR are associated with survival in a large cohort of patients who started HD in childhood. Methods Retrospective analysis on a cohort of patients <30 years, on chronic HD since childhood (<19 years), having received thrice-weekly HD 2004–2016 in outpatient DaVita centers. Outcome: Survival while remaining on HD. Predictors: (I) primary analysis: mean delivered dialysis dose stratified as spKt/V ≤1.4/1.4–1.6/>1.6 (Kaplan–Meier analysis), (II) secondary analyses: UFR and alternative dialysis adequacy measures [eKt/V, body-surface normalized Kt/BSA] on continuous scale (Weibull regression model). Results A total of 1780 patients were included (age at the start of HD: 0–12y: n=321, >12–18y: n=1459; median spKt/V=1.55, eKt/V=1.31, Kt/BSA=31.2 L/m2, UFR=10.6 mL/kg/h). (I) spKt/V<1.4 was associated with lower survival compared to spKt/V>1.4–1.6 (P<0.001, log-rank test), and spKt/V>1.6 (P<0.001), with 10-year survival of 69.3% (59.4–80.9%) versus 83.0% (76.8–89.8%) and 84.0% (79.6–88.5%), respectively. (II) Kt/BSA was a better predictor of survival than spKt/V or eKt/V. UFR was additionally associated with survival (P<0.001), with increased mortality <10/>18 mL/kg/h. Associations did not alter significantly following adjustment for demographic characteristics (age, etiology of kidney disease, and ethnicity). Conclusions Our results suggest usefulness of targeting Kt/BSA>30 L/m2 for best long-term outcomes, corresponding to spKt/V>1.4 (>12 years) and >1.6 (<12 years). In contrast to adults, higher UFR of 10–18 ml/kg/h was not associated with greater mortality in this population.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

et al. 2021

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“…The cohort is composed of patients who started chronic hemodialysis (HD) in childhood and have then received thrice-weekly HD between 05/2004 and 03/2016, with a maximum follow-up until < 30 years of age. The dataset consists of demographic factors such as the age from the start of dialysis, gender, as well as etiology of kidney disease and comorbidities, dialysis dose in terms of spKt/V, eKt/V (Daugirdas, 1993;Daugirdas and Schneditz, 1995), fluid removal in terms of UFR (mL/kg/h) and total ultrafiltration (UF, % per kg dry weigth per session), and the interdialytic weight gain (IDWG) (Marsenic et al, 2016). It should be noted that this dataset is rather challenging, given the high percentage of censored observations (see Table 1).…”

Section: Datasetsmentioning

confidence: 99%

A Deep Variational Approach to Clustering Survival Data

Manduchi¹,

Marcinkevičs²,

Massi³

et al. 2021

Preprint

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Survival analysis has gained significant attention in the medical domain and has many far-reaching applications. Although a variety of machine learning methods have been introduced for tackling time-to-event prediction in unstructured data with complex dependencies, clustering of survival data remains an under-explored problem. The latter is particularly helpful in discovering patient subpopulations whose survival is regulated by different generative mechanisms, a critical problem in precision medicine. To this end, we introduce a novel probabilistic approach to cluster survival data in a variational deep clustering setting. Our proposed method employs a deep generative model to uncover the underlying distribution of both the explanatory variables and the potentially censored survival times. We compare our model to the related work on survival clustering in comprehensive experiments on a range of synthetic, semi-synthetic, and real-world datasets. Our proposed method performs better at identifying clusters and is competitive at predicting survival times in terms of the concordance index and relative absolute error. To further demonstrate the usefulness of our approach, we show that our method identifies meaningful clusters from an observational cohort of hemodialysis patients that are consistent with previous clinical findings.

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“…Berbagai penelitian menyebutkan bahwa sebagian besar pasien hemodialisis tidak patuh dalam pembatasan cairan dan natrium (Dilek dan Semra, 2015). Kondisi tersebut dapat berpengaruh buruk terhadap kondisi pasien diantaranya adalah peningkatan tekanan darah (Marsenic, Anderson, Couloures, 2016). Selain berpengaruh buruk pada kondisi kesehatanya, ketidakpatuhan pasien hemodialisis terhadap terapi yang harus dijalaninya akan mengakibatkan kerugian secara ekomomi.…”

Section: Pendahuluanunclassified

Pemberdayaan Perawat Dalam Penyusunan Media Edukasi Berbasis Buklet Bagi Pasien Hemodialisis

Pratiwi¹,

Sari²,

Kurniawan³

2019

mkk

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Pasien hemodialisis harus menjalankan berbagai pengobatan. Berbagai penelitian menjelaskan bahwa sebagian besar pasien hemodialisis tidak patuh dalam menjalankan self-management. Ketidakpatuhan pasien dalam menjalankan pengobatan dapat memperburuk kondisi pasien sehingga kualitas hidupnya akan menurun. Petugas kesehatan khususnya perawat harus memberikan edukasi dan evaluasi terhadap kepatuhan pasien dalam menjalankan self-management. Media yang tepat dibutuhkan untuk menjalankan program yang efektif. Program pengabdian kepada masyarakat ini dilakukan untuk mengidentifikasi dan menyusun media buklet panduan dan catatan harian pasien hemodialisis. Media buklet panduan dan catatan harian akan lebih efektif apabila sesuai dengan kebutuhan dan kondisi lapangan. Program Pengabdian Pada Masyarakat ini dilakukan dengan menggunakan metodeFocus Group Discussion (FGD) yang melibatkan 14 orang perawat hemodialisisdi Jawa Barat.Berdasarkan hasil FGD tersebut, terdapat beberapa materi yang dibutuhkan dalam buklet pasien hemodialisis yaitu informasi mengenai penyakit (gagal ginjal), hemodialisis, pengobatan, pembatasan asupan cairan dan diet, serta cacatan harian yang berisi catatan asupan cairan dan diet, catatan hasil lab dan perkembangan berat badan..Penggunaan buklet panduan dan catatan harian pasien hemodialisis sepenuhnya memandirikan pasien dalam mengelola kondisi kesehatannya. Keluarga diharapkan dapat memberikan dukungan kepada pasien dalam menjalankan self-management. Keluarga dapat mengingatkan pasien untuk mengisi dan mengevaluasi catatannya sendiri dan memberikan motivasi untuk tetap menjaga asupan cairan dan diet. Kata kunci : Buklet, catatan harian, edukasi, hemodialysis.

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Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Cited by 10 publications

References 13 publications

Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

A Deep Variational Approach to Clustering Survival Data

Pemberdayaan Perawat Dalam Penyusunan Media Edukasi Berbasis Buklet Bagi Pasien Hemodialisis

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