Risk factors and outcomes of cardiovascular disease readmission within the first year after dialysis in peritoneal dialysis patients

Li, Jianbo; Huang, Naya; Zhong, Zhong; Joe, Pema; Wang, Dan; Ai, Zhen; Wu, Lijuan; Jiang, Lanping; Huang, Fengxian

doi:10.1080/0886022x.2020.1866009

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…The 2021 ESC guideline [19] states that elderly people should have their levels of CV risk assessed on a regular basis to prevent poor outcomes. Aside from age, CVD history also accounted for a large percentage of points, which is consis-tent with results presented in other related studies [20], implying that individuals with a history of CVD are at a higher risk of experiencing new CV complications. This may be explained by some other factors.…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, our results show that the risk of CV events increased alongside the decline in eGFR, which aligns with the current consensus. Furthermore, most of the studies [20,[28][29][30] in the literature indicate that hypoalbuminemia is associated with adverse kidney and CV outcomes. Our outcomes also indicate the same phenomenon, which support the importance of routinely testing serum albumin.…”

Section: Discussionmentioning

confidence: 99%

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Development and Validation of a Cardiovascular Disease Risk Prediction Model for Patients with Non-Dialysis-Dependent Chronic Kidney Diseases Based on the Nomogram

Wang

Yang

et al. 2022

Kidney Blood Press Res

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Introduction Most CKD patients experience cardiovascular issues before commencing renal replacement therapy. An accuracy prediction model is helpful for physicians to assess cardiovascular prognoses in each individual, and to provide insights on how to outline individualized lines of therapy. Method This study enrolled 1138 participants with non-dialysis-dependent chronic kidney disease (NDD-CKD). Following a proportion of 7:3, patients were randomly assigned to training and validation cohorts. The relevant predictors of cardiovascular events were screened using the least absolute shrinkage and selection operator (Lasso) regression. The area under the receiver operating characteristic curve (AUC) and the calibration curve with 1000 bootstraps resamples were used to assess the nomogram's performance. Tests on the discrimination of the prediction model used Kaplan-Meier (KM) curve. Results After screening all the predictors by lasso regression, the five remaining ones (albumin, estimated glomerular filtration rate, etiology of CKD, cardiovascular disease history, and age) were used to construct the prediction model. The AUC of 1-year, 2-year, and 3-year was 0.81 (95% CI = 0.75–0.87), 0.80 (95% CI = 0.75–0.86), and 0.80 (95% CI = 0.73–0.86), respectively. The calibration curve and the KM curve showed good prediction features, and the external validation also had a good prediction performance (AUC of 1-, 2-, and 3-years were 0.77, 0.84, and 0.82, respectively). Conclusion We successfully developed a novel nomogram that has decent prediction performance and can be used for assessing the probability of cardiovascular events in patients with NDD-CKD, displaying valuable potential for clinical application.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Cardiovascular Disease Risk Prediction Model for Patients with Non-Dialysis-Dependent Chronic Kidney Diseases Based on the Nomogram

Wang

Yang

et al. 2022

Kidney Blood Press Res

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“…Other significant risk factors include inflammation, hyperhomocysteinemia, oxidative stress, anemia, and uremia. [ 19 ] Patients on dialysis have a 3–45-fold risk of CVD. [ 20 ] As a result, treatment approaches for each of these risk factors should be carefully addressed.…”

Section: Discussionmentioning

confidence: 99%

Effect of Omega-3 Fatty Acids Supplementation on Homocysteine Level in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Badri

Gholipur‐Shahraki

Vahdat

et al. 2022

Journal of Research in Pharmacy Practice

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Objective: One of the most common diseases with high morbidity and mortality rates is chronic kidney disease. Cardiovascular disease affects most patients with chronic kidney disorders, particularly patients undergoing dialysis; hence, appropriate prevention and management approaches are essential. This study aimed to evaluate the reduction of inflammatory biomarkers, especially homocysteine, by omega-3 fatty acids in peritoneal dialysis patients. Methods: This study enrolled 60 peritoneal dialysis patients who met specified inclusion and exclusion criteria and were randomized to intervention or placebo groups. Omega-3 capsules were given at a dose of 3 g/d for 8 weeks. Inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), homocysteine, albumin, and lipid profile measured before and after the study. Findings: Results of this trial revealed that the levels of homocysteine, hs-CRP, and albumin did not change significantly during the study. Analysis of lipid profiles before and after intervention showed omega-3 has no significant effect on the level of total cholesterol or low-density lipoprotein cholesterol; However, the level of triglyceride reduced remarkably ( P = 0.002). In addition, serum levels of high-density lipoprotein cholesterol increased at the end of the study ( P < 0.001). Conclusion: Omega-3 does not seem to be able to change the inflammatory markers significantly, particularly homocysteine. More extensive trials must be conducted to better understand the impact of omega-3 on inflammatory and nutritional markers, particularly in peritoneal dialysis patients.

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“…Patients with end-stage renal disease going to routine hemodialysis (HD) programs are often more vulnerable to being hospitalized and readmitted than the general population. 5 İt is said that in 2018, 34% of patients going to hemodialysis in the United States were readmitted to the hospital in just 30 days. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Mohamed¹,

Jeele²

2022

IJGM

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Background End-stage renal disease (ESRD) in Somalia remains unexamined due to a lack of a national registry system, and the impact of the disease in the country is not estimated yet. The present study is the first report that aims to evaluate the epidemiological characteristics, causes, and dialysis-related factors associated with readmissions in ESRD patients who were going to routine hemodialysis. Patients and methods This cross-sectional observational study enrolled 208 patients with ESRD. Also, this study investigated patients readmitted to the hospital (n=135) after they enrolled in hemodialysis. The sociodemographic characteristics, risk factors, and comorbidities associated with these patients were reviewed. Admission site, length of hospital stay, outcome, and dialysis-related factors associated with readmissions in the first six months after being on a regular hemodialysis program were also assessed. Results The mean age of the patients was 52.7±15.0 years, 43.3% were >60 years, and 61.5% were male. The most common cause was diabetes at 39.4%, followed by hypertension (35.6%) and 12.5% for postrenal obstruction. The prevalence of 6-month hospital readmissions was 65%. The most common dialysis-related factor associated with readmissions was uremic complications due to missed hemodialysis sessions (40%), vascular access/catheter infection (20%), and anemia (17.8%) (95% CI: 0.825–5.357, OR: 3.017, p<0.04). Female cases were more vulnerable to vascular catheter site infection, anemia, and hyponatremia (p<0.001). 27.5% of the patients were admitted to the intensive care unit (ICU), and the most common reason for ICU admissions was pulmonary edema (53.8%), sepsis (42.8%), and uremia due to hemodialysis skip (26.4%) (95% CI: 1.507–13.632, OR: 2.08, p=0.01). The mortality rate was 5.2%. Conclusion The prevalence of unplanned hospital readmissions within six months was very high, and a missed hemodialysis session was identified as the leading cause. Inadequate knowledge, wrong social beliefs about the concept of dialysis and a lack of a health insurance system that covers the higher costs of each dialysis session are believed to be the causes of missed dialysis occasions.

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Risk factors and outcomes of cardiovascular disease readmission within the first year after dialysis in peritoneal dialysis patients

Cited by 7 publications

References 41 publications

Development and Validation of a Cardiovascular Disease Risk Prediction Model for Patients with Non-Dialysis-Dependent Chronic Kidney Diseases Based on the Nomogram

Development and Validation of a Cardiovascular Disease Risk Prediction Model for Patients with Non-Dialysis-Dependent Chronic Kidney Diseases Based on the Nomogram

Effect of Omega-3 Fatty Acids Supplementation on Homocysteine Level in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

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