Risk Factors for Mortality in Chinese Patients on Continuous Ambulatory Peritoneal Dialysis

Zhang, Fan; Liu, Hong; Gong, Xin; Liu, Fuyou; Peng, Youming; Cheng, Meichu; Zhang, Hongqing; Liu, Yang; Liu, Yuyuan; Guo, Chun-Yan

doi:10.3747/pdi.2013.00164

Cited by 19 publications

(15 citation statements)

References 21 publications

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“…Only death attributed to cardiovascular disease was used as the final event in the patient cardiovascular mortality analysis, and patients who with death attributed to other reasons or still alive at the end of the study were considered censored data. While analyzing the technique survival, dropout attributed to death or transferred to HD was used as the end point, and patients who remained alive and on PD therapy were considered censored data [11].…”

Section: Discussionmentioning

confidence: 99%

Serum Albumin at Start of Peritoneal Dialysis Predicts Long-Term Outcomes in Anhui Han Patients on Continuous Ambulatory Peritoneal Dialysis: A Retrospective Cohort Study

et al. 2018

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Objective: This study assessed the relationship between serum albumin (ALB) at start of peritoneal dialysis (PD) and long-term outcomes of continuous ambulatory PD (CAPD) in Anhui Han patients. Methods: A total of 149 Anhui Han CAPD patients were enrolled in this study and followed up for 3 years. They were initially diagnosed with the end-stage renal disease and underwent surgical PD catheter placement from January 2009 to December 2013. According to serum ALB at start of PD, the patients were divided into two groups: low ALB group (ALB < 35 g/L) and high ALB group (ALB ≥35 g/L). Demographic, hematologic, biochemical, and dialysis-related data were collected. Kaplan-Meier survival analysis and log-rank test were conducted to compare patient mortality, cardiovascular mortality and technique failure between the low ALB group and the high ALB group. Cox regression analysis was performed to analyze the risk factors, calculate the hazard ratio (HR), adjusted HR (AHR) and 95% confidence interval (CI). Results: The low ALB group showed a greater number of diabetes mellitus compared with the high ALB group. Patient mortality, cardiovascular mortality, and technique failure in the high ALB group were significantly lower than those in the low ALB group. In Cox regression analysis, serum ALB < 35 g/L was an independent predictor of patient mortality (AHR 3.043, 95% CI 1.085–8.536, p = 0.034), cardiovascular mortality (AHR 11.587, 95% CI 1.466–91.574, p = 0.020), and technique failure (AHR 3.148, 95% CI 1.603–6.182, p = 0.001) in CAPD patients after adjustment for sex, age, estimated glomerular filtration rate, primary renal disease, diabetes mellitus, and cardiovascular disease. Conclusions: In Anhui Han patients on CAPD, the levels of serum ALB at start of PD are inversely correlated with patient mortality, cardiovascular mortality, and technique failure, and the long-term outcomes of patients with hypoalbuminemia at start of PD are poor. To improve the long-term outcomes of Anhui Han CAPD patients, patients with hypoalbuminemia at start of PD should be closely monitored.

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Section: Discussionmentioning

confidence: 99%

Serum Albumin at Start of Peritoneal Dialysis Predicts Long-Term Outcomes in Anhui Han Patients on Continuous Ambulatory Peritoneal Dialysis: A Retrospective Cohort Study

et al. 2018

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“…Additional data from other Indian centers are included in table 2. Similarly, a brief reference of the outcome in China can be obtained in the study by Zhang et al [27]. …”

Section: Issues Related To Peritoneal Dialysis In Asian Countriesmentioning

confidence: 99%

“…Cardiovascular diseases and infection remained the leading cause of death [26]. In another single-center retrospective study in which 421 PD patients were analyzed from 2001 to 2011, patient survival at 1 and 5 years was 92.5 and 74.4%, respectively [27]. …”

Section: Issues Related To Peritoneal Dialysis In Asian Countriesmentioning

confidence: 99%

Peritoneal Dialysis in Asia

Kwong¹,

Li²

2015

Kidney Dis

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Background: There is a growing demand of dialysis in Asia for end-stage renal failure patients. Diabetes mellitus is the leading cause of end-stage renal failure in many countries in Asia. Summary: The growth of peritoneal dialysis (PD) in Asia is significant and seeing a good trend. With the enhanced practices of PD, the quality of care in PD in Asia is also improved. Overall, PD and hemodialysis (HD) are comparable in clinical outcome. There is a global trend in the reduction of peritonitis rates and Asian countries also witness such improvement. The socio-economic benefits of PD for end-stage renal failure patients in both urban and rural areas in the developed and developing regions of Asia are an important consideration. This can help to reduce the financial burden of renal failure in addressing the growing demand of patients on dialysis. Initiatives should be considered to further drive down the cost of PD in Asia. Key Messages: Growing demand for dialysis by an increasing number of end-stage renal failure patients requires the use of a cost-effective quality dialysis modality. PD is found to be comparable to HD in outcome and quality. In most countries in Asia, PD should be more cost-effective than HD. A ‘PD-first' or a ‘PD as first considered therapy' policy can be an overall strategy in many countries in Asia in managing renal failure patients, taking the examples of Hong Kong and Thailand. Facts from East and West: (1) PD is cheaper than HD and provides a better quality of life worldwide, but its prevalence is significantly lower than that of HD in all countries, with the exception of Hong Kong. Allowing reimbursement of PD but not HD has permitted to increase the use of PD over HD in many Asian countries like Hong Kong, Vietnam, Taiwan, Thailand, as well as in New Zealand and Australia over the last years. In the Western world, however, HD is still promoted, and the proportion of patients treated with PD decreases. Japan remains an exception in Asia where PD penetration is very low. Lack of adequate education of practitioners and information of patients might as well be reasons for the low penetration of PD in both the East and West. (2) Patient survival of PD varies between and within countries but is globally similar to HD. (3) Peritonitis remains the main cause of morbidity in PD patients. South Asian countries face specific issues such as high tuberculosis and mycobacterial infections, which are rare in developed Asian and Western countries. The infection rate is affected by climatic and socio-economic factors and is higher in hot, humid and rural areas. (4) Nevertheless, the promotion of a PD-first policy might be beneficial particularly for remote populations in emerging countries where the end-stage renal disease rate is increasing dramatically.

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“…A single-center study done in South Korea [9] demonstrated that young age was a signi cant independent factor associated with long term PD maintenance, but gender was not. Zhang F et al [10] studied the survival of 421 PD patients and found that the survival of patients was related to age. In addition, there were several studies [8][11] indicating gender had no correlations with technology failure.…”

Section: Discussionmentioning

confidence: 99%

Correlations between gender, age and the risk of withdrawal from peritoneal dialysis

Zhang¹,

He²,

Wan³

et al. 2020

Preprint

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Background With the increasing incidence of end stage renal disease(ESRD),peritoneal dialysis(PD) has become the preferred method of kidney replacement therapy for an increasing number of patients with end stage renal disease due to its many advantages.The intent of this study was to explore the correlations between sex, age and risk of withdrawal from peritoneal dialysis.Methods All patients who underwent PD catheterization and initiated PD at Wuhan No.1 Hospital between 2013 and 2018 were screened.Clinical information of these patients was collected and compared according to gender and age,then was applied to the Cox proportional hazards model to determine the impact of factors of withdrawal from peritoneal dialysis.Results ①Hazard ratios(HRs) of withdrawal of PD associate with gender and age at initiation were 0.736(P = 0.289)、1.151༈P = 0.489༉respectively.Nonetheless,male patients under 60 years old had a 1.58-fold higher risk of withdrawal than others(HR 0.63,P = 0.031).②The withdrawal risk of patients with total Creatinine clearance rate (Ccr) above 60L/W was 82.4% higher than that of patients who did not meet the standard (HR 1.82,P = 0.005).③The withdrawal risk of patients with high D/P Creatinine༈Cr༉value which was calculated from peritoneal equilibration test(PET) were 2.06 times higher than low-average and high-average transport patients(HR2.06,P = 0.008).④Patients with serum albumin above 35 g/L were intended to withdraw from PD than those below 35 g/L (HR 0.56,P = 0.006).Conclusions There were significant differences in total KT/V, total Ccr,serum creatinine(Scr) and blood Urea nitrogen(BUN)among patients with PD of different gender and age.The analysis showed that male patients under 60 years old, Ccr, value of D/Pcr and serum albumin had a high correlation with the technical survival rates.While gender or age at PD initiation were not associated with technique survival,male patients under 60 years old had a 1.58-fold higher risk of withdrawal from PD than others.The outcome that the withdrawal risk of patients with Ccr above 60L/W was 82.4% higher than other patients who did not meet the standard suggested that Ccr was not suitable as an index for evaluating the adequacy of PD,especially for men under 60 years old.And patients with high D/Pcr value or with serum albumin under 35 g/L were related risk factors for technique survival.

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Risk Factors for Mortality in Chinese Patients on Continuous Ambulatory Peritoneal Dialysis

Cited by 19 publications

References 21 publications

Serum Albumin at Start of Peritoneal Dialysis Predicts Long-Term Outcomes in Anhui Han Patients on Continuous Ambulatory Peritoneal Dialysis: A Retrospective Cohort Study

Serum Albumin at Start of Peritoneal Dialysis Predicts Long-Term Outcomes in Anhui Han Patients on Continuous Ambulatory Peritoneal Dialysis: A Retrospective Cohort Study

Peritoneal Dialysis in Asia

Correlations between gender, age and the risk of withdrawal from peritoneal dialysis

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