The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study

Wang, Qin; Hu, Ke-Jie; Ren, Ye-Ping; Dong, Jie; Han, Qing-Feng; Zhu, Tao; Chen, Jianghua; Zhao, Hongxia; Chen, Menghua; Xu, Rong; Wang, Yue; Hao, Chuan‐Ming; Zhang, Xiao-Hui; Wang, Mei; Tian, Na; Wang, Haiyan

doi:10.3747/pdi.2015.00100

Cited by 14 publications

(5 citation statements)

References 32 publications

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“…In this study, 55.56% of patients had SCD, which was higher than the cross-sectional study conducted by Chinese scholars on peritoneal dialysis (PD) patients (42.9%) [22], but similar to the results of a previous meta-analysis on subjective cognitive complaints of ESRD patients [15]. This may be related to the loss of acute vascular capacity during dialysis dehydration in MHD patients, which leads to decreased cerebrovascular pressure and reduced cerebral perfusion, thus affecting the cognitive function of MHD patients [23,24].…”

Section: Prevalence Of Scd In Mhd Patientscontrasting

confidence: 55%

Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: A cross-sectional study

Li,

Gao,

et al. 2024

Preprint

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Background Subjective cognitive decline (SCD) significantly increases a patient's risk of long-term cognitive decline and is common in adults. However, few studies have evaluated patients with end-stage renal disease receiving maintenance hemodialysis (MHD). In addition, the relationship between frailty and SCD in MHD patients remains unclear. Therefore, this study aims to assess the potential factors affecting SCD in MHD patients and to investigate the relationship between frailty and SCD. Methods This is a cross-sectional study. From December 2023 to April 2024, using convenience sampling method, a total of 171 patients from West China Hospital of Sichuan University were recruited to participate in this study. The demographic and sociological characteristics of the participants were assessed using a general information questionnaire. The subjective cognitive decline - questionnaire 9 (SCD - Q9), the Tilburg frailty indicator (TFI), the subjective global nutritional assessment (SGA) and grip dynamometer were used to assess participants' subjective cognitive level, frailty, nutrition status, and grip strengh, respectively. Univariate analyses examined potential factors associated with SCD. Linear regression was used to analyze the relationship between these factors and SCD. Spearman's correlation was used to assess the association between SCD and frailty. Results The 171 maintenance hemodialysis patients with subjective cognitive decline scores were 4.00 (2.00–7.00), and 95 patients (55.56%) with scores > 3 presented SCD. Linear regression analysis showed that gender, work status, grip strength, SGA, and frailty were influential factors in MHD, explaining a total of 38.80% of the total variation in SCD. Spearman's analysis showed that SCD was positively correlated with frailty in MHD patients (r = 0.431, P<0.001). Conclusions The prevalence of SCD in patients with MHD is common and correlates with certain patient characteristics, including gender, work status, grip strength, SGA, and frailty. Healthcare workers should pay attention to the assessment of subjective cognitive function in this population, stay alert to the risk factors of SCD, and take targeted interventions as early as possible, which can help to improve the quality of survival and slow down the occurrence of cognitive impairment.

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Section: Prevalence Of Scd In Mhd Patientscontrasting

confidence: 55%

Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: A cross-sectional study

Li,

Gao,

et al. 2024

Preprint

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“…Limited hemodialysis slots are thereby reserved for those who fail CAPD or have medical contraindications to CAPD. This unselective policy determining our CAPD patient population along with the low educational levels and socioeconomic status of our patients (a majority being unemployed, living in impoverished areas, and not having completed grade 12) may have contributed to an increased intrinsic peritonitis risk [ 14 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Peritonitis outcomes in patients with HIV and end-stage renal failure on peritoneal dialysis: a prospective cohort study

2017

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BackgroundFew studies have investigated the management of human immunodeficiency virus (HIV)-associated end-stage renal failure particularly in low-resource settings with limited access to renal replacement therapy. We aimed to evaluate the effects of HIV infection on continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis outcomes and technique failure in highly active antiretroviral therapy (HAART)-treated HIV-positive CAPD populations.MethodsWe conducted a single-center prospective cohort study of consecutive incident CAPD patients recruited from two hospitals in Durban, South Africa from September 2012-February 2015. Seventy HIV-negative and 70 HIV-positive end-stage renal failure patients were followed monthly for 18 months at a central renal clinic. Primary outcomes of peritonitis and catheter failure were assessed for the first 18 months of CAPD therapy. We assessed risk factors for peritonitis and catheter failure using Cox regression survival analysis.ResultsThe HIV-positive cohort had a significantly increased rate of peritonitis compared to the HIV-negative cohort (1.86 vs. 0.76 episodes/person-years, respectively; hazard ratio [HR], 2.41; 95% confidence interval [CI], 1.69–3.45, P < 0.001). When the baseline CD4 count was below 200 cells/μL, the peritonitis rate rose to 3.69 episodes/person-years (HR 4.54, 95% CI 2.35–8.76, P < 0.001), while a baseline CD4 count above 350 cells/μL was associated with a peritonitis rate of 1.60 episodes/person-years (HR 2.10, CI 1.39–3.15, P = 0.001). HIV was associated with increased hazards of peritonitis relapse (HR, 3.88; CI, 1.37–10.94; P = 0.010). Independent predictors associated with increased peritonitis risk were HIV (HR, 1.84; CI, 1.07–3.16; P = 0.027), diabetes (HR, 2.09; CI, 1.09–4.03; P = 0.027) and a baseline CD4 count < 200 cells/μL (HR, 3.28; CI, 1.42–7.61; P = 0.006). Catheter failure rates were 0.34 (HIV-positive cohort) and 0.24 (HIV-negative cohort) episodes/person-years (HR, 1.42; 95% CI, 0.73–2.73; P = 0.299). Peritonitis (HR, 14.47; CI, 2.79–75.00; P = 0.001), average hemoglobin concentrations (HR, 0.75; CI, 0.59–0.95; P = 0.016), and average serum C-reactive protein levels were independent predictors of catheter failure.ConclusionsHIV infection in end-stage renal disease patients managed by CAPD was associated with increased peritonitis risk; however, HIV infection did not increase the risk for CAPD catheter failure rate at 18 months.

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“…Ideally, a prospective study should be conducted for the purpose of averting the analysis bias associated with retrospective studies. Secondly, despite extensive adjustments for confounding factors, some factors that may affect the occurrence of peritonitis have not been taken into account, such as seasonality, training, and socioeconomic status, among others ( 27 , 72 , 73 ). Lastly, the clinical data, including the serum PTH levels, were baseline values for one measurement only.…”

Section: Discussionmentioning

confidence: 99%

Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis

Zhao

Yan

et al. 2023

Front. Endocrinol.

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BackgroundPeritonitis is considered as one of the most serious complications that cause hospitalization in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). There is limited evidence on the impact of the parathyroid hormone (PTH) on the first peritoneal dialysis (PD)-associated peritonitis episode. We aimed to investigate the influence of serum intact parathyroid hormone (iPTH) on peritonitis in patients undergoing PD.MethodsThis was a retrospective cohort study. Patients undergoing initial CAPD from a single center in China were enrolled. The baseline characteristics and clinical information were recorded. The primary outcome of interest was the occurrence of the first PD-associated peritonitis episode. Five Cox proportional hazard models were constructed in each group set. In group set 1, all participants were divided into three subgroups by tertiles of the serum concentration of iPTH; in group set 2, all participants were divided into three subgroups based on the serum concentration of iPTH with 150 pg/ml interval (<150, 150–300, and >300 pg/ml). Hazard ratios and 95% confidence intervals (CIs) were calculated for each model. The multivariate linear regression analysis elimination procedure assessed the association between the clinical characteristics at baseline and the iPTH levels. Restricted cubic spline models were constructed, and stratified analyses were also conducted.ResultsA total of 582 patients undergoing initial PD (40% women; mean age, 45.1 ± 11.5 years) from a single center in China were recruited. The median follow-up duration was 25.3 months. Multivariate Cox regression analysis showed that, in the fully adjusted model, a higher serum iPTH level (tertile 3, iPTH >300 pg/ml) was significantly associated with a higher risk of PD-associated peritonitis at 3 years [tertile 3: hazard ratio (HR) = 1.53, 95%CI = 1.03–2.55, p = 0.03; iPTH > 300 pg/ml: HR = 1.57, 95%CI = 1.08–2.27, p = 0.02]. The hazard ratio for every 100 pg/ml increase in serum iPTH level was 1.12 (95%CI = 1.05–1.20, p < 0.01) in the total cohort when treating iPTH as a continuous variable.ConclusionsAn elevated iPTH level was significantly associated with an increased risk of peritonitis in patients undergoing CAPD.

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The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study

Abstract: Our study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis.

Cited by 14 publications

References 32 publications

Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: A cross-sectional study

Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: A cross-sectional study

Peritonitis outcomes in patients with HIV and end-stage renal failure on peritoneal dialysis: a prospective cohort study

Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis

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