The relationship between bone mineral indices and survival in patients on peritoneal dialysis

Yaghoubi, Fatemeh; Hakemi, Monirossadat; Taghizadeh, Hannaneh; Alatab, Sudabeh

doi:10.34172/jrip.2021.36

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Blood uric acid is the most abundant antioxidant in plasma, and hypouricaemia is thought to increase the risk of reduced renal function by reducing antioxidant capacity [26]. Previous studies have not been consistent about the effect of blood uric acid levels on PDAP [26][27], but the lower the uric acid the greater the likelihood of PDAP [29], which reminds us that that we should keep blood uric acid levels relatively stable.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Prediction Modeling of Peritoneal Dialysis-Associated Peritonitis

2024

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In order to find the risk factors of Peritoneal Dialysis-Associated Peritonitis (PDAP) and to construct a nomogram model for predicting the risks of PDAP, providing a basis for the prevention and treatment of PDAP. We collected the data of 181 peritoneal dialysis (PD) patients admitted to the Nephrology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from February 2021 to October 2023. We divided them into the peritonitis group (n=62) and the non-peritonitis group (n=119) according to the hospital infection. Logistic regression analysis was used for risk factor screening, and variables with statistically significant differences in univariate analysis were included in a multifactorial Logistic regression analysis model to explore the influencing factors of Peritoneal Dialysis-Associated Peritonitis and to construct a nomogram prediction model, and by plotting the subjects' work characteristics (ROC) curve, Hosmer-Lemeshow calibration curve, and clinical decision curve (DCA) to evaluate the differentiation, calibration, and clinical applicability of the model. Resultly, based on multifactorial logistic regression analysis incorporating body mass index(BMI), age at peritoneal dialysis, neutrophil percentage/lymphocyte percentage, albumin, blood potassium, blood uric acid, blood phosphorus, and Chinese medicine concurrently were the risk factors for PDAP (P<0.05). Based on the constructed nomogram model, the ROC curve showed that the area under the curve (AUC) of the model was 0.959. Additionally, the calibration curve and DCA curve demonstrated good accuracy and application value. In conclusion, the nomogram prediction model constructed in this study has good predictive efficacy for PDAP, which can provide a reference for the early detection and identification of PDAP by clinicians and nurses.

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Section: Discussionmentioning

confidence: 99%

Nomogram Prediction Modeling of Peritoneal Dialysis-Associated Peritonitis

2024

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International variations in serum PTH and calcium levels and their mortality associations in peritoneal dialysis patients: Results from PDOPPS

Nitta,

Bieber,

Karaboyas

et al. 2024

Perit Dial Int

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Background: Mineral bone disorder (MBD) in chronic kidney disease (CKD) is associated with high symptom burden, fractures, vascular calcification, cardiovascular disease and increased morbidity and mortality. CKD-MBD studies have been limited in peritoneal dialysis (PD) patients. Here, we describe calcium and parathyroid hormone (PTH) control, related treatments and mortality associations in PD patients. Methods: We used data from eight countries (Australia and New Zealand (A/NZ), Canada, Japan, Thailand, South Korea, United Kingdom, United States (US)) participating in the prospective cohort Peritoneal Dialysis Outcomes and Practice Patterns Study (2014–2022) among patients receiving PD for >3 months. We analysed the association of baseline PTH and albumin-adjusted calcium (calciumAlb) with all-cause mortality using Cox regression, adjusted for potential confounders, including serum phosphorus and alkaline phosphatase. Results: Mean age ranged from 54.6 years in South Korea to 63.5 years in Japan. PTH and serum calciumAlb were measured at baseline in 12,642 and 14,244 patients, respectively. Median PTH ranged from 161 (Japan) to 363 pg/mL (US); mean calciumAlb ranged from 9.1 (South Korea, US) to 9.8 mg/dL (A/NZ). The PTH/mortality relationship was U-shaped, with the lowest risk at PTH 300–599 pg/mL. Mortality was nearly 20% higher at serum calciumAlb 9.6+ mg/dL versus 8.4–<9.6 mg/dL. MBD therapy prescriptions varied substantially across countries. Conclusions: A large proportion of PD patients in this multi-national study have calcium and/or PTH levels in ranges associated with substantially higher mortality. These observations point to the need to substantially improve MBD management in PD to optimise patient outcomes. Lay Summary Chronic kidney disease-mineral bone disorder (MBD) is a systemic condition, common in dialysis patients, that results in abnormalities in parathyroid hormone (PTH), calcium, phosphorus and vitamin D metabolism. A large proportion of peritoneal dialysis (PD) patients in this current multi-national study had calcium and/or PTH levels in ranges associated with substantially higher risks of death. Our observational study design limits our ability to determine whether these abnormal calcium and PTH levels cause more death due to possible confounding that was not accounted for in our analysis. However, our findings, along with other recent work showing 48–75% higher risk of death for the one-third of PD patients having high phosphorus levels (>5.5 mg/dL), should raise strong concerns for a greater focus on improving MBD management in PD patients.

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The relationship between bone mineral indices and survival in patients on peritoneal dialysis

Cited by 2 publications

References 16 publications

Nomogram Prediction Modeling of Peritoneal Dialysis-Associated Peritonitis

Nomogram Prediction Modeling of Peritoneal Dialysis-Associated Peritonitis

International variations in serum PTH and calcium levels and their mortality associations in peritoneal dialysis patients: Results from PDOPPS

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