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He Y, Xiao F, Luo Q, Liao J, Huang H, He Y, Gao M, Liao Y, Xiong Z. Red cell distribution width to albumin ratio predicts treatment failure in peritoneal dialysis-associated peritonitis. Ther Apher Dial 2024; 28:399-408. [PMID: 38112028 DOI: 10.1111/1744-9987.14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND This study aims to investigate the potential correlation between baseline red cell distribution width (RDW) to albumin ratio (RAR) levels and treatment failure in peritoneal dialysis-associated peritonitis (PDAP) patients. METHODS A retrospective single-center study was conducted on 286 PDAP patients. Logistic regression and generalized estimation equation (GEE) analyses were employed to assess the relationship between RAR and treatment failure. RESULTS RAR emerged as a robust predictor of treatment failure in PDAP patients. Elevated RAR levels were associated with an increased risk of treatment failure, exhibiting a linear relationship. Even after adjusting for demographic and clinical variables, this association remained statistically significant. ROC analysis revealed that RAR outperformed RDW and albumin individually in predicting PDAP prognosis. CONCLUSION This study highlights RAR as a superior prognostic marker for treatment failure in PDAP patients, offering new insights into risk assessment and management strategies for this challenging condition.
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Affiliation(s)
- Yujian He
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Fei Xiao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Qingyun Luo
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Jinlan Liao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Huie Huang
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Yan He
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Min Gao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Yumei Liao
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
| | - Zibo Xiong
- Renal Division, Peking University Shenzhen Hospital (PKU-Shenzhen Clinical Institute of Shantou University Medical College, PKU-Shenzhen Clinical Institute of Shenzhen University Medical College), Shenzhen, China
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Demirci R, Sahtiyancı B, Bakan A, Akyuz O. The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience. J Vasc Access 2023; 24:76-81. [PMID: 34137310 DOI: 10.1177/1129729821998836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter. METHODS A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient's demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records. RESULTS The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019-0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188-4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210-2.064, p = 0.001) were independent predictors for the CRBSI development. ROC curve analysis demonstrated that a catheter duration of 22 days was predictive for presence of CRBSI (78% sensitivity, 76% specificity, AUC: 0.825, 95% CI: 0.724-0.925, p < 0.001). CONCLUSIONS Prolonged catheter duration, low serum albumin, and high mean platelet volume independently predict the development of CRBSI in patients undergoing hemodialysis for acute kidney injury or chronic kidney disease.
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Affiliation(s)
- Recep Demirci
- Department of Nephrology, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Kucukcekmece/Istanbul, Turkey
| | - Berrak Sahtiyancı
- Department of Nephrology, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Kucukcekmece/Istanbul, Turkey
| | - Ali Bakan
- Department of Nephrology, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Kucukcekmece/Istanbul, Turkey
| | - Okan Akyuz
- Department of Nephrology, Bilecik State Hospital, Bilecik, Turkey
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Infectious Complications of Hemodialysis Tunneled Catheters—Types, Diagnosis, and Treatment Strategies. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02095-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Silverstein DM, Trerotola SO, Clark T, James G, Ng W, Dwyer A, Florescu MC, Shingarev R, Ash SR. Clinical and Regulatory Considerations for Central Venous Catheters for Hemodialysis. Clin J Am Soc Nephrol 2018; 13:1924-1932. [PMID: 30309840 PMCID: PMC6302318 DOI: 10.2215/cjn.14251217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Central venous catheters remain a vital option for access for patients receiving maintenance hemodialysis. There are many important and evolving clinical and regulatory considerations for all stakeholders for these devices. Innovation and transparent and comprehensive regulatory review of these devices is essential to stimulate innovation to help promote better outcomes for patients receiving maintenance hemodialysis. A workgroup that included representatives from academia, industry, and the US Food and Drug Administration was convened to identify the major design considerations and clinical and regulatory challenges of central venous catheters for hemodialysis. Our intent is to foster improved understanding of these devices and provide the foundation for strategies to foster innovation of these devices.
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Affiliation(s)
- Douglas M. Silverstein
- Center for Devices and Radiological Health, Division of Reproductive, Gastro-Renal, and Urological Devices, Renal Devices Branch, US Food and Drug Administration, Silver Spring, Maryland
| | - Scott O. Trerotola
- Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Timothy Clark
- Interventional Radiology, Penn-Presbyterian Medical Center, Hospitals of the University of Pennsylvania, , Philadelphia, Pennsylvania
| | - Garth James
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana
| | - Wing Ng
- Regulatory Affairs and Patient Recovery, Cardinal Health, Inc., Dublin, Ohio
| | - Amy Dwyer
- Internal Medicine and Interventional Nephrology, University of Louisville, Louisville, Kentucky
| | - Marius C. Florescu
- Internal Medicine and Nephrology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Roman Shingarev
- Internal Medicine and Nephrology, University of Alabama at Birmingham Medical Center, Birmingham, Alabama
| | - Stephen R. Ash
- Indiana University Health Arnett Hospital, Lafayette, Indiana
- HemoCleanse Technologies, LLC, Lafayette, Indiana; and
- Ash Access Technology, Inc., Lafayette, Indiana
| | - on behalf of the Kidney Health Initiative HDF Workgroup
- Center for Devices and Radiological Health, Division of Reproductive, Gastro-Renal, and Urological Devices, Renal Devices Branch, US Food and Drug Administration, Silver Spring, Maryland
- Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
- Interventional Radiology, Penn-Presbyterian Medical Center, Hospitals of the University of Pennsylvania, , Philadelphia, Pennsylvania
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana
- Regulatory Affairs and Patient Recovery, Cardinal Health, Inc., Dublin, Ohio
- Internal Medicine and Interventional Nephrology, University of Louisville, Louisville, Kentucky
- Internal Medicine and Nephrology, University of Nebraska Medical Center, Omaha, Nebraska
- Internal Medicine and Nephrology, University of Alabama at Birmingham Medical Center, Birmingham, Alabama
- Indiana University Health Arnett Hospital, Lafayette, Indiana
- HemoCleanse Technologies, LLC, Lafayette, Indiana; and
- Ash Access Technology, Inc., Lafayette, Indiana
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Stefanidis CJ. Preventing catheter-related infections in children undergoing hemodialysis. Expert Rev Anti Infect Ther 2011; 8:1239-49. [PMID: 21073289 DOI: 10.1586/eri.10.114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The increased use of tunneled cuffed catheters in children on chronic hemodialysis is the result of their relative ease of insertion, pain-free dialysis and immediate use. The disadvantage of their use is that they are associated with catheter-related bacteremia (CRB), which in turn is related with increased morbidity, access loss and occasionally metastatic infections and even death. A CRB might be difficult to diagnose and is often associated with a previous history of CRB, exit-site infection, low serum albumin and long duration of catheter use. There is evidence that the use of arteriovenous fistulae is associated with lower infection rates. The implementation of effective strategies for the prevention of CRBs include the adoption of policies for improving arteriovenous fistula rates, appropriate surgical catheter insertion and optimal nursing care of the exit site, and a safe connection technique. Recently, the effectiveness of antimicrobial catheter solutions for preventing CRB has been documented in a number of randomized clinical trials. In addition, the application of antibiotic ointments at the exit sites of tunneled cuffed catheters might be significant for the reduction of Staphylococcus-related CRB. The upside is that education-based programs combining specific preventive measures can significantly reduce CRBs.
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BEHL M, SUN Y, AGABA EI, MARTINEZ M, SERVILLA KS, RAJ DSC, MURATA GH, TZAMALOUKAS AH. Death during hospitalization in patients on chronic hemodialysis. Hemodial Int 2010; 14 Suppl 1:S14-21. [DOI: 10.1111/j.1542-4758.2010.00485.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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