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Wong TS, Chen Q, Zhong Q, Hu B, Feng G, Huang F, Lu J, Yin L, Yu Z, Akinwunmi BO, Huang J, Zhang CJ, Ming WK. Cost-effectiveness analysis of autogenous arteriovenous fistula, arteriovenous graft, and tunneled-cuffed catheter for hemodialysis in patients with end-stage kidney disease in Southern China. J Vasc Access 2024; 25:953-962. [PMID: 36540049 DOI: 10.1177/11297298221143010] [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] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To evaluate the cost-effectiveness of three permanent vascular accesses for maintenance hemodialysis patients from a hospital perspective throughout 5 years, which is the average life expectancy of patients with end-stage kidney disease. SUBJECTS AND METHODS We conducted a EuroQol(EQ-5D) questionnaire survey between January 2021 and March 2021 with 250 patients to estimate the health utility of various states in patients under different hemodialysis vascular access. We designed a Markov model and conducted a cost-effectiveness analysis to compare the cost-effectiveness of three hemodialysis vascular access in Guangzhou throughout 5 years. RESULTS The mean costs were US$44,481 with tunneled-cuffed catheter (TCC), and US$68,952 and US$59,247 with arteriovenous graft (AVG) and autogenous arteriovenous fistula (AVF), respectively. The mean quality-adjusted life-years (QALYs) was 1.41 with TCC, and 2.37 and 2.73 with AVG and AVF, respectively. AVG had an incremental cost-effectiveness ratio (ICER) of US$25,491 per QALY over TCC; AVF had an ICER of -US$26,958 per QALY over AVG. At a willingness to pay below US$10,633.8 per QALY, TCC is likely the most cost-effective vascular access. At any willingness to pay between US$10,633.8 and US$30,901.4 per QALY, AVF is likely the most cost-effective vascular access. CONCLUSION These findings illustrate the value of AVF given its relative cost-effectiveness to other hemodialysis modalities. Although AVG costs much more than TCC for slightly higher QALYs than TCC, AVG still has a greater advantage over TCC for patients with longer life expectancy due to its lower probability of death.
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Affiliation(s)
- Tak-Sui Wong
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Qian Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Qiongqiong Zhong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Bo Hu
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Guanrui Feng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Fengqiu Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Jian Lu
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Lianghong Yin
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Zongchao Yu
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | | | - Jian Huang
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Casper Jp Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wai-Kit Ming
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong
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Mai Q, Liang X, Hu J, Meng X, Zhang Q, Wang C, Song Y. The effect of perceived stress on social isolation in young and middle-aged maintenance haemodialysis patients: A polynomial regression and response surface analysis. Stress Health 2024; 40:e3304. [PMID: 37583077 DOI: 10.1002/smi.3304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
Patients on maintenance haemodialysis (MHD) face social isolation due to the far-reaching effects of their disease and treatment. Based on the Transactional Model of Stress and Coping, we analysed the relationship between perceived stress and social isolation in patients, and the mediating role of internal health-related locus of control (IHLC) from the perspective of co-existence of perceived helplessness (HEL) and perceived self-efficacy (SEL). We used structured questionnaires to investigate 332 cases of young and middle-aged MHD patients in four tertiary hospitals in Guangdong, China. Polynomial regression and response surface analysis were conducted, along with tests of mediating effects on the data. The research was based on STROBE guidelines. The results showed that perceived stress is significantly and positively associated with social isolation. When the HEL and SEL of perceived stress were congruent, the joint effect of the two was in a positive curvilinear relationship to social isolation, when the two were incongruent, the risk of social isolation was lower for "low HEL-high SEL" patients compared to the "high HEL-low SEL" combination. The more congruent in HEL -SEL, the lower the risk of social isolation for the patients, with the IHLC playing a mediating role in this association. This study reveals that the coexistence of perceived stress's HEL and SEL affects social isolation through congruent and incongruent matching mechanism, providing additional explanations for the mechanism of occurrence of patients' social isolation.
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Affiliation(s)
- Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingshan Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingyi Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangxin Meng
- Department of Nephrology, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Qiulin Zhang
- Department of Nephrology, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Chao Wang
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Gan T, Guan H, Li P, Huang X, Li Y, Zhang R, Li T. Risk prediction models for cardiovascular events in hemodialysis patients: A systematic review. Semin Dial 2024; 37:101-109. [PMID: 37743062 DOI: 10.1111/sdi.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/25/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To perform a systematic review of risk prediction models for cardiovascular (CV) events in hemodialysis (HD) patients, and provide a reference for the application and optimization of related prediction models. METHODS PubMed, The Cochrane Library, Web of Science, and Embase databases were searched from inception to 1 February 2023. Two authors independently conducted the literature search, selection, and screening. The Prediction model Risk Of Bias Assessment Tool (PROBAST) was applied to evaluate the risk of bias and applicability of the included literature. RESULTS A total of nine studies containing 12 models were included, with performance measured by the area under the receiver operating characteristic curve (AUC) lying between 0.70 and 0.88. Age, diabetes mellitus (DM), C-reactive protein (CRP), and albumin (ALB) were the most commonly identified predictors of CV events in HD patients. While the included models demonstrated good applicability, there were still certain risks of bias, primarily related to inadequate handling of missing data and transformation of continuous variables, as well as a lack of model performance validation. CONCLUSION The included models showed good overall predictive performance and can assist healthcare professionals in the early identification of high-risk individuals for CV events in HD patients. In the future, the modeling methods should be improved, or the existing models should undergo external validation to provide better guidance for clinical practice.
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Affiliation(s)
- Tiantian Gan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hua Guan
- Health Management Center, Sichuan Academy of Medical Sciences·Sichuan People's Hospital, Chengdu, China
| | - Pengli Li
- Department of Nephrology, Sichuan Academy of Medical Sciences·Sichuan People's Hospital, Chengdu, China
| | - Xinping Huang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Li
- Health Management Center, Sichuan Academy of Medical Sciences·Sichuan People's Hospital, Chengdu, China
| | - Rui Zhang
- Health Management Center, Sichuan Academy of Medical Sciences·Sichuan People's Hospital, Chengdu, China
| | - Tingxin Li
- Health Management Center, Sichuan Academy of Medical Sciences·Sichuan People's Hospital, Chengdu, China
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Tian L, Fu S, Li M, Zhao X, Li H. Cost-effectiveness analysis of sodium zirconium cyclosilicate for treating hyperkalemia among Chinese patients. Front Public Health 2023; 11:1196789. [PMID: 38145082 PMCID: PMC10740179 DOI: 10.3389/fpubh.2023.1196789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/14/2023] [Indexed: 12/26/2023] Open
Abstract
Objectives Hyperkalemia most commonly develops in chronic kidney disease (CKD) or heart failure (HF) patients. Sodium zirconium cyclosilicate (SZC) is a new selective potassium (K+) binder for treating hyperkalemia. The aim of this study was to evaluate the cost-effectiveness of SZC vs. usual care for the treatment of hyperkalemia among CKD patients or HF patients in China. Methods Individual patient microsimulation models were constructed to simulate a CKD cohort until the initiation of renal replacement therapy (RRT) and a HF cohort across the lifetime horizon. K+ levels were based on two phase 3 clinical trials. Health state utility and event incidence rates were retrieved from literature. Drug costs and healthcare utilization costs were obtained from negotiated price, literature, and expert interviews. Costs and quality-adjusted life-years (QALYs) were both discounted at 5%. The main outcomes were overall costs, QALYs, and incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold in China is CNY 80,976-242,928/QALY, which is one to three times the gross domestic product per capita. Sensitivity analyses were performed to characterize the models' uncertainty. Results In the HF cohort, the base case results revealed that SZC was associated with 2.86 QALYs and the total cost was CNY 92671.58; usual care was associated with 1.81 QALYs and CNY 54101.26. In the CKD cohort, SZC was associated with 3.23 QALYs and CNY 121416.82 total cost; usual care was associated with 2.91 QALYs and CNY 111464.57. SZC resulted in an ICER of CNY 36735.87/QALY for the HF cohort and CNY 31181.55/QALY for the CKD cohort, respectively. The one-way and probability sensitivity analyses found that the results were robust. Conclusion SZC is a cost-effective treatment compared to usual care in HF and CKD patients. SZC is an important novel treatment option for managing patients with hyperkalemia in China.
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Affiliation(s)
| | | | | | | | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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Mai Q, Xu S, Hu J, Sun X, Chen G, Ma Z, Song Y, Wang C. The association between socioeconomic status and health-related quality of life among young and middle-aged maintenance hemodialysis patients: multiple mediation modeling. Front Psychiatry 2023; 14:1234553. [PMID: 37795510 PMCID: PMC10546310 DOI: 10.3389/fpsyt.2023.1234553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
Objective To explore the relationship between socioeconomic status (SES), illness perception, social functioning, and health-related quality of life (HRQoL) of young and middle-aged maintenance hemodialysis (MHD) patients and the internal mechanism of action. Design A multicenter cross-sectional study. Methods An aggregate of 332 young and middle-aged MHD patients were enrolled from hemodialysis centers in four general hospitals in Guangzhou, Guangdong, China, from June to December 2022. The questionnaires used included one for general demographic data, the Brief Illness Perception Questionnaire (BIPQ), Social Dysfunction Screening Scale (SDSS), and the 12-item Short Form Health Survey (SF-12). Results Both SES and HRQoL were negatively correlated with illness perception and social functioning, respectively. SES was positively correlated with HRQoL. Illness perception was positively correlated with social functioning. The indirect effects of illness perception and social functioning on the relationship between SES and HRQoL were 0.33 and 0.31, making up 41.06% and 38.91% of the sum. The chain indirect effect of illness perception and social functioning was 0.10, making up 12.59% of the total effect, while gender did not play a moderating role. Conclusion Illness perception and social functioning may independently and accumulatively mediate the association between SES and HRQoL. Nurses should consider developing individual intervention program for young and middle-aged MHD patients with low SES, focusing on establishing targeted counseling and health education strategies corresponding to illness perception and social functioning to help patients improve their HRQoL.
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Affiliation(s)
- Qingxin Mai
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Siyi Xu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingyi Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoming Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gangyi Chen
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhen Ma
- Department of Nephrology, Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chao Wang
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Liu J, Zhang H, Diao Z, Guo W, Huang H, Zuo L, Liu W. Epidemiological analysis of death among patients on maintenance hemodialysis: results from the beijing blood purification quality Control and Improvement Center. BMC Nephrol 2023; 24:236. [PMID: 37582779 PMCID: PMC10426135 DOI: 10.1186/s12882-023-03271-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/16/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND China has the largest number of patients on maintenance hemodialysis (MHD) worldwide. Despite continuous improvements in hemodialysis techniques, patients on MHD have a higher mortality rate than the general population. Understanding the characteristics of death in this population can better promote clinical practice, thereby improving patients' survival. METHODS We collected demographic and clinical data for patients on MHD registered in the Beijing Blood Purification Quality Control and Improvement Center database from 2014 to 2020. The annual mortality rate was calculatedand the primary cause of end-stage renal disease (ESRD), dialysis vintage, and cause of death among deceased patients were analyzed. RESULTS (1) 24,363 patients on MHD were included, of which 6,065 patients died from 2014 to 2020. The annual mortality rate fluctuated between 7.4% and 8.0%. The median age of death was 70.0 (60.8-79.0) years and the male to female ratio was 1.27:1 (2). The top three primary causes of ESRD in deceased patients were chronic glomerulonephritis (CGN), diabetic nephropathy (DN), and hypertensive nephropathy (HN). Comparison of the annual mortality rate showed DN > HN > CGN (3). The median dialysis vintage of deceased patients was 3.7 (1.8-6.9) years, which slowly increased annually. Patients with diabetes had a shorter dialysis vintage than patients without diabetes (3.4 vs. 4.1 years, Z = 8.3, P < 0.001) (4). The major causes of death were cardiovascular disease (20.2%), sudden death (18.1%), infection (17.9%), and cerebrovascular disease (12.6%). Proportions of death from cardiovascular disease, infection, and sudden death were higher in patients with diabetes (22.2%, 20.2%, and 20.0%) than patients without diabetes (18.4%, 15.8%, and 16.3%). Sudden death was the leading cause of death in young (18-44 years; 27.0%) and middle aged (45-64 years; 20.8%) patients, whereas infection was the leading cause of death in patients aged ≥ 75 years (24.5%). CONCLUSION The annual mortality rate of patients on MHD in Beijing was relatively stable from 2014 to 2020. Sudden death was more likely to occur in young and middle-aged patients, and more patients aged ≥ 75 years died from infections.
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Affiliation(s)
- Jing Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Huixian Zhang
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zongli Diao
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wang Guo
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongdong Huang
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Peking University, Beijing, China.
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Ni Z, Lu R, Xu X, Bian X, Zhou Z, Yang J, Luo Q, Chen M, Chen C, Sun X, Yu L, He Q, Jiang H, Yuan W, Li Y, Zhou R, Wang J, Zhang X, Zuo L, Meng X, Chang Z, Zhao J, Wessman P, Xiang P. DIALIZE China: A Phase IIIb, Randomized, Placebo-Controlled Study to Reduce Predialysis Hyperkalemia With Sodium Zirconium Cyclosilicate in Chinese Patients. Clin Ther 2023; 45:633-642. [PMID: 37385905 DOI: 10.1016/j.clinthera.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/18/2023] [Accepted: 04/23/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE The DIALIZE China study (Reduce Incidence of Pre-Dialysis Hyperkalaemia With Sodium Zirconium Cyclosilicate in Chinese Subjects) (NCT04217590) evaluated sodium zirconium cyclosilicate (SZC) for the management of hyperkalemia in Chinese patients undergoing hemodialysis. METHODS In the double-blind, Phase IIIb DIALIZE China study, Chinese adults with kidney failure and predialysis hyperkalemia (predialysis serum potassium [sK+] concentration >5.4 mmol/L after the long interdialytic interval [LIDI] and >5.0 mmol/L after ≥1 short interdialytic interval) who were receiving hemodialysis 3 times weekly were randomized to placebo or SZC 5 g once daily on nondialysis days. Doses were titrated towards maintaining normokalemia for 4 weeks (titration period) in 5-g increments up to 15 g. Primary efficacy was the proportion of responders during the 4-week evaluation period following the titration period (ie, those with a predialysis sK+ of 4.0-5.0 mmol/L for at least 3 of 4 hemodialysis visits following the LIDI) who did not require urgent rescue therapy. FINDINGS Overall, 134 adults (mean [SD] age, 55 [11.3] years) were randomized to SZC or placebo (n = 67 each). There were significantly more responders with SZC (37.3%) versus placebo (10.4%; estimated odds ratio [OR] = 5.10; 95% CI, 1.90-15.12; P < 0.001). The probability of all predialysis sK+ concentrations being 3.5 to 5.5 mmol/L was significantly higher with SZC versus placebo (estimated OR = 6.41; 95% CI, 2.71-15.12; P < 0.001). A greater proportion of patients achieved an sK+ of 3.5 to 5.5 mmol/L on at least 3 of 4 LIDI visits during evaluation with SZC (73.1%) versus placebo (29.9%). Serious adverse events occurred in 9.1% and 11.9% of patients in the SZC and placebo groups, respectively. IMPLICATIONS SZC treatment for predialysis hyperkalemia is effective and well tolerated in Chinese patients with kidney failure receiving hemodialysis. CLINICALTRIALS gov identifier: NCT04217590.
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Affiliation(s)
- Zhaohui Ni
- Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Renhua Lu
- Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xudong Xu
- Central Hospital of Minhang District, Shanghai, China
| | | | - Zhihong Zhou
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junwei Yang
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qun Luo
- Ningbo Huamei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Menghua Chen
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Chaosheng Chen
- The First Affiliated Hospital of Wenzhou College, Wenzhou, China
| | - Xiuli Sun
- Baotou City Central Hospital, Baotou, China
| | - Lei Yu
- Inner Mongolia People's Hospital, Hohhot, China
| | - Qiang He
- Zhejiang Traditional Chinese Medicine Hospital, Hangzhou, China
| | - Hong Jiang
- People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
| | | | - Yi Li
- Dongguan People's Hospital, Dongguan, China
| | - Rong Zhou
- Shanghai Yangpu District Central Hospital, Shanghai, China
| | - Jianqin Wang
- Lanzhou University Second Hospital, Lanzhou, China
| | | | - Li Zuo
- Peking University People's Hospital, Beijing, China
| | | | | | - June Zhao
- BioPharmaceuticals Clinical, AstraZeneca R&D, Gaithersburg, Maryland
| | - Peter Wessman
- BioPharmaceuticals Clinical, AstraZeneca R&D, Gothenburg, Sweden
| | - Peng Xiang
- Global R&D (China), AstraZeneca, Shanghai, China
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Seifu L, Getachew S, Abebe B, Debay Z. Clinical and Epidemiological Profiles of Patients with End Stage Kidney Disease on Dialysis at Dialysis Centers in Addis Ababa, Ethiopia. Ethiop J Health Sci 2023; 33:499-506. [PMID: 37576172 PMCID: PMC10416342 DOI: 10.4314/ejhs.v33i3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/04/2023] [Indexed: 08/15/2023] Open
Abstract
Background End-stage kidney disease is increasing worldwide, primarily in the developing countries. It is affecting mainly the productive age group. Though the prevalence of the disease is increasing in Ethiopia, there are few studies. We therefore sought to describe the clinical and epidemiological characteristics of hemodialysis patients. Methods A descriptive cross-sectional study was conducted at 17 hemodialysis centers in Addis Ababa. Patients who received hemodialysis for at least three months were included in the study. Socio-demographic and clinical data were collected via questionnaires from October to November 2021. Results This study involved 318 participants with males making up 197 (61.9%) of the participants. Among the total, 248 (78.0%) were in the age group of 20 to 60 years and 155 (48.7%) were unemployed. Hypertension and diabetes mellitus were the major risk factors for end-stage kidney disease. The mean duration of dialysis was 2.26 years. The frequency of dialysis was twice weekly in 150 (47.2%) of the patients and thrice weekly in 138 (43.4%) of the patients. Arterio veneous fistula was used in approximately three-quarters of patients, i.e. 237 (74.5%). The majority of the patients on hemodialysis, 193 (60.7%), pay their own expenses, and 52 (16.4%) of the patients received hemodialysis at public hemodialysis centers. More than two-third of the patients were not in the process of undergoing a kidney transplant due to a variety of factors, including inability to find a donor, 106 (47.7%), being unfit for surgery, 56 (25.2%), and financial constraints, 38 (17.1%). Conclusion The majority of the patients on dialysis were men, middle-aged, and unemployed. The majority of the patients underwent dialysis in private institutions and were self-funded, and most of them had inadequate dialysis doses. The inability to find a living donor was the most difficult aspect of undergoing kidney transplantation.
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Affiliation(s)
- Lissane Seifu
- Department of Internal Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seifemichael Getachew
- Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bezaye Abebe
- Department of Pediatrics, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zerihun Debay
- Santé Medical Center, Private Clinic, Addis Ababa, Ethiopia
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Liang Y, Gan L, Shen Y, Li W, Zhang D, Li Z, Ren J, Xu M, Zhao X, Ma Y, Zuo L, Wang M. Clinical characteristics and management of hemodialysis patients with pre-dialysis hypertension: a multicenter observational study. Ren Fail 2022; 44:1811-1818. [DOI: 10.1080/0886022x.2022.2136527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Yaoxian Liang
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Liangying Gan
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Yulan Shen
- Department of Nephrology, Miyun Hospital, Beijing, China
| | - Weihua Li
- Department of Nephrology, Shijingshan Hospital, Beijing, China
| | - Dongliang Zhang
- Department of Nephrology, Peking University International Hospital, Beijing, China
| | - Zhongxin Li
- Department of Nephrology, Capital Medical University Affiliated Luhe Hospital, Beijing, China
| | - Jianwei Ren
- Department of Nephrology, Aviation General Hospital, Beijing, China
| | - Mingcheng Xu
- Department of Nephrology, Zhanlanlu Hospital of Xicheng District, Beijing, China
| | - Xiaolin Zhao
- Jiaozhou Bethune Blood Purification Center, Shandong, China
| | - Yingchun Ma
- Department of Nephrology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Li Zuo
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Mei Wang
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
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10
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Prediction model for cardiovascular disease risk in hemodialysis patients. Int Urol Nephrol 2021; 54:1127-1134. [PMID: 34487297 DOI: 10.1007/s11255-021-02984-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To derive and validate a prediction score for cardiovascular disease (CVD) risk in hemodialysis patients in China. METHODS Three hundred and eighty-eight patients with regular hemodialysis for more than 3 months were recruited from January 1, 2015 to September 30, 2019 and followed up till May 31, 2020. We derived a prediction score using all participants as a training data set and validated using a bootstrap validation data set. Discriminatory ability of the prediction score was assessed by the area under the receiver operating characteristic curve (AUC). RESULTS Of 388 patients without CVD at baseline, 132 developed first CVD events during an average follow-up of 3.27 (inter-quartile range = 3.08) years. Of 26 clinical parameters, age, hypertension, diabetes and abnormal white blood cell (WBC) count were identified as significant predictors and included in the prediction model. Compared to those without any of these risk factors, those with one, two, and three to four points showed increased risks of CVD, with the adjusted hazards ratio and 95% confidence interval (CI) being 3.29 (1.17-9.26), 7.42 (2.68-20.51) and 15.43 (5.44-43.75), respectively. The score showed satisfactory discriminatory ability in both training and validation data set (AUC = 0.7025, 95% CI 0.6520-0.7530, and 0.6876, 95% CI 0.6553-0.7200, respectively). CONCLUSION We derived and validated a prediction score for CVD risk in hemodialysis patients in China. Given there is a rapid increase in the number of hemodialysis patients, this simple point score can be used to identify high-risk individuals in clinical practice for more precise and efficient personalized treatment.
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Ko PJ, Yu SY, Chang JCH, Hsieh MJ, Chu SY, Tan JWH, Cheng WL, Ho P. Using a Web-Based Platform as an Alternative for Conducting International, Multidisciplinary Medical Conferences During the Novel COVID-19 Pandemic: Analysis of a Conference. JMIR MEDICAL EDUCATION 2021; 7:e23980. [PMID: 33970866 PMCID: PMC8191725 DOI: 10.2196/23980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/30/2020] [Accepted: 04/13/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND The COVID-19 pandemic has stunted medical education activities, resulting in most conferences being cancelled or postponed. To continue professional education during this crisis, web-based conferences can be conducted via livestream and an audience interaction platform as an alternative. OBJECTIVE The unprecedented COVID-19 pandemic has affected human connections worldwide. Conventional conferences have been replaced by web-based conferences. However, web-based conferencing has its challenges and limitations. This paper reports the logistics and preparations required for converting an international, on-site, multidisciplinary conference into a completely web-based conference within 3 weeks during the pandemic. METHODS The program was revised, and a teleconference system, live recording system, director system setup, and broadcasting platform were arranged to conduct the web-based conference. RESULTS We used YouTube (Alphabet Inc) and WeChat (Tencent Holdings Limited) for the web-based conference. Of the 24 hours of the conventional conference, 21.5 hours (90%) were retained in the web-based conference via live broadcasting. The conference was attended by 71% (37/52) of the original international faculties and 71% (27/38) of the overall faculties. In total, 61 out of 66 presentations (92%) were delivered. A special session-"Dialysis access management under the impact of viral epidemics"-was added to replace precongress workshops and competitions. The conference received 1810, 1452, and 1008 visits on YouTube and 6777, 4623, and 3100 visits on WeChat on conference days 1, 2, and 3, respectively. CONCLUSIONS Switching from a conventional on-site conference to a completely web-based format within a short period is a feasible method for maintaining professional education in a socially responsible manner during a pandemic.
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Affiliation(s)
- Po-Jen Ko
- Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan, Taiwan
- College of Medicine, School of Medicine, Chang Gung University, Linkou, Taiwan
| | - Sheng-Yueh Yu
- Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan, Taiwan
| | - John Chien-Hwa Chang
- Division of Cardiovascular Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Taiwan
- College of Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ming-Ju Hsieh
- College of Medicine, School of Medicine, Chang Gung University, Linkou, Taiwan
- Department of Surgery, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan, Taiwan
| | - Sung-Yu Chu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan, Taiwan
| | - Jimmy Wei-Hwa Tan
- Department of Cardiovascular Surgery, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Wan-Ling Cheng
- Department of Nursing, Chang Gung Memorial Hospital Linkou Main Branch and Chang Gung University, Taoyuan, Taiwan
| | - Pei Ho
- Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore, Singapore
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Duan D, Yang L, Zhang M, Song X, Ren W. Depression and Associated Factors in Chinese Patients With Chronic Kidney Disease Without Dialysis: A Cross-Sectional Study. Front Public Health 2021; 9:605651. [PMID: 34123983 PMCID: PMC8192721 DOI: 10.3389/fpubh.2021.605651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has been a globally public health problem over the past decades. The maintenance of physical and mental health is of importance for patients nowadays. Notably, depression is prevalent and associated with various adverse events in CKD patients without dialysis. Prior studies have reported that pain, negative illness perception, pain, and low self-esteem are potential risk factors of depression, while few studies have comprehensively investigated the mechanisms among these factors and depression among this population. Purpose: This study aims to investigate the prevalence of depression and further explore the factors associated with depression among CKD patients without dialysis in China. Design and Methods: We conducted a cross-sectional study in patients with diagnosed CKD to investigate the prevalence of depression was by the Beck Depression Inventory-II (BDI-II). The data on pain interference, illness perception, and self-esteem were also collected via self-administered questionnaires. A structural equation model (SEM) was used to examine the factors associated with depression. Main Findings: From June to October 2019, we successfully interviewed 334 CKD patients at the outpatient clinics. Their mean age was 45.6 years (ranging from 19 to 74 years), and 48.5% were male. Most respondents were at early CKD stages (77.5% stage 1–3) and the prevalence of depression was 22.2%. We found a moderate association between illness perception and depression, which was modified by self-esteem. Similar but weaker association was found between pain interference and depression. Conclusion and Recommendations: Negative illness perception, low self-esteem and severe pain interference were associated with depression among Chinese CKD patients without dialysis. Future studies are warranted to investigate the underlying mechanism and formulate the intervention strategies for this high-risk population.
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Affiliation(s)
- Difei Duan
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.,West China School of Nursing, Sichuan University, Sichuan, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Min Zhang
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Xiaoli Song
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Wen Ren
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
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Luo L, Chen Q. Effect of CKD-MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study. J Int Med Res 2020; 48:300060519895844. [PMID: 32054360 PMCID: PMC7105727 DOI: 10.1177/0300060519895844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients with different chronic kidney disease–mineral and bone disorder (CKD–MBD) phenotypes. Methods Patients undergoing maintenance hemodialysis (MHD) at our center from 1 July to 31 August 2017 were enrolled. Patients who received hemodialysis for less than 3 months or displayed poor compliance, or those with incomplete clinical data were excluded. QoL was evaluated using the Kidney Disease Quality of Life–Short Form (KDQOL-SF™) 1.3 scale. The influential factors were stratified based on different CKB–MBD phenotypes. Results There were 296 patients enrolled. The serum intact parathyroid hormone (iPTH) concentration was 436.40 ± 490.99 pg/mL, serum calcium (Ca) concentration was 2.14 ±0.27 mmol/L, serum phosphorus (P) concentration was 1.81 ± 0.56 mmol/L, the kidney disease and dialysis-related QoL (KDTA) score was 57.07 ± 10.40, and the SF-36 score was 51.45 ± 17.62. Among patients with different CKD–MBD phenotypes, HRQoL was highest in the group with an iPTH concentration of 150 to 300 pg/mL, serum Ca concentration of <2.10 mmol/L, and serum P concentration of >1.78 mmol/L. Conclusions CKD−MBD phenotypes significantly affected HRQoL. Comprehensive management of serum iPTH, Ca, and P levels is important to improve QoL in patients receiving hemodialysis.
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Affiliation(s)
- Laimin Luo
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China
| | - Qinkai Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China
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Ji A, Pan C, Wang H, Jin Z, Lee JH, Wu Q, Jiang Q, Cui L. Prevalence and Associated Risk Factors of Chronic Kidney Disease in an Elderly Population from Eastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224383. [PMID: 31717585 PMCID: PMC6888049 DOI: 10.3390/ijerph16224383] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022]
Abstract
Chronic kidney disease (CKD) is a global major public health problem. Almost all of previous studies evaluating the prevalence of CKD focused on adults, while studies among the elderly were relatively rare, especially in China. The aim of this study was to investigate the prevalence and associated risk factors of CKD among the elderly in Qingdao, China. This was a cross-sectional study with 38,038 inhabitants (aged 60-109) randomly recruited in Qingdao, China. All participants were required to complete a questionnaire for their demographic characteristics. Blood and urine samples of participants were collected, and the albumin and creatinine levels were measured for albuminuria and estimated glomerular filtration rate (eGFR) assessment. The associations between risk factors and indicators of kidney damage were analyzed by logistic regression. A total of 34,588 inhabitants completed the survey. The overall prevalence of CKD was 11.41% (95% confidence interval (CI): 11.07-11.74%) in the elders from Qingdao in 2016. The prevalence of albuminuria and low eGFR (<60 mL/min per 1·73 m²) were 8.47% (95% CI: 8.17-8.76%) and 3.98% (95% CI: 3.78-4.19%), respectively. Older age, hypertension, diabetes, anemia, hyperuricemia, hyperhomocysteinemia, hypertriglyceridemia, obesity, and LDL-C ≥ 4.1 mmol/L were independently associated with the presence of CKD. In conclusion, common chronic non-communicable diseases, including hypertension, diabetes, obesity, hyperhomocysteinemia, hyperuricemia, and hypertriglyceridemia, were associated with greater prevalence of CKD.
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Affiliation(s)
- Andong Ji
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Chunlei Pan
- Health Center of Liuting Street, Chengyang District, Qingdao 266108, Shandong Province, China; (C.P.); (H.W.)
| | - Hongxia Wang
- Health Center of Liuting Street, Chengyang District, Qingdao 266108, Shandong Province, China; (C.P.); (H.W.)
| | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Joseph H. Lee
- Sergievsky Center, Taub Institute, and Department of Epidemiology, Mailman School of Public Health, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
| | - Qincheng Wu
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Qixiao Jiang
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Lianhua Cui
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
- Correspondence: ; Tel.: +86-532-8299-1503
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