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Xu X, Yang Z, Li S, Pei H, Zhao J, Zhang Y, Xiong Z, Liao Y, Li Y, Lin Q, Hu W, Li Y, Zheng Z, Duan L, Fu G, Guo S, Zhang B, Yu R, Sun F, Ma X, Hao L, Liu G, Zhao Z, Xiao J, Shen Y, Zhang Y, Du X, Ji T, Wang C, Deng L, Yue Y, Chen S, Ma Z, Li Y, Zuo L, Zhao H, Zhang X, Wang X, Liu Y, Gao X, Chen X, Li H, Du S, Zhao C, Xu Z, Zhang L, Chen H, Li L, Wang L, Yan Y, Ma Y, Wei Y, Zhou J, Li Y, Zheng Y, Wang J, Zhao MH, Dong J. Cut-off values of haemoglobin and clinical outcomes in incident peritoneal dialysis: the PDTAP study. Nephrol Dial Transplant 2024; 39:251-263. [PMID: 37458807 DOI: 10.1093/ndt/gfad166] [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: 02/20/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND To explore the cut-off values of haemoglobin (Hb) on adverse clinical outcomes in incident peritoneal dialysis (PD) patients based on a national-level database. METHODS The observational cohort study was from the Peritoneal Dialysis Telemedicine-assisted Platform (PDTAP) dataset. The primary outcomes were all-cause mortality, major adverse cardiovascular events (MACE) and modified MACE (MACE+). The secondary outcomes were the occurrences of hospitalization, first-episode peritonitis and permanent transfer to haemodialysis (HD). RESULTS A total of 2591 PD patients were enrolled between June 2016 and April 2019 and followed up until December 2020. Baseline and time-averaged Hb <100 g/l were associated with all-cause mortality, MACE, MACE+ and hospitalizations. After multivariable adjustments, only time-averaged Hb <100 g/l significantly predicted a higher risk for all-cause mortality {hazard ratio [HR] 1.83 [95% confidence interval (CI) 1.19-281], P = .006}, MACE [HR 1.99 (95% CI 1.16-3.40), P = .012] and MACE+ [HR 1.77 (95% CI 1.15-2.73), P = .010] in the total cohort. No associations between Hb and hospitalizations, transfer to HD and first-episode peritonitis were observed. Among patients with Hb ≥100 g/l at baseline, younger age, female, use of iron supplementation, lower values of serum albumin and renal Kt/V independently predicted the incidence of Hb <100 g/l during the follow-up. CONCLUSION This study provided real-world evidence on the cut-off value of Hb for predicting poorer outcomes through a nation-level prospective PD cohort.
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Affiliation(s)
- Xiao Xu
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Zhikai Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Shaomei Li
- Renal Division, Department of Medicine, Second Hospital of Hebei Medical University, Hebei, China
| | - Huayi Pei
- Renal Division, Department of Medicine, Second Hospital of Hebei Medical University, Hebei, China
| | - Jinghong Zhao
- Department of Nephrology, Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ying Zhang
- Department of Nephrology, Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zibo Xiong
- Renal Division, Department of Medicine, Peking University Shenzhen Hospital, Guangdong, China
| | - Yumei Liao
- Renal Division, Department of Medicine, Peking University Shenzhen Hospital, Guangdong, China
| | - Ying Li
- Renal Division, Department of Medicine, Third Hospital of Hebei Medical University; Hebei, China
| | - Qiongzhen Lin
- Renal Division, Department of Medicine, Third Hospital of Hebei Medical University; Hebei, China
| | - Wenbo Hu
- Renal Division, Department of Medicine, People's Hospital of Qinghai Province, Qinghai, China
| | - Yulin Li
- Renal Division, Department of Medicine, People's Hospital of Qinghai Province, Qinghai, China
| | - Zhaoxia Zheng
- Renal Division, Department of Medicine, Handan Central Hospital, Hebei, China
| | - Liping Duan
- Renal Division, Department of Medicine, Handan Central Hospital, Hebei, China
| | - Gang Fu
- Renal Division, Department of Medicine, Peking Haidian Hospital, Beijing, China
| | - Shanshan Guo
- Renal Division, Department of Medicine, Peking Haidian Hospital, Beijing, China
| | - Beiru Zhang
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Rui Yu
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fuyun Sun
- Renal Division, Department of Medicine, Cangzhou Central Hospital, Hebei, China
| | - Xiaoying Ma
- Renal Division, Department of Medicine, Cangzhou Central Hospital, Hebei, China
| | - Li Hao
- Renal Division, Department of Medicine, Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Guiling Liu
- Renal Division, Department of Medicine, Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Zhanzheng Zhao
- Renal Division, Department of Medicine, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Jing Xiao
- Renal Division, Department of Medicine, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Yulan Shen
- Renal Division, Department of Medicine, Beijing Miyun District Hospital, Beijing, China
| | - Yong Zhang
- Renal Division, Department of Medicine, Beijing Miyun District Hospital, Beijing, China
| | - Xuanyi Du
- Renal Division, Department of Medicine, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Tianrong Ji
- Renal Division, Department of Medicine, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Caili Wang
- Renal Division, Department of Medicine, First Affiliated Hospital of BaoTou Medical College, Neimenggu, China
| | - Lirong Deng
- Renal Division, Department of Medicine, First Affiliated Hospital of BaoTou Medical College, Neimenggu, China
| | - Yingli Yue
- Renal Division, Department of Medicine, People's Hospital of Langfang, Hebei, China
| | - Shanshan Chen
- Renal Division, Department of Medicine, People's Hospital of Langfang, Hebei, China
| | - Zhigang Ma
- Renal Division, Department of Medicine, People's Hospital of Gansu, Gansu, China
| | - Yingping Li
- Renal Division, Department of Medicine, People's Hospital of Gansu, Gansu, China
| | - Li Zuo
- Renal Division, Department of Medicine, Peking University People's Hospital, Beijing, China
| | - Huiping Zhao
- Renal Division, Department of Medicine, Peking University People's Hospital, Beijing, China
| | - Xianchao Zhang
- Renal Division, Department of Medicine, Pingdingshan First People's Hospital, Henan, China
| | - Xuejian Wang
- Renal Division, Department of Medicine, Pingdingshan First People's Hospital, Henan, China
| | - Yirong Liu
- Renal Division, Department of Medicine, First People's Hospital of Xining, Qinghai, China
| | - Xinying Gao
- Renal Division, Department of Medicine, First People's Hospital of Xining, Qinghai, China
| | - Xiaoli Chen
- Renal Division, Department of Medicine, Taiyuan Central Hospital, Shanxi, China
| | - Hongyi Li
- Renal Division, Department of Medicine, Taiyuan Central Hospital, Shanxi, China
| | - Shutong Du
- Renal Division, Department of Medicine, Cangzhou People's Hospital, Hebei, China
| | - Cui Zhao
- Renal Division, Department of Medicine, Cangzhou People's Hospital, Hebei, China
| | - Zhonggao Xu
- Renal Division, Department of Medicine, First Hospital of Jilin University, Jilin, China
| | - Li Zhang
- Renal Division, Department of Medicine, First Hospital of Jilin University, Jilin, China
| | - Hongyu Chen
- Renal Division, Department of Medicine, People's Hospital of Chuxiong Yi Autonomous Prefecture, Yunnan, China
| | - Li Li
- Renal Division, Department of Medicine, People's Hospital of Chuxiong Yi Autonomous Prefecture, Yunnan, China
| | - Lihua Wang
- Renal Division, Department of Medicine, Second Hospital of Shanxi Medical University, Shanxi, China
| | - Yan Yan
- Renal Division, Department of Medicine, Second Hospital of Shanxi Medical University, Shanxi, China
| | - Yingchun Ma
- Renal Division, Department of Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing, China
| | - Yuanyuan Wei
- Renal Division, Department of Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing, China
| | - Jingwei Zhou
- Renal Division, Department of Medicine, Beijing Dongzhimen Hospital, Beijing, China
| | - Yan Li
- Renal Division, Department of Medicine, Beijing Dongzhimen Hospital, Beijing, China
| | - Yingdong Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
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Yang Z, Hao J, Abi N, Zhang Y, Xu Y, Ma T, Dong J. Self-reported impact of the exit-site on usual activities and its association with clinical outcomes in patients undergoing peritoneal dialysis. J Nephrol 2022; 35:2151-2153. [PMID: 35986862 DOI: 10.1007/s40620-022-01368-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Zhikai Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Jiayu Hao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Nanzha Abi
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Yuhui Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Ying Xu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Tiantian Ma
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,Institute of Nephrology, Peking University, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China.,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China. .,Institute of Nephrology, Peking University, Beijing, People's Republic of China. .,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, People's Republic of China. .,Key Laboratory of Renal Disease, Ministry of Education, Beijing, People's Republic of China.
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Biebuyck GKM, Neradova A, de Fijter CWH, Jakulj L. Impact of telehealth interventions added to peritoneal dialysis-care: a systematic review. BMC Nephrol 2022; 23:292. [PMID: 35999512 PMCID: PMC9396599 DOI: 10.1186/s12882-022-02869-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background Telehealth could potentially increase independency and autonomy of patients treated with peritoneal dialysis (PD). Moreover, it might improve clinical and economic outcomes. The demand for telehealth modalities accelerated significantly in the recent COVID-19 pandemic. We evaluated current literature on the impact of telehealth interventions added to PD-care on quality of life (QoL), clinical outcomes and cost-effectiveness. Methods An electronic search was performed in Embase, PubMed and the Cochrane Library in order to find studies investigating associations between telehealth interventions and: i. QoL, including patient satisfaction; ii. Standardized Outcomes in Nephrology (SONG)-PD clinical outcomes: PD-related infections, mortality, cardiovascular disease and transfer to hemodialysis (HD); iii. Cost-effectiveness. Studies investigating hospitalizations and healthcare resource utilization were also included as secondary outcomes. Due to the heterogeneity of studies, a meta-analysis could not be performed. Results Sixteen reports (N = 10,373) were included. Studies varied in terms of: sample size; design; risk of bias, telehealth-intervention and duration; follow-up time; outcomes and assessment tools. Remote patient monitoring (RPM) was the most frequently studied intervention (11 reports; N = 4982). Telehealth interventions added to PD-care, and RPM in particular, might reduce transfer to HD, hospitalization rate and length, as well as the number of in-person visits. It may also improve patient satisfaction. Conclusion There is a need for adequately powered prospective studies to determine which telehealth-modalities might confer clinical and economic benefit to the PD-community. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02869-6.
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Affiliation(s)
- Geertje K M Biebuyck
- Dianet Dialysis Center/Division of Nephrology, Department of Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands. .,Department of Medicine, Division of Nephrology, Amsterdam UMC location University of Amsterdam, Internal Medicine and Nephrology, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands.
| | - Aegida Neradova
- Dianet Dialysis Center/Division of Nephrology, Department of Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands.,Department of Medicine, Division of Nephrology, Amsterdam UMC location University of Amsterdam, Internal Medicine and Nephrology, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands
| | | | - Lily Jakulj
- Dianet Dialysis Center/Division of Nephrology, Department of Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands.,Department of Medicine, Division of Nephrology, Amsterdam UMC location University of Amsterdam, Internal Medicine and Nephrology, Meibergdreef 9, AZ, 1105, Amsterdam, the Netherlands
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