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Yang W, Zeng L, Yang H, Guo F, Zhou D, Cui W, Wu S, Chen C, Zhao J, Wang W, Yang N, Lin H, Li L. Effect of national holidays on health outcomes of patients receiving peritoneal dialysis in a single center over a ten-year period. Ren Fail 2023; 45:2153697. [PMID: 36645059 PMCID: PMC9848312 DOI: 10.1080/0886022x.2022.2153697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND National holidays are associated with high mortality in some diseases, but little is known about patients undergoing peritoneal dialysis (PD). The research aimed to investigate the impact of national holidays on the health outcomes of PD patients. METHODS Over ten years, all episodes of unplanned hospitalization, death, and peritonitis in PD patients were collected in our center. Seven national holidays in China were chosen, and non-holiday days were selected as the control period. The effect of national holidays was observed by comparing the hospitalization, death, and peritonitis rates between holiday and non-holiday groups. RESULTS There were 297 events in all holiday periods and 1247 in non-holiday periods. There is no significant difference in hospitalization rate between holiday and non-holiday groups (32.4% ± 6.4% vs. 29.2% ± 3.4%, p = 0.175). So is the death rate [6.3% (4.8-12.3%) vs.5.0% (4.2-8.9%), p = 0.324] and peritonitis rate [0.19 (0.13-0.53) vs. 0.22 (0.18-0.27), p = 0.445] between the two groups. Significant differences were observed in the distribution of peritonitis causes between the two groups (p = 0.017). The rate of secondary to other infections in the holiday group was significantly higher than in the non-holiday group (25.0 vs. 10.3%, p = 0.015). CONCLUSION Our study suggested no national holiday effect on health outcomes of PD patients based on ten-year data in our center.
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Affiliation(s)
- Wei Yang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Li Zeng
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Huibin Yang
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Fujia Guo
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Dan Zhou
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,College of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Wenting Cui
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shuran Wu
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Cong Chen
- Graduate School, Dalian Medical University, Dalian, China
| | - Jiayao Zhao
- Graduate School, Dalian Medical University, Dalian, China
| | - Weidong Wang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ning Yang
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hongli Lin
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,Hongli Lin Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Longkai Li
- Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China,CONTACT Longkai Li
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Liang Q, Zhao H, Wu B, Niu Q, Lu L, Qiao J, Men C, He Y, Chu X, Zuo L, Wang M. Effect of different dialysis duration on the prognosis of peritoneal dialysis-associated peritonitis: a single-center, retrospective study. Ren Fail 2023; 45:2177496. [PMID: 36786676 PMCID: PMC9930808 DOI: 10.1080/0886022x.2023.2177496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Peritoneal dialysis (PD)-associated peritonitis is a serious complication observed in peritoneal dialysis patients. Herein, we investigated the clinical characteristics and treatment outcomes of PD peritonitis in patients with different PD durations. METHODS All peritonitis episodes from January 2007 to December 2020 at Peking University People's hospital PD center were retrospectively analyzed and divided into the long-dialysis duration (≥60 months, LDD) and short-dialysis duration (<60 months, SDD) groups. Clinical characteristics and outcomes were compared between these groups. The risk factors for treatment failure were analyzed using a logistic regression model. RESULTS During 14 years, 156 patients had 267 peritonitis episodes. There were 83 (31.1%) peritonitis episodes in the LDD group and 184 (68.9%) in the SDD group. No statistical difference was noted in peritonitis causes and the composition of causative pathogens between the two groups. The hospitalization, treatment failure, and transfer-to-hemodialysis rates, and peritonitis-related mortality were significantly higher in the LDD group than in the SDD group (all p < .05). Logistic regression analysis revealed that PD duration was an independent risk factor for PD-associated hospitalization, treatment failure and peritonitis-related death (p < .05). The receiver operating characteristic curve analysis results showed that when the cutoff value of PD duration was 5.5 years, the sensitivity of predicting PD peritonitis treatment failure was 51.1%, specificity was 78.8%, and the area under the curve was 0.679 (95% confidence interval: 0.594-0.765, p < .001). CONCLUSIONS PD duration is an independent risk factor for poor prognosis in PD peritonitis. Careful and active attention should be paid to the prevention of peritonitis in PD patients with long PD duration.
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Affiliation(s)
- Qichen Liang
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Huiping Zhao
- Department of Nephrology, Peking University People’s Hospital, Beijing, China,CONTACT Huiping Zhao Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Bei Wu
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Qingyu Niu
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Lixia Lu
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Jie Qiao
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Chuncui Men
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Yuting He
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Xinxin Chu
- Department of Nephrology, Peking University People’s Hospital, 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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Xie W, Qin L, Huang J, Gu A, Fang W, Jiang N, Yuan J. Clinical risk factors for peritoneal dialysis withdrawal at different dialysis duration. Ren Fail 2023; 45:2274965. [PMID: 37905952 PMCID: PMC11001373 DOI: 10.1080/0886022x.2023.2274965] [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: 07/31/2023] [Accepted: 10/19/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND The duration of patients maintained on peritoneal dialysis (PD) varied. This study investigated the clinical risk factors for PD withdrawal at different dialysis duration. METHODS Patients who initiated PD from 1994 to 2011 were recruited and followed for at least 10 years until 2021. Patients were grouped into four groups according to dialysis duration or time on treatment (TOT) when withdrew PD. RESULTS A cohort of 586 patients were enrolled (mean age of 54.9 years, median dialysis duration or TOT of 47.9 months). Patients who maintained PD for longer than 10 years were younger, with lower prevalence of diabetes, lower serum C-reactive protein (CRP) level and white blood cell (WBC) count, higher serum albumin and pre-albumin level, higher normalized protein catabolic rate (nPCR) and residual kidney function, and more common use of renin-angiotensin system inhibitors (RASi) at baseline (p < 0.05 for all). Peritonitis related death and ultrafiltration failure related HD transferring increased along with time on PD (p < 0.001). Old age, diabetes, low serum albumin, high WBC count, hypertensive nephropathy, and nonuse of RASi were associated with increased risk of non-transplantation related PD withdrawal (p < 0.05 for all). Low baseline CRP and use of RASi were independent predictors for long-term PD maintenance (p < 0.05 for all). CONCLUSIONS Long-term PD patients demonstrated young age, low prevalence of diabetes, better nutrition status, absence of inflammation, better residual kidney function, and higher proportion of RASi usage at baseline. Absence of inflammation and use of RASi were independently associated with long-term PD maintenance.
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Affiliation(s)
- Weizhen Xie
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Li Qin
- Department of Nephrology, School of Medicine, Baoshan Site of Renji Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China
| | - Jiaying Huang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Aiping Gu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wei Fang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Na Jiang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nephrology, Ningbo Hangzhou Bay Hospital, Ningbo, People’s Republic of China
| | - Jiangzi Yuan
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nephrology, School of Medicine, Baoshan Site of Renji Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China
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Li M, Yan J, Zhang H, Wu Q, Wang J, Liu J, Xing C, Zhou Y. Analysis of outcome and factors correlated with maintenance peritoneal dialysis. J Int Med Res 2019; 47:4683-4690. [PMID: 31446816 PMCID: PMC6833380 DOI: 10.1177/0300060519862091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objectives This study aimed to analyze the outcome and factors correlated with maintenance peritoneal dialysis (PD) to provide guidance for improving prognosis, and prolonging the catheterization and survival times of patients on PD with end-stage renal disease. Methods Clinical data of patients at The Third Xiangya Hospital of Central South University were retrospectively analyzed. We compared the survival and technique survival rates of patients, and analyzed relevant factors. Results A total of 510 cases of PD were included. Two hundred thirty-nine patients continued to receive PD treatment, 73 received kidney transplants, 72 transferred to hemodialysis, and 126 died. The main reasons of death were cardiovascular (27.00%) and cerebrovascular diseases (23.80%). The main reasons of transfer to HD were peritonitis and inadequate dialysis. The survival rates at 1, 2, 3, 5, and 7 years were 95.75%, 90.34%, 82.35%, 66.21%, and 54.32%, respectively. The technique survival rates at 1, 2, 3, 5, and 7 years were 93.22%, 86.76%, 77.91%, 63.16%, and 47.67%, respectively. Female sex and older age were protective factors that affected patients’ withdrawal from PD and survival time. Conclusions Death is the primary reason for withdrawal from PD. Female sex and older age affect patients’ withdrawal from PD and survival.
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Affiliation(s)
- Min Li
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jin Yan
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Hao Zhang
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Qiongying Wu
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jianwen Wang
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jishi Liu
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Chengling Xing
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Yuqiong Zhou
- Department of Nephrology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
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Laurent S, Boutouyrie P, Cunha PG, Lacolley P, Nilsson PM. Concept of Extremes in Vascular Aging. Hypertension 2019; 74:218-228. [DOI: 10.1161/hypertensionaha.119.12655] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Stephane Laurent
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pierre Boutouyrie
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pedro Guimarães Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Serviço de Medicina Interna do Hospital da Senhora da Oliveira, Guimarães, Portugal (P.G.C.)
- Life and Health Science Research Institute, School of Medicine, University of Minho, Guimarães, Portugal (P.G.C.)
| | | | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden (P.M.N.)
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