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Thammathiwat T, Tatiyanupanwong S, Parinyasiri U, Wannigama DL, Chatsuwan T, Kanjanabuch T. Peritoneal dialysis-associated peritonitis from pauci-septated mold: Life-threatening but curable. Med Mycol Case Rep 2023; 42:100612. [PMID: 37854361 PMCID: PMC10579521 DOI: 10.1016/j.mmcr.2023.100612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/20/2023] Open
Abstract
Two cases of PD-associated peritonitis due to Cunninghamella (C. bertholletiae and C. guizhouensis) were reported here with favorable outcomes, albeit presenting with septicemia. Both patients presented with classic features of bacterial peritonitis, cloudy effluent with a neutrophil predominance, followed by fever and septicemia/septic shock. The pathogen species were confirmed and verified by molecular phylogeny using universal and specific fungal primers. All isolations were susceptible/intermediately susceptible to amphotericin B but resistant to other antifungal agents, including triazoles, caspofungin, and terbinafine. Both cases were successfully treated with timely PD catheter removal and antifungal medications for 2-4 weeks.
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Affiliation(s)
- Theerachai Thammathiwat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Sajja Tatiyanupanwong
- Division of Nephrology, Department of Internal Medicine, Chaiyaphum Hospital, Thailand
| | - Uraiwan Parinyasiri
- Kidney Diseases Clinic, Department of Internal Medicine, Songkhla Hospital, Songkhla, Thailand
| | - Dhammika Leshan Wannigama
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Boongird S, Phannajit J, Kanjanabuch T, Chuengsaman P, Dandecha P, Halue G, Lorvinitnun P, Boonyakrai C, Treamtrakanpon W, Tatiyanupanwong S, Lounseng N, Perl J, Johnson DW, Pecoits-Filho R, Sritippayawan S, Tungsanga K, Kantachuvesiri S, Ophascharoensuk V. Enhancing healthcare quality and outcomes for peritoneal dialysis patients in Thailand: An evaluation of key performance indicators and PDOPPS cohort representativeness. Nephrology (Carlton) 2023; 28 Suppl 1:14-23. [PMID: 37534842 DOI: 10.1111/nep.14204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 08/04/2023]
Abstract
AIM To assess whether the peritoneal dialysis (PD) centres included in the Peritoneal Dialysis Outcomes and Practise Patterns Study (PDOPPS) in Thailand are representative of other PD centres in the country, based on 8 key performance indicators (KPIs 1-8). METHODS A retrospective analysis was conducted comparing PD-related clinical outcomes between PD centres included in the PDOPPS (the PDOPPS group) and those not included (the non-PDOPPS group) from January 2018 to December 2019. Logistic regression analysis was used to identify predictors associated with achieving the target KPIs. RESULTS Of 181 PD centres, 22 (12%) were included in the PDOPPS. PD centres in the PDOPPS group were larger and tended to serve more PD patients than those in the non-PDOPPS group. However, the process and outcome KPIs (KPIs 1-8) were comparable between the 2 groups. Large hospitals (≥120 beds), providing care to ≥100 PD cases and having experience for >10 years were independent predictors of achieving the peritonitis rate target of <0.5 episodes/year. Most PD centres in Thailand showed weaknesses in off-target haemoglobin levels and culture-negative peritonitis rate. CONCLUSIONS The PD centres included in Thai PDOPPS were found to be representative of other PD centres in Thailand in terms of clinical outcomes. Thus, Thai PDOPPS findings may apply to the broader PD population in Thailand.
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Affiliation(s)
- Sarinya Boongird
- Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jeerath Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Piyatida Chuengsaman
- Banphaeo-Charoenkrung Peritoneal Dialysis Centre, Banphaeo Dialysis Group, Banphaeo Hospital, Bangkok, Thailand
| | - Phongsak Dandecha
- Division of Nephrology, Department of Internal Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Guttiga Halue
- Department of Medicine, Phayao Hospital, Phayao, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Chanchana Boonyakrai
- Department of Medicine, King Taksin Memorial Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | | | - Sajja Tatiyanupanwong
- Division of Nephrology, Department of Internal Medicine, Chaiyaphum Hospital, Chaiyaphum, Thailand
| | | | - Jeffrey Perl
- Division of Nephrology and Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - David W Johnson
- Department of Kidney and Transplant Services, Division of Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Australasian Kidney Trials Network, Centre of Health Services Research, University of Queensland, Brisbane, Australia
- Centre of Kidney Disease Research, Translational Research Institute, Brisbane, Australia
| | - Roberto Pecoits-Filho
- Pontifical Catholic University of Parana, Curitiba, Brazil
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Suchai Sritippayawan
- Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Surasak Kantachuvesiri
- Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Vuddhidej Ophascharoensuk
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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3
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Halue G, Tharapanich H, Phannajit J, Kanjanabuch T, Banjongjit A, Lorvinitnun P, Sritippayawan S, Sopassathit W, Poonvivatchaikarn U, Buranaosot S, Somboonsilp W, Wongtrakul P, Boonyakrai C, Narenpitak S, Tatiyanupanwong S, Saikong W, Uppamai S, Panyatong S, Chieochanthanakij R, Lounseng N, Wongpiang A, Treamtrakanpon W, Rattanasoonton P, Lukrat N, Songviriyavithaya P, Parinyasiri U, Rojsanga P, Kanjanabuch P, Puapatanakul P, Pongpirul K, Johnson DW, Perl J, Pecoits-Filho R, Ophascharoensuk V, Tungsanga K. Constipation and clinical outcomes in peritoneal dialysis: Results from Thailand PDOPPS. Nephrology (Carlton) 2023; 28 Suppl 1:35-47. [PMID: 37534844 DOI: 10.1111/nep.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are widely recognized as valuable predictors of clinical outcomes in peritoneal dialysis (PD). Our study aimed to explore the connections between patient-reported constipation and clinical outcomes. METHODS We assessed constipation in patients across 22 facilities participating in the Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) from 2014 to 2017. Constipation diagnosis utilized objective assessment tools such as the Bristol stool form scale (BSFS) and a self-reported questionnaire known as the constipation severity score (CSS). The BSFS is a 7-level scale that visually inspects feces based on texture and morphology, while the CSS measures constipation duration and severity using a 5-point Likert scale for various factors. We employed Cox proportional hazards model regression to determine the associations between constipation and clinical outcomes, including mortality, hemodialysis (HD) transfer and peritonitis. RESULTS Among 975 randomly selected PD patients from 22 facilities, 845 provided written informed consent, and 729 completed CSS questionnaire. Constipation was prevalent in the PD population (13%), particularly among older patients, those who were caregiver dependent, had diabetes and poorer nutritional status (indicated by lower time-averaged serum albumin, potassium, creatinine and phosphate concentrations). Twenty-seven percent of which experiencing symptoms of constipation for over a year. Notably, self-reported constipation at baseline was significantly associated with a shorter time to first peritonitis and higher rates of peritonitis and death. However, no significant association was found between constipation and HD transfer after adjusting for various factors, including age, gender, PD vintage, comorbidities, shared frailty by study sites and serum albumin. CONCLUSION Patient-reported constipation independently correlated with increased risks of peritonitis and all-cause mortality, though no such correlation was observed with HD transfer. These findings underscore the need for further investigation to identify effective interventions for constipation in PD patients.
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Affiliation(s)
- Guttiga Halue
- Department of Medicine, Phayao Hospital, Phayao, Thailand
| | | | - Jeerath Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Suchai Sritippayawan
- Division of Nephrology, Department of Internal Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Wichai Sopassathit
- Division of Nephrology, Department of Internal Medicine, Pranangklao Hospital, Nonthaburi, Thailand
| | | | | | - Wanida Somboonsilp
- Division of Nephrology, Department of Internal Medicine, Chaoprayayomraj Hospital, Suphanburi, Thailand
| | - Pimpong Wongtrakul
- Division of Nephrology, Department of Internal Medicine, Chaoprayayomraj Hospital, Suphanburi, Thailand
| | - Chanchana Boonyakrai
- Department of Medicine, King Taksin Memorial Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Surapong Narenpitak
- Renal Unit, Department of Internal Medicine, Udonthani Hospital, Udon Thani, Thailand
| | - Sajja Tatiyanupanwong
- Division of Nephrology, Department of Internal Medicine, Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Wadsamon Saikong
- CAPD Clinic, Department of Internal Medicine, Mukdahan Hospital, Mukdahan, Thailand
| | - Sriphrae Uppamai
- Department of Internal Medicine, Sukhothai Hospital, Sukhothai, Thailand
| | - Setthapon Panyatong
- Kidney Center, Department of Internal Medicine, Nakornping Hospital, Chiang Mai, Thailand
| | | | | | | | | | | | - Narumon Lukrat
- Medical Staff Organization, KhueangNai Hospital, Ubon Ratchatani, Thailand
| | | | - Uraiwan Parinyasiri
- Kidney diseases clinic, Department of internal medicines, Songkhla Hospital, Songkhla, Thailand
| | - Piyarat Rojsanga
- Renal Unit, Department of Internal Medicine, Udonthani Hospital, Udon Thani, Thailand
| | - Patnarin Kanjanabuch
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Krit Pongpirul
- Department of Preventive and Social Medicine and Center of Excellence in Preventive & Integrative Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - David W Johnson
- Department of Kidney and Transplant Services, Division of Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Queensland, Australia
| | - Jeffrey Perl
- St. Michael's Hospital, Toronto, Ontario, Canada
| | - Roberto Pecoits-Filho
- Pontifical Catholic University, of Parana, Curitiba, Brazil
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Vuddhidej Ophascharoensuk
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Panaput T, Domrongkitchaiporn S, Thinkhamrop B, Sirivongs D, Praderm L, Anukulanantachai J, Kanokkantapong C, Tungkasereerak P, Pongskul C, Anutrakulchai S, Keobounma T, Narenpitak S, Intarawongchot P, Suwattanasin A, Tatiyanupanwong S, Niwattayakul K. Early as compared to late initiation of twice-weekly hemodialysis and short-term survival among end-stage renal disease patients. Hemodial Int 2022; 26:509-518. [PMID: 35726582 DOI: 10.1111/hdi.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/21/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The impact of timing of hemodialysis (HD) for end-stage renal disease (ESRD) patients treated with twice-weekly HD remains unclear. We aimed to determine the effects of late initiation of HD on short-term mortality and hospitalization. METHODS A multicenter cohort study was conducted in 11 HD centers in Northeastern Thailand (HEmodialysis Network of the NorthEastern Thailand study group). We recruited adult ESRD patients who were treated with twice-weekly HD for more than 3 months and had data on eGFR at HD initiation. Clinical and laboratory values at the time of recruitment were recorded. Late and early (eGFR at start <5 and >5 ml/min/1.73 m2 ) initiations were defined. Outcomes were disease-related death (excluding any accidental deaths) and first hospitalization. Data analysis was performed by multivariable cox-regression analysis. FINDINGS A total of 407 patients who had data on eGFR at HD initiation (303 in late group and 104 in early group) were included for analysis. There were 56.8% male with a mean age of 55 years. During the 15.1 months of follow-up, there were 27 (6.6%) disease-related deaths. The 1-year survival rate was similar among late and early initiation groups. The incidence density of first hospitalization in the late group was significantly lower than those in the early group (HR adjusted, 0.63; 95% CI, 0.40-0.99, p = 0.047). Among 303 patients who were in the late start group, patients with diabetes had a higher mortality rate (HR, 3.49; 95% CI, 1.40-8.70, p = 0.007) when compared to non-diabetic patients. DISCUSSION Early initiation of HD at eGFR >5 ml/min/1.73 m2 had no short-term survival benefit compared to the late group in ESRD patients treated with twice-weekly HD for at least 3 months in a resource-limited setting. A survival benefit from an early start of HD was found among diabetic patients.
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Affiliation(s)
| | | | | | - Dhavee Sirivongs
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | | | | | | | | | - Cholatip Pongskul
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
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5
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Parapiboon W, Sangsuk J, Nopsopon T, Pitsawong W, Tatiyanupanwong S, Kanjanabuch T, Johnson DW. Randomized Study of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Temporary Hemodialysis in Patients Transitioning to Kidney Failure. Kidney Int Rep 2022; 7:1866-1877. [PMID: 35967116 PMCID: PMC9366533 DOI: 10.1016/j.ekir.2022.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 10/27/2022] Open
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6
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Kanjanabuch T, Nopsopon T, Chatsuwan T, Purisinsith S, Johnson DW, Udomsantisuk N, Halue G, Lorvinitnun P, Puapatanakul P, Pongpirul K, Poonvivatchaikarn U, Tatiyanupanwong S, Chowpontong S, Chieochanthanakij R, Thamvichitkul O, Treamtrakanpon W, Saikong W, Parinyasiri U, Chuengsaman P, Dandecha P, Perl J, Tungsanga K, Eiam-Ong S, Sritippayawan S, Kantachuvesiri S. Predictors and outcomes of peritoneal dialysis-related infections due to filamentous molds (MycoPDICS). PLoS One 2022; 17:e0268823. [PMID: 35609049 PMCID: PMC9129032 DOI: 10.1371/journal.pone.0268823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/09/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction We sought to evaluate the predictors and outcomes of mold peritonitis in patients with peritoneal dialysis (PD). Methods This cohort study included PD patients from the MycoPDICS database who had fungal peritonitis between July 2015-June 2020. Patient outcomes were analyzed by Kaplan Meier curves and the Log-rank test. Multivariable Cox proportional hazards model regression was used to estimating associations between fungal types and patients’ outcomes. Results The study included 304 fungal peritonitis episodes (yeasts n = 129, hyaline molds n = 122, non-hyaline molds n = 44, and mixed fungi n = 9) in 303 patients. Fungal infections were common during the wet season (p <0.001). Mold peritonitis was significantly more frequent in patients with higher hemoglobin levels, presentations with catheter problems, and positive galactomannan (a fungal cell wall component) tests. Patient survival rates were lowest for non-hyaline mold peritonitis. A higher hazard of death was significantly associated with leaving the catheter in-situ (adjusted hazard ratio [HR] = 6.15, 95%confidence interval [CI]: 2.86–13.23) or delaying catheter removal after the diagnosis of fungal peritonitis (HR = 1.56, 95%CI: 1.00–2.44), as well as not receiving antifungal treatment (HR = 2.23, 95%CI: 1.25–4.01) or receiving it for less than 2 weeks (HR = 2.13, 95%CI: 1.33–3.43). Each additional day of antifungal therapy beyond the minimum 14-day duration was associated with a 2% lower risk of death (HR = 0.98, 95%CI: 0.95–0.999). Conclusion Non-hyaline-mold peritonitis had worse survival. Longer duration and higher daily dosage of antifungal treatment were associated with better survival. Deviations from the 2016 ISPD Peritonitis Guideline recommendations concerning treatment duration and catheter removal timing were independently associated with higher mortality.
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Affiliation(s)
- Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Bangkok, Thailand
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Dialysis Policy and Practice Program (Di3P), Bangkok, Thailand
- * E-mail:
| | | | - Tanittha Chatsuwan
- Department of Microbiology, Bangkok, Thailand
- Faculty of Medicine, Antimicrobial Resistance and Stewardship Research Unit, Chulalongkorn University, Bangkok, Thailand
| | | | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
| | | | - Guttiga Halue
- Department of Medicine, Phayao Hospital, Phayao, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Bangkok, Thailand
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Krit Pongpirul
- Department of Preventive and Social Medicine, Bangkok, Thailand
| | | | - Sajja Tatiyanupanwong
- Nephrology Division, Department of Internal Medicine, Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Saowalak Chowpontong
- Division of Nephrology, Department of Medicine, Phra Nakhon Si Ayutthaya Hospital, Phra Nakhon Si Ayutthaya, Thailand
| | | | | | | | - Wadsamon Saikong
- Continuous Ambulatory Peritoneal Dialysis Clinic, Mukdahan Hospital, Mukdahan, Thailand
| | - Uraiwan Parinyasiri
- Kidney diseases clinic, Department of internal medicines, Songkhla Hospital, Songkhla, Thailand
| | - Piyatida Chuengsaman
- Banphaeo Dialysis Group (Bangkok), Banphaeo Hospital (Public organization), Bangkok, Thailand
| | - Phongsak Dandecha
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Bangkok, Thailand
| | - Suchai Sritippayawan
- Division Nephrology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Surasak Kantachuvesiri
- Division Nephrology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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7
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Cheawchanwattana A, Kanjanabuch T, Puapatanakul P, Narenpitak S, Halue G, Tungsanga K, Tatiyanupanwong S, Lorvinitnun P, Sritippayawan S, Chieochanthanakij R, Tungsanga S, Thamcharoen N, Krit Pongpirul MD, Shen JI, Johnson DW, Davies SJ, Finkelstein FO, Perl J, Robinson B. Spiritual Well-Being and Its Relationship with Patient Characteristics and Other Patient-Reported Outcomes in Peritoneal Dialysis Patients: Findings from the PDOPPS. Nephrology (Carlton) 2022; 27:621-631. [PMID: 35238113 DOI: 10.1111/nep.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/19/2022] [Accepted: 02/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spiritual well-being (SWB), an individual's understanding of the meaning and purpose of life, may help patients with chronic or terminal illnesses cope with their disease. This study aimed to assess SWB in patients on peritoneal dialysis (PD), as well as its relationship with patient characteristics and patient-reported outcomes (PRO). METHODS The data were obtained from questionnaires that formed part of the PD Outcomes and Practice Patterns Study (PDOPPS). Measures used in this study were SWB scores derived from the WHO Quality of Life, Spirituality, Religiousness, and Personal Beliefs (WHOQOL-SRPB) tool including 32 items from 8 facets; physical (PCS) and mental component summary (MCS) scores of the 12-Item Short-Form Health Survey (SF-12), Center of Epidemiologic Studies Depression Scale-10 (CES-D-10) scores, burden of kidney disease scores, and functional status scores. RESULTS Overall, 529 out of 848 participants (62%) completely responded to the questionnaires and were included in the analysis. Over two-thirds of PD patients (70%) had moderate or higher SWB scores. The SWB scores were significantly lower in patients with age > 65 years and unemployed status. SWB scores positively correlated with higher PCS, MCS, burden of kidney disease scores, and functional status scores, while negatively correlated with depression scores by CES-D-10 scale. Patients who reported significant depressive symptoms (CES-D-10 score ≥ 10) had significantly lower SWB scores. CONCLUSION Better SWB was significantly associated with better health-related QOL (HRQOL) and the absence of depressive symptoms. SWB may be an essential consideration in the delivery of high-quality PD.
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Affiliation(s)
- Areewan Cheawchanwattana
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Dialysis Policy & Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Dialysis Policy & Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Surapong Narenpitak
- Renal unit, Department of Internal Medicine of Udonthani Hospital, Udon Thani, Thailand
| | - Guttiga Halue
- Department of Medicine of Phayao Hospital, Phayao, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sajja Tatiyanupanwong
- Nephrology Division, Department of Internal Medicine, Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine of Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | | | | | - Somkanya Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Natanong Thamcharoen
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M D Krit Pongpirul
- Dialysis Policy & Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of International Health and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Jenny I Shen
- Division of Nephrology and Hypertension, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Simon J Davies
- Faculty of Medicine and Health Sciences, Keele University, Keele, UK
| | - Fredric O Finkelstein
- Renal Research Institute, Hospital of St. Raphael, Yale University, New Haven, Connecticut, USA
| | - Jeffrey Perl
- Division of Nephrology and Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
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8
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Tungsanga S, Tatiyanupanwong S, Faisatjatham S, Kleebchaiyaphum C, Towannang P, Tiankanon K, Puapatanakul P, Kanjanabuch T, Tungsanga K. POS-719 A NOVEL GUIDE WIRE-FREE TENCKHOFF'S CATHETER INSERTION TECHNIQUE (SAJJA'S TECHNIQUE) FOR INITIATION OF PERITONEAL DIALYSIS: A PROSPECTIVE COHORT. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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9
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TREAMTRAKANPON W, Kanjanabuch T, Nopsopon T, Chuengsaman P, Dandecha P, Boongird S, Khositrangsikun K, Wongluechai L, Tatiyanupanwong S, Puapatanakul P, Sritippayawan S, Jaturapisanukul S, Narenpitak S, Siribamrungwong M, Kingwatanakul P. POS-032 BARRIER TO AND CONSTRAINTS OF ACUTE PERITONEAL DIALYSIS IN ACUTE KIDNEY INJURY: A NATIONAL SURVEY. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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10
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Kanjanabuch T, Puapatanakul P, Halue G, Lorvinitnun P, Tangjittrong K, Pongpirul K, Narenpitak S, Boonyakrai C, Tatiyanupanwong S, Chieochanthanakij R, Treamtrakanpon W, Parinyasiri U, Lounseng N, Songviriyavithaya P, Sritippayawan S, Perl J, Pecoits-Filho R, Robinson B, Davies SJ, Johnson DW, Tungsanga K. Implementation of PDOPPS in a middle-income country: Early lessons from Thailand. Perit Dial Int 2021; 42:83-91. [PMID: 33706584 DOI: 10.1177/0896860821993950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Despite the implementation of a 'Peritoneal Dialysis (PD) First' policy in Thailand since 2008, nationwide PD practices and patients' outcomes have rarely been reported. METHODS As part of the multinational PD Outcomes and Practice Patterns Study (PDOPPS), PD patients from 22 PD centres from different geographic regions, sizes and affiliations, representing Thailand PD facilities, have been enrolled starting in May 2016. Demographic, clinical and laboratory data and patients' outcomes were prospectively collected and analysed. RESULTS The pilot and implementation phases demonstrated excellent concordance between study data and validation data collected at enrolment. In the implementation phase, 848 PD patients (including 262 (31%) incident PD patients) were randomly sampled from 5090 patients in participating centres. Almost all participants (95%) performed continuous ambulatory PD (CAPD), and a high proportion had hypoalbuminemia (67%, serum albumin < 3.5 g/dL), anaemia (42%, haemoglobin <10 g/dL) and hypokalaemia (37%, serum potassium < 3.5 mmol/L). The peritonitis rate was 0.40 episodes/year, but the culture-negative rate was high (0.13 episodes/year, 28% of total episodes). The patients from PD clinics located in Bangkok metropolitan region had higher socio-economic status, more optimal nutritional markers, blood chemistries, haemoglobin level and lower peritonitis rates compared to the provincial regions, emphasizing the centre effect on key success factors in PD. CONCLUSIONS Participation in the PDOPPS helps unveil the critical barriers to improving outcomes of PD patients in Thailand, including a high prevalence of hypokalaemia, anaemia, poor nutritional status and culture-negative peritonitis. These factors should be acted upon to formulate solutions and implement quality improvement on a national level.
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Affiliation(s)
- Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | | | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Kittisak Tangjittrong
- Division of Nephrology, Department of Internal Medicine, Phranangklao Hospital, Nonthaburi, Thailand
| | - Krit Pongpirul
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Chanchana Boonyakrai
- Department of Medicine, Taksin Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Sajja Tatiyanupanwong
- Division of Nephrology, Department of Internal Medicine, Chaiyaphum Hospital, Thailand
| | | | | | - Uraiwan Parinyasiri
- Kidney Diseases Clinic, Department of Internal Medicines, Songkhla Hospital, Thailand
| | | | | | - Suchai Sritippayawan
- Division of Nephrology, Department of Internal Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Jeffrey Perl
- Division of Nephrology, St. Michael's Hospital and the Keenan Research Center in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Roberto Pecoits-Filho
- Pontifical Catholic University of Paraná, Curitiba, Brazil.,Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Simon J Davies
- Faculty of Medicine and Health Sciences, Keele University, Keele, UK
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australasian Kidney Trials Network, Centre for Kidney Disease Research, University of Queensland, Brisbane, QLD, Australia.,Department of Kidney Research, Translational Research Institute, Woolloongabba, Australia
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11
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Treamtrakanpon W, Kanjanabuch T, Nopsopon T, Chuengsaman P, Dandecha P, Boongird S, Khositrangsikun K, Wongluechai L, Tatiyanupanwong S, Puapatanakul P, Srisawat N, Eiam-Ong S, Johnson DW, Sritippayawan S, Kantachuvesiri S. Barriers to and constraints of acute peritoneal dialysis in acute kidney injury: A nationwide survey. Perit Dial Int 2021; 42:92-95. [PMID: 33588659 DOI: 10.1177/0896860821989878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This national survey of barriers to and constraints of acute peritoneal dialysis (aPD) in acute kidney injury (AKI) was performed by distributing an online questionnaire to all medical directors of public dialysis units registered with the Nephrology Society of Thailand during September-November 2019. One hundred and thirteen adult facilities responded to the survey covering 75 from 76 provinces (99%) of Thailand. aPD was performed in 66 centres (58%). In facilities where aPD practice was available, the utilization rate was relatively low (<10 cases/year) and limited to specific conditions, including HIV seropositive patients, previous receiving dialysis education and plan and difficult vascular access creation. Only 9% of facilities performed aPD routinely, but interestingly all such units permitted bedside catheter insertion by the nephrologists or internists. The major constraints placed on aPD practice were PD catheter insertion competency, timely catheter insertion support and the medical supporting team's knowledge/competency deficits. aPD for AKI is underutilized in Thailand and limited by the inability to undertake timely PD catheter insertion and knowledge and competency deficits.
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Affiliation(s)
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanawin Nopsopon
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Piyatida Chuengsaman
- Banphaeo Dialysis Group (Bangkok), Banphaeo Hospital (Public organization), Bangkok, Thailand
| | - Phongsak Dandecha
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, 26686Prince of Songkla University, Songkhla, Thailand
| | - Sarinya Boongird
- Division of Nephrology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kamol Khositrangsikun
- Renal Unit, Department of Internal Medicine, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand
| | - Laddaporn Wongluechai
- Division of Nephrology, Department of Internal Medicine, 155169Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Sajja Tatiyanupanwong
- Division of Nephrology, Department of Internal Medicine, 469885Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nattachai Srisawat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Australasian Kidney Trials Network, Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia.,Department of Kidney Research, Translational Research Institute, Brisbane, Queensland, Australia
| | - Suchai Sritippayawan
- Division of Nephrology, 26687Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Surasak Kantachuvesiri
- Division of Nephrology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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12
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Kanjanabuch T, Chatsuwan T, Udomsantisuk N, Nopsopon T, Puapatanakul P, Halue G, Lorvinitnun P, Tangjittrong K, Narenpitak S, Boonyakrai C, Tatiyanupanwong S, Chieochanthanakij R, Treamtrakanpon W, Parinyasiri U, Lounseng N, Songviriyavithaya P, Sritippayawan S, Eiam-Ong S, Tungsanga K, Johnson DW, Robinson B, Perl J. Association of Local Unit Sampling and Microbiology Laboratory Culture Practices With the Ability to Identify Causative Pathogens in Peritoneal Dialysis-Associated Peritonitis in Thailand. Kidney Int Rep 2021; 6:1118-1129. [PMID: 33912761 PMCID: PMC8071630 DOI: 10.1016/j.ekir.2021.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction This describes variations in facility peritoneal dialysis (PD) effluent (PDE) culture techniques and local microbiology laboratory practices, competencies, and quality assurance associated with peritonitis, with a specific emphasis on factors associated with culture-negative peritonitis (CNP). Methods Peritonitis data were prospectively collected from 22 Thai PD centers between May 2016 and October 2017 as part of the Peritoneal Dialysis Outcomes and Practice Patterns Study. The first cloudy PD bags from PD participants with suspected peritonitis were sent to local and central laboratories for comparison of pathogen identification. The associations between these characteristics and CNP were evaluated. Results CNP was significantly more frequent in local laboratories (38%) compared with paired PDE samples sent to the central laboratory (12%, P < 0.05). Marked variations were observed in PD center practices, particularly with respect to specimen collection and processing, which often deviated from International Society for Peritoneal Dialysis Guideline recommendations, and laboratory capacities, capabilities, and certification. Lower rates of CNP were associated with PD nurse specimen collection, centrifugation of PDE, immediate transfer of samples to the laboratory, larger hospital size, larger PD unit size, availability of an on-site nephrologist, higher laboratory capacity, and laboratory ability to perform aerobic cultures, undertake standard operating procedures in antimicrobial susceptibilities, and obtain local accreditation. Conclusion There were large variations in PD center and laboratory capacities, capabilities, and practices, which in turn were associated with the likelihood of culturing and correctly identifying organisms responsible for causing PD-associated peritonitis. Deviations in practice from International Society for Peritoneal Dialysis guideline recommendations were associated with higher CNP rates.
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Affiliation(s)
- Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanittha Chatsuwan
- Antimicrobial Resistance and Stewardship Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nibondh Udomsantisuk
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanawin Nopsopon
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pongpratch Puapatanakul
- Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Guttiga Halue
- Department of Medicine, Phayao Hospital, Phayao, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | | | | | - Chanchana Boonyakrai
- Department of Medicine, Taksin Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | | | | | | | | | | | | | - Suchai Sritippayawan
- Division of Nephrology, Department of Internal Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Jeffrey Perl
- St. Michael's Hospital, Toronto, Ontario, Canada
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13
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Cha'on U, Wongtrangan K, Thinkhamrop B, Tatiyanupanwong S, Limwattananon C, Pongskul C, Panaput T, Chalermwat C, Lert-Itthiporn W, Sharma A, Anutrakulchai S. CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand. BMC Public Health 2020; 20:1299. [PMID: 32854662 PMCID: PMC7450931 DOI: 10.1186/s12889-020-09387-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of chronic kidney disease (CKD) is high in the Northeast Thailand compared to other parts of the country. Therefore, a broad program applying all levels of care is inevitable. This paper describes the results of the first year trial of the Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), a quality improvement project collaboratively established to curb CKD. METHODS We have covered general population, high risk persons and all stages of CKD patients with expansive strategies such as early screening, effective CKD registry, prevention and CKD comprehensive care models including cost effectiveness analysis. RESULTS The preliminary results from CKD screening in general population of two rural sub-districts show that 26.8% of the screened population has CKD and 28.9% of CKD patients are of unknown etiology. We have established the CKD registry that has enlisted a total of 10.4 million individuals till date, of which 0.13 million are confirmed to have CKD. Pamphlets, posters, brochures and other media of 94 different types in the total number of 478,450 has been distributed for CKD education and awareness at the community level. A CKD guideline that suits for local situation has been formulated to deal the problem effectively and improve care. Moreover, our multidisciplinary intervention and self-management supports were effective in improving glomerular filtration rate (49.57 versus 46.23 ml/min/1.73 m2; p < 0.05), blood pressure (129.6/76.1 versus 135.8/83.6 mmHg) and quality of life of CKD patients included in the program compared to those of the patients under conventional care. The cost effectiveness analysis revealed that lifetime cost for the comprehensive health services under the CKDNET program was 486,898 Baht compared to that of the usual care of 479,386 Baht, resulting in an incremental-cost effectiveness ratio of 18,702 Baht per quality-adjusted life years gained. CONCLUSION CKDNET, a quality improvement project of the holistic approach is currently applying to the population in the Northeast Thailand which will facilitate curtailing of CKD burden in the region.
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Affiliation(s)
- Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Kanok Wongtrangan
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Data Management and Statistical Analysis Center, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Sajja Tatiyanupanwong
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Chulaporn Limwattananon
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Faculty of Pharmaceutical Science, Khon Kaen University, Khon Kaen, Thailand
| | - Cholatip Pongskul
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thanachai Panaput
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen Hospital, Khon Kaen, Thailand
| | - Chalongchai Chalermwat
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Worachart Lert-Itthiporn
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand.
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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14
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Chamroensakchai T, Kleebchaiyaphum C, Tatiyanupanwong S, Eiam-Ong S, Kanjanabuch T. Tinea nigra palmaris-associated peritonitis, caused by Hortaea werneckii: The first case report in a peritoneal dialysis patient. Perit Dial Int 2020; 41:333-336. [PMID: 32783526 DOI: 10.1177/0896860820944778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the first case of peritoneal dialysis (PD) patients with peritonitis from Hortaea werneckii, a halotolerant black yeast-like fungus. The pathogen was confirmed by nucleotide sequences of internal transcribed spacer regions of the ribosomal RNA gene. A potential cause of this infection was tinea nigra on the patient's palm. Therefore, gloving might be advised during PD bag exchange in patients or caregivers who have an obvious lesion of the palm.
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Affiliation(s)
- Tamonwan Chamroensakchai
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand
| | | | | | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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15
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Pena MJ, Stenvinkel P, Kretzler M, Adu D, Agarwal SK, Coresh J, Feldman HI, Fogo AB, Gansevoort RT, Harris DC, Jha V, Liu ZH, Luyckx VA, Massy ZA, Mehta R, Nelson RG, O'Donoghue DJ, Obrador GT, Roberts CJ, Sola L, Sumaili EK, Tatiyanupanwong S, Thomas B, Wiecek A, Parikh CR, Heerspink HJL. Strategies to improve monitoring disease progression, assessing cardiovascular risk, and defining prognostic biomarkers in chronic kidney disease. Kidney Int Suppl (2011) 2017; 7:107-113. [PMID: 30675424 DOI: 10.1016/j.kisu.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Chronic kidney disease (CKD) is a major global public health problem with significant gaps in research, care, and policy. In order to mitigate the risks and adverse effects of CKD, the International Society of Nephrology has created a cohesive set of activities to improve the global outcomes of people living with CKD. Improving monitoring of renal disease progression can be done by screening and monitoring albuminuria and estimated glomerular filtration rate in primary care. Consensus on how many times and how often albuminuria and estimated glomerular filtration rate are measured should be defined. Meaningful changes in both renal biomarkers should be determined in order to ascertain what is clinically relevant. Increasing social awareness of CKD and partnering with the technological community may be ways to engage patients. Furthermore, improving the prediction of cardiovascular events in patients with CKD can be achieved by including the renal risk markers albuminuria and estimated glomerular filtration rate in cardiovascular risk algorithms and by encouraging uptake of assessing cardiovascular risk by general practitioners and nephrologists. Finally, examining ways to further validate and implement novel biomarkers for CKD will help mitigate the global problem of CKD. The more frequent use of renal biopsy will facilitate further knowledge into the underlying etiologies of CKD and help put new biomarkers into biological context. Real-world assessments of these biomarkers in existing cohorts is important, as well as obtaining regulatory approval to use these biomarkers in clinical practice. Collaborations among academia, physician and patient groups, industry, payer organizations, and regulatory authorities will help improve the global outcomes of people living with CKD.
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Affiliation(s)
- Michelle J Pena
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Matthias Kretzler
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Dwomoa Adu
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Sanjay Kumar Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Josef Coresh
- Johns Hopkins University Bloomberg School of Public Health, George W. Comstock Center for Public Health Research and Prevention, Baltimore, Maryland, USA.,Johns Hopkins University School of Medicine, Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Harold I Feldman
- Department of Biostatistics, Epidemiology, and Informatics, and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Agnes B Fogo
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ron T Gansevoort
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - David C Harris
- Centre for Transplantation and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Vivekanand Jha
- George Institute for Global Health India, New Delhi, India.,University of Oxford, Oxford, UK
| | - Zhi-Hong Liu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Valerie A Luyckx
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland.,Klinik für Nephrologie, Universitätsspital, Zurich, Switzerland
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne Billancourt/Paris, France.,French National Institute of Health and Medical Research (INSERM) U1018, Team5, Centre for Research in Epidemiology and Population Health (CESP), Paris-Ile-de-France-West, Versailles-Saint-Quentin-en-Yvelines University, Villejuif, France
| | - Ravindra Mehta
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Robert G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
| | - Donal J O'Donoghue
- Department of Renal Medicine, Salford Royal National Health Service (NHS) Foundation Trust, Salford, UK.,Department of Renal Medicine, University of Manchester, Manchester, UK
| | - Gregorio T Obrador
- Faculty of Health Sciences & Universidad Panamericana, Mexico City, Mexico
| | - Charlotte J Roberts
- Standardisation, International Consortium for Health Outcomes Measurement, London, UK
| | - Laura Sola
- Division Epidemiologia, Dirección General de Salud (DIGESA)-Ministerio Salud Publica, Montevideo, Uruguay
| | - Ernest K Sumaili
- Renal Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, DR Congo
| | | | - Bernadette Thomas
- Department of Global Health, The University of Washington, Seattle, Washington, USA
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Chirag R Parikh
- Program of Applied Translational Research, Department of Medicine, Yale University, New Haven, Connecticut, USA.,Veterans Affairs Medical Center, West Haven, Connecticut, USA
| | - Hiddo J L Heerspink
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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16
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Panaput T, Thinkhamrop B, Domrongkitchaiporn S, Sirivongs D, Praderm L, Anukulanantachai J, Kanokkantapong C, Tungkasereerak P, Pongskul C, Anutrakulchai S, Keobounma T, Narenpitak S, Intarawongchot P, Suwattanasin A, Tatiyanupanwong S, Niwattayakul K. Dialysis Dose and Risk Factors for Death Among ESRD Patients Treated with Twice-Weekly Hemodialysis: A Prospective Cohort Study. Blood Purif 2015; 38:253-62. [DOI: 10.1159/000368885] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/04/2014] [Indexed: 11/19/2022]
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