scholarly journals Serum total indoxyl sulfate and clinical outcomes in hemodialysis patients: results from the Japan Dialysis Outcomes and Practice Patterns Study

2020 ◽  
Author(s):  
Suguru Yamamoto ◽  
Douglas S Fuller ◽  
Hirotaka Komaba ◽  
Takanobu Nomura ◽  
Ziad A Massy ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Practice Patterns ◽  
Large Cohort ◽  
Indoxyl Sulfate ◽  
Study Phase ◽  
Uremic Toxin ◽  
Dialysis Vintage ◽  
All Cause Mortality ◽  
Large Cohort Study ◽  
Dialysis Outcomes

Abstract Background Uremic toxins are associated with various chronic kidney disease-related comorbidities. Indoxyl sulfate (IS), a protein-bound uremic toxin, reacts with vasculature, accelerating atherosclerosis and/or vascular calcification in animal models. Few studies have examined the relationship of IS with clinical outcomes in a large cohort of hemodialysis (HD) patients. Methods We included 1170 HD patients from the Japan Dialysis Outcomes and Practice Patterns Study Phase 5 (2012–15). We evaluated the associations of serum total IS (tIS) levels with all-cause mortality and clinical outcomes including cardiovascular (CV)-, infectious- and malignancy-caused events using Cox regressions. Results The median (interquartile range) serum tIS level at baseline was 31.6 μg/mL (22.6–42.0). Serum tIS level was positively associated with dialysis vintage. Median follow-up was 2.8 years (range: 0.01–2.9). We observed 174 deaths (14.9%; crude rate, 0.06/year). Serum tIS level was positively associated with all-cause mortality [adjusted hazard ratio per 10 μg/mL higher, 1.16; 95% confidence interval (CI) 1.04–1.28]. Association with cause-specific death or hospitalization events, per 10 μg/mL higher serum tIS level, was 1.18 (95% CI 1.04–1.34) for infectious events, 1.08 (95% CI 0.97–1.20) for CV events and 1.02 (95% CI 0.87–1.21) for malignancy events after adjusting for covariates including several nutritional markers. Conclusions In a large cohort study of HD patients, serum tIS level was positively associated with all-cause mortality and infectious events.

scholarly journals Physical Function and Clinical Outcomes in Hemodialysis Patients: China Dialysis Outcomes and Practice Patterns Study

2021 ◽  
pp. 1-8
Author(s):  
Qingyu Niu ◽  
Xinju Zhao ◽  
Liangying Gan ◽  
Xinling Liang ◽  
Zhaohui Ni ◽  
...  
Keyword(s):  
Physical Function ◽  
Clinical Outcomes ◽  
Practice Patterns ◽  
Cox Regression ◽  
Demographic Data ◽  
Simple Method ◽  
Daily Dialysis ◽  
All Cause Mortality ◽  
Dialysis Outcomes ◽  
Climbing Stairs

Background: Hemodialysis (HD) patients usually have impaired physical function compared with the general population. Self-reported physical function is a simple method to implement in daily dialysis care. This study aimed to examine the association of self-reported physical function with clinical outcomes of HD patients. Methods: The Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective cohort study. Data on 1,427 HD patients in China DOPPS5 were analyzed. Self-reported physical function was characterized by 2 items of “moderate activities limited level” and “climbing stairs limited level.” Demographic data, comorbidities, hospitalization, and death records were collected from patients’ records. Associations between physical function and outcomes were analyzed using COX regression models. Results: Compared to “limited a lot” in moderate activities, “limited a little” and “not limited at all” groups were associated with lower all-cause mortality after adjusted for covariates (HR: 0.652, 95% CI: 0.435–0.977, and HR: 0.472, 95% CI: 0.241–0.927, respectively). And, not limited in moderate activities was associated with lower risk of hospitalization than the “limited a lot” group after adjusted for covariates (HR: 0.747, 95% CI: 0.570–0.978). Meanwhile, compared to “limited a lot” in climbing stairs, “limited a little” and “not limited at all” groups were associated with lower all-cause mortality (HR: 0.574, 95% CI: 0.380–0.865 and HR: 0.472, 95% CI: 0.293–0.762, respectively) but not hospitalization after fully adjusted. Conclusion: Higher limited levels in self-reported physical function were associated with higher risk of all-cause mortality and hospitalization in HD patients.

scholarly journals Physical Function and Clinical Outcomes in Hemodialysis Patients: The China Dialysis Outcomes and Practice Pattern Study

2020 ◽  
Author(s):  
Qingyu Niu ◽  
Xinju Zhao ◽  
Liangying Gan ◽  
Xinling Liang ◽  
Zhaohui Ni ◽  
...  
Keyword(s):  
Physical Function ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Demographic Data ◽  
Simple Method ◽  
Daily Dialysis ◽  
Dialysis Vintage ◽  
All Cause Mortality ◽  
Dialysis Outcomes ◽  
Climbing Stairs

Abstract Background: Hemodialysis (HD) patients usually have impaired physical function compared with general population. Self-reported physical function is a simple method to implement in daily dialysis care. This study aimed to examine the association of self-reported physical function with clinical outcomes of HD patients.Methods: Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective cohort study. Data on 1427 HD patients in China DOPPS5 were analyzed. Self-reported physical function was characterized by 2 items of ‘moderate activities limited level’ and ’climbing stairs limited level’. Demographic data, comorbidities, hospitalization and death records were collected from patients’ records. Associations between physical function and outcomes were analyzed using COX regression models. The generalized linear mixed models were used to examine correlates of physical function limited level.Results: Compared to ‘limited a lot’ in moderate activities, ‘limited a little’ and ‘not limited at all’ groups were associated with lower all-cause mortality after adjusted for covariates (HR: 0.652, 95% CI: 0.435-0.977 and HR: 0.472, 95% CI: 0.241-0.927, respectively). And not limited in moderate activities was associated with lower risk of hospitalization compared with ‘limited a lot’ group after adjusted for covariates (HR: 0.747, 95% CI: 0.570-0.978). Meanwhile, compared to ‘limited a lot’ in climbing stairs, ‘limited a little’ and ‘not limited at all’ groups were associated with lower all-cause mortality (HR: 0.574, 95% CI: 0.380-0.865 and HR: 0.472, 95% CI: 0.293-0.762, respectively) but not hospitalization after fully adjusted. Factors including old age, female gender, longer dialysis vintage, catheter use, low serum albumin and combining with diabetes, coronary artery disease and cerebrovascular disease were related to higher limited levels of physical function (P < 0.05).Conclusion: Higher limited levels in self-reported physical function were associated with higher risk of all-cause mortality and hospitalization in HD patients.

scholarly journals Clinical outcomes of COVID-19 in Wuhan, China: a large cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jiao Liu ◽  
Sheng Zhang ◽  
Zhixiong Wu ◽  
You Shang ◽  
Xuan Dong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Large Cohort ◽  
Large Cohort Study

Low Predialysis Plasma Calculated Osmolality Is Associated with Higher All-Cause Mortality: The Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS)

Nephron ◽  
2020 ◽  
Vol 144 (3) ◽  
pp. 138-146
Author(s):  
Yasushi Tsujimoto ◽  
Yusuke Tsutsumi ◽  
Tsuyoshi Ohnishi ◽  
Miho Kimachi ◽  
Yosuke Yamamoto ◽  
...  
Keyword(s):  
Practice Patterns ◽  
All Cause Mortality ◽  
Dialysis Outcomes

scholarly journals Twice-Weekly Hemodialysis and Clinical Outcomes in the China Dialysis Outcomes and Practice Patterns Study

2018 ◽  
Vol 3 (4) ◽  
pp. 889-896 ◽  
Author(s):  
Yucheng Yan ◽  
Mia Wang ◽  
Jarcy Zee ◽  
Doug Schaubel ◽  
Charlotte Tu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Practice Patterns ◽  
Dialysis Outcomes

scholarly journals FP713HEPATITIS C PREVALENCE AND CLINICAL OUTCOMES IN THE DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii314-iii314 ◽  
Author(s):  
Brian Bieber ◽  
David A Goodkin ◽  
Chizoba Nwankwo ◽  
Jean Marie Arduino ◽  
Takashi Akiba ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Practice Patterns ◽  
Dialysis Outcomes

scholarly journals Baseline data report of the China Dialysis Outcomes and Practice Patterns Study (DOPPS)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xinju Zhao ◽  
Qingyu Niu ◽  
Liangying Gan ◽  
Fan Fan Hou ◽  
Xinling Liang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Asian Country ◽  
Baseline Data ◽  
Target Range ◽  
Chronic Glomerulonephritis ◽  
Study Phase ◽  
Hepatitis C Infection ◽  
Number Of Patients ◽  
Dialysis Vintage ◽  
Dialysis Outcomes

AbstractThe number of patients on hemodialysis (HD) is rapidly increasing in China. As an Asian country with a large number of HD patients, understanding the status of Chinese HD patients has a special significance. We reported here the baseline data for China Dialysis Outcomes and Practice Pattern Study Phase 5 (DOPPS5). The DOPPS is an international prospective, observational cohort study. Patients were restricted to the initial sample of patients who participated in China DOPPS5. We summarized the baseline demographic and clinical data of patients. Results were weighted by facility sampling fraction. 1186 patients were initial patients in China DOPPS5. The mean age was 58.7 ± 3.5 years, with 54.6% males. The median dialysis vintage was 3.4 (1.5, 6.3) years. The main assigned primary end-stage kidney disease (ESKD) causes was chronic glomerulonephritis (45.9%), followed by diabetes (19.9%). 17.6% patients had hepatitis B infection, and 10.0% patients had hepatitis C infection. 25.9% patients had a single-pooled Kt/V < 1.2. 86.6% patients had albumin > 3.5 g/dl. 18.8% patients had hemoglobin < 9 g/dl. 66.5% patients had serum calcium in target range (8.4–10.2 mg/dl), 41.5% patients had serum phosphate in target range (3.5–5.5 mg/dl) and 51.2% patients maintained PTH in 150–600 pg/dl. 88.2% patients used fistula as their vascular access. Meanwhile, there were differences in the demographic, clinical, laboratory, and treatment characteristics among the three cities participated in China DOPPS. We observed a relatively higher albumin level and a higher rate of fistula usage in our patients. But it remains a major challenge to us on the management of CKD-MBD and anemia. This study did not include patients in small cities and remote areas, where the situation of HD patients might be worse than reported.

scholarly journals Meta-analysis of the association between sclerostin level and adverse clinical outcomes in patients undergoing maintenance haemodialysis

2021 ◽  
Vol 12 ◽  
pp. 204062232096714
Author(s):  
Sha-Sha Li ◽  
Zhi-Qin Zhang ◽  
Da-Wei He ◽  
Ao-Lin He ◽  
Qi-Feng Liu
Keyword(s):  
Clinical Outcomes ◽  
Cardiovascular Events ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Maintenance Haemodialysis ◽  
Dialysis Vintage ◽  
All Cause Mortality ◽  
Predictive Role

Background: Studies regarding the relationship of sclerostin (Scl) with clinical outcomes in patients undergoing maintenance haemodialysis have yielded controversial findings. This meta-analysis was performed to investigate the predictive role of Scl in this patient population. Methods: Several electronic medical databases (e.g. PubMed, Embase, Web of Science and Cochrane Library) were searched for eligible studies through December 20, 2019. Summary hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated based on Scr level (high or low) using a random or fixed effects model. Results: From among 641 initially screened publications, 16 eligible studies were included in this meta-analysis. A high Scl level was not associated with cardiovascular events [HR = 0.8 (95% CI, 0.42–1.35)] or all-cause mortality [HR = 0.93 (95% CI, 0.56–1.54)]. There was high heterogeneity, but no evidence of publication bias. Interestingly, a high Scl level was associated with reduced cardiovascular events [HR = 0.44 (95% CI, 0.29–0.69)] in the subgroup by shorter follow-up period or all-cause mortality [pooled HR = 0.58 (95% CI, 0.36–0.91)] by shorter dialysis vintage. Conclusion: This meta-analysis indicated that a high Scl level did not predict total clinical outcomes in patients undergoing maintenance haemodialysis despite survival benefits in the subgroups. The predictive role of Scl in these patients should be further evaluated in large prospective studies.

scholarly journals The dialysis outcomes and practice patterns study phase 5 in the Gulf Cooperation Council countries: Design and study methods

2016 ◽  
Vol 27 (7) ◽  
pp. 1 ◽  
Author(s):  
RonaldL Pisoni ◽  
BrianA Bieber ◽  
Jamal Al Wakeel ◽  
Sameer Al Arrayed ◽  
Naser Alkandari ◽  
...  
Keyword(s):  
Practice Patterns ◽  
Gulf Cooperation Council ◽  
Study Phase ◽  
Study Methods ◽  
Dialysis Outcomes

scholarly journals Citric Acid-Containing Dialysate and Survival Rate in the Dialysis Outcomes and Practice Patterns Study

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006182020
Author(s):  
Pablo Ureña-Torres ◽  
Brian Bieber ◽  
Fitsum Guebre Egziabher ◽  
Rim Ossman ◽  
Michel Jadoul ◽  
...  
Keyword(s):  
Citric Acid ◽  
Practice Patterns ◽  
Cox Regression ◽  
Hemodialysis Patients ◽  
Hemodynamic Stability ◽  
Patient Demographics ◽  
Dependent Relationship ◽  
All Cause Mortality ◽  
Dialysis Outcomes ◽  
Dose Dependent

Background: Metabolic acidosis is a common threat for hemodialysis patients, managed by alkaline dialysate. The main base is bicarbonate, to which small amounts of acetic, citric, or hydrochloric acid are added. The first two ones are metabolized to bicarbonate, mostly by the liver. Citric acid-containing dialysate might improve dialysis efficiency, anticoagulation, calcification propensity score, and intradialytic hemodynamic stability. However, a recent report from the French dialysis registry suggested that this dialysate increases mortality risk. This prompted us to assess whether citric acid-containing bicarbonate-based dialysate was associated with mortality in the international Dialysis Outcomes and Practice Patterns Study (DOPPS). Methods: Detailed patient-based information on dialysate composition was collected in DOPPS phases 5 and 6 (2012 to 2017). Cox regression was used to model the association between baseline bicarbonate dialysate containing citric acid versus not containing citric acid and mortality among DOPPS country/phases where citric acid-containing dialysate was used. Results: Citrate-containing dialysate was most commonly used in Japan, Italy, and Belgium (25%, 25%, 21% of DOPPS phase 6 patients) and used in < 10% of patients in other countries. Among 11,306 patients in DOPPS country-phases with at least 15 patients using citrate-containing dialysate, patient demographics, comorbidities, and labs were similar among patients using (14%) vs. not using (86%) citrate-containing dialysate. After accounting for case mix, we did not observe a directional association between citric acid-containing dialysate use (any vs. none) and mortality [HR (95% CI) = 1.14 (0.97-1.34)], nor did we find evidence of a dose-dependent relationship when parameterizing the citrate concentration in the dialysate as 1, 2, and 3+ mEq/L. Conclusions: The use of citric acid-containing dialysate was not associated with greater risk of all-cause mortality in hemodialysis patients participating in DOPPS. Clinical indications for the use of citric acid-containing dialysate deserve further investigation.

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