scholarly journals Peritoneal dialysis related peritonitis as a risk factor for cardiovascular events

2020 ◽  
Author(s):  
Kirsten S. Hepburn ◽  
Kelly Lambert ◽  
Judy Mullan ◽  
Brendan McAlister ◽  
Maureen Lonergan ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Cardiovascular Events

scholarly journals Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Gram Negative Organisms ◽  
Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

The Iron Biology Status of Peritoneal Dialysis Patients May be a Risk Factor for Development of Infectious Peritonitis

2019 ◽  
Vol 39 (4) ◽  
pp. 362-374 ◽  
Author(s):  
Marwh Aldriwesh ◽  
Noura Al-Dayan ◽  
Jonathan Barratt ◽  
Primrose Freestone
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Stress Hormones ◽  
Infection Risk ◽  
Mortality And Morbidity ◽  
Peritoneal Dialysate ◽  
Susceptibility To Infection ◽  
Infection Risk Factors

Background Infectious peritonitis is a clinically important condition contributing to the significant mortality and morbidity rates observed in peritoneal dialysis (PD) patients. Although some of the socioeconomic risk factors for PD-associated peritonitis have been identified, it is still unclear why certain patients are more susceptible than others to infection. Methods We examined the molecular components of human peritoneal dialysate (HPD) in an attempt to identify factors that might increase patient susceptibility to infection. Characterization studies were performed on initial and follow-up dialysate samples collected from 9 renal failure patients on PD. Results Our in vitro data showed that peritonitis-causing bacteria grew differently in the patient dialysates. Proteomic analysis identified an association between transferrin presence and infection risk, as peritoneal transferrin was discovered to be iron-saturated, which was in marked contrast to transferrin in blood. Further, use of radioactive iron-labeled transferrin showed peritoneal transferrin could act as a direct iron source for the growth of peritonitis-causing bacteria. We also found catecholamine stress hormones noradrenaline and adrenaline were present in the dialysates and were apparently involved in enhancing the growth of the bacteria via transferrin iron provision. This suggests the iron biology status of the PD patient may be a risk factor for development of infectious peritonitis Conclusions Collectively, our study suggests transferrin and catecholamines within peritoneal dialysate may be indicators of the potential for bacterial growth in HPD and, as infection risk factors, represent possible future targets for therapeutic manipulation.

Cardiovascular events in patients with type 2 diabetes

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S4-S8
Author(s):  
Erland Erdmann
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Adverse Effects ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

scholarly journals Association of nephronophthisis 4 genetic variation with cardiorenal syndrome and cardiovascular events in Japanese general population: the Yamagata (Takahata) study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y Otaki ◽  
T W Watanabe ◽  
J G Goto ◽  
Y S Saito ◽  
T A Aono ◽  
...  
Keyword(s):  
Risk Factor ◽  
General Population ◽  
Cardiovascular Events ◽  
Cardiorenal Syndrome ◽  
Health Study ◽  
Nucleotide Polymorphisms ◽  
Logistic Analysis ◽  
Cox Proportional Hazard Regression ◽  
Gene Variability ◽  
Stage Renal Disease

Abstract Background Nephronophthisis (NPHP) 4 gene encoding nephrocystin-4, which contributes to end-stage renal disease in children and young adults, is involved in the development of the heart and kidneys. Cardiorenal syndrome (CRS), which consists of bidirectional dysfunction of the heart and kidneys, is a risk factor for cardiovascular events. Single nucleotide polymorphisms (SNPs) within the NPHP4 gene are reportedly associated with kidney function, even in adults. However, the association of NPHP4 gene variability with CRS and cardiovascular events remains unknown. Purpose To examine whether NPHP4 gene variability is related to CRS and cardiovascular events in general population. Methods and results This prospective cohort study included 2,946 subjects who participated in a community-based health study with a 16-year follow-up period. We genotyped 11 SNPs within the NPHP4 gene whose minor allele frequency was greater than 0.1 in the Japanese population. The SNP rs12058375 was significantly associated with CRS and cardiovascular events. Multivariate logistic analysis demonstrated a significant association between the homozygous A-allele of rs12058375 with the presence of CRS. Haplotype analysis identified the haplotype with the A-allele of rs12058375 as an increased susceptibility factor for CRS. Kaplan-Meier analysis demonstrated that homozygous A-allele carriers of rs12058375 had the greatest risk of developing cardiovascular events among the NPHP4 variants. Multivariate Cox proportional hazard regression analysis revealed that the homozygous A-allele and heterozygous carriers of rs12058375 were associated with cardiovascular events after adjusting for confounding factors. The net reclassification index and integrated discrimination index were significantly improved by the addition of rs12058375 as a cardiovascular risk factor. Conclusion Genetic variations in the NPHP4 gene were associated with CRS and cardiovascular events in the general population, suggesting that it may facilitate the early identification of high-risk subjects with CRS and cardiovascular events. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Peritoneal dialysis - associated peritonitis during treatment with continuous ambulatory peritoneal dialysis

2019 ◽  
pp. 47-52
Author(s):  
M. Malasaiev ◽  
I. Dudar ◽  
A. Shymova
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
First Year ◽  
Significant Progress ◽  
Main Risk Factor ◽  
Common Cause ◽  
Hemodialysis Treatment ◽  
Methodological Approaches ◽  
Peritoneal Function

 Infections associated with peritoneal dialysis (infection of the catheter, tunnel infection and peritonitis) are the most common complications of this method. Despite significant progress in the methodological approaches to the prevention, diagnosis and treatment of PD associated infections, peritonitis remains the main risk factor for mortality in PD patients (up to 6%) and plays a significant role in more than 1/6 of the deaths associated with non-infectious complications such as cardiovascular and / or cerebrovascular disease. Besides, PD-associated infections are the most common cause of loss of peritoneal function and the patients’ transition to hemodialysis treatment. About 5% of PD patients are converted to hemodialysis treatment in the first year after postponed peritonitis.

scholarly journals SP483EXCESS WEIGHT GAIN DURING THE FIRST YEAR OF PERITONEAL DIALYSIS IS A RISK FACTOR FOR A RAPID DECREASE IN RESIDUAL RENAL FUNCTION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii539-iii539
Author(s):  
Hyung Jik Kim ◽  
Sung Gyun Kim ◽  
Jwa-Kyung Kim ◽  
Chan Ho Kim ◽  
Seung Jun Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Residual Renal Function ◽  
Rapid Decrease ◽  
First Year
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