scholarly journals One-Year Mortality Rates in US Children with End-Stage Renal Disease

2015 ◽  
Vol 41 (2) ◽  
pp. 121-128 ◽  
Author(s):  
Blanche M. Chavers ◽  
Julia T. Molony ◽  
Craig A. Solid ◽  
Michelle N. Rheault ◽  
Allan J. Collins
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mortality Rates ◽  
Transplant Recipients ◽  
Dialysis Patients ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background/Aims: Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. Methods: In this retrospective cohort study, we used the US Renal Data System database to identify period-prevalent cohorts of patients aged younger than 19 for each year during the period 1995-2010. Yearly cohorts averaged approximately 1,200 maintenance dialysis patients (60% hemodialysis, 40% peritoneal dialysis) and 1,100 transplant recipients. Patients were followed for up to 1 year and censored at change in modality, loss to follow-up, or death. We calculated the unadjusted model-based mortality rates per time at risk, within each cohort year, by treatment modality (hemodialysis, peritoneal dialysis, transplant) and patient characteristics; percentage of deaths by cause; and overall adjusted odds of mortality by characteristics and modality. Results: Approximately 50% of patients were in the age group 15-18, 55% were male, and 45% were female. The most common causes of ESRD were congenital/reflux/obstructive causes (55%) and glomerulonephritis (30%). One-year mortality rates showed evidence of a decrease in the number of peritoneal dialysis patients (6.03 per 100 patient-years, 1995; 2.43, 2010; p = 0.0263). Mortality rates for transplant recipients (average 0.68 per 100 patient-years) were consistently lower than the rates for all dialysis patients (average 4.36 per 100 patient-years). Conclusions: One-year mortality rates differ by treatment modality in pediatric ESRD patients.

Management of the Diabetic Patients with End Stage Renal Disease

1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 6-10 ◽  
Author(s):  
Pablo Amair ◽  
Ramesh Khanna ◽  
Bernard Leibel ◽  
Andreas Pierratos ◽  
Stephen Vas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Intraperitoneal Administration ◽  
Good Control ◽  
Diabetic Patients ◽  
Serum Triglycerides ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Twenty diabetics with end-stage renal disease who had never previously received dialysis treatment were treated with continuous ambulatory peritoneal dialysis for periods of two to 36 months (average, 14.5). Intraperitoneal administration of insulin achieved good control of blood sugar Even though creatinine clearance decreased significantly (P = 0.001), contro of blood urea nitrogen and serum creatinine was adequate. Hemoglobin and serum albumin levels increased significantly (P = 0.005 and 0.04 respectively). Similarly, there was a significant increase in serum triglycerides and alkaline phosphatase (P = 0.02 and 0.05). Blood pressure became normal without medications in all but one of the patients. Retinopathy, neuropathy, and osteodystrophy remained unchanged. Peritonitis developed once in every 20.6 patient-months a rate similar to that observed in nondiabetics. The calculated survival rate was 92 per cent at one year; the calculated rate of continuation on ambulatory peritoneal dialysis was 87 per cent.

The Phantom of Metformin-Induced Lactic Acidosis in End-Stage Renal Disease Patients: Time to Reconsider with Peritoneal Dialysis Treatment

2017 ◽  
Vol 37 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Abdullah K. Al-Hwiesh ◽  
Ibrahiem Saeed Abdul-Rahman ◽  
Abdul-Salam Noor ◽  
Mohammed A. Nasr-El-Deen ◽  
Abdalla Abdelrahman ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lactic Acidosis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Diabetic Control ◽  
Plasma Lactate ◽  
Lactate Levels ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

ObjectiveMetformin continues to be the safest and most widely used antidiabetic drug. In spite of its well-known benefits; metformin use in end-stage renal disease (ESRD) patients is still restricted. Little has been reported about the effect of peritoneal dialysis (PD) on metformin clearance and the phantom of lactic acidosis deprives ESRD patients from metformin therapeutic advantages. Peritoneal dialysis is probably a safeguard against lactic acidosis, and it is likely that using this drug would be feasible in this group of patients.Material and methodsThe study was conducted on 83 PD patients with type 2 diabetes mellitus. All patients were on automated PD (APD). Metformin was administered in a dose of 500 - 1,000 mg daily. Patients were monitored for glycemic control. Plasma lactic acid and plasma metformin levels were monitored on a scheduled basis. Peritoneal fluid metformin levels were measured. In addition, the relation between plasma metformin and plasma lactate was studied.ResultsMean fasting blood sugar (FBS) was 10.9 ± 0.5 and 7.8 ± 0.7, and mean hemoglobin A1-C (HgA1C) was 8.2 ± 0.8 and 6.4 ± 1.1 at the beginning and end of the study, respectively (p < 0.001). The mean body mass index (BMI) was 29.1 ± 4.1 and 27.3 ± 4.5 at the beginning and at the end of the study, respectively (p < 0.001). The overall mean plasma lactate level across all blood samples was 1.44 ± 0.6. Plasma levels between 2 and 3 mmol/L were found in 11.8% and levels of 3 - 3.6 mmol/L in 2.4% plasma samples. Hyperlactemia (level > 2 and < 5 mmol/L) was not associated with overt acidemia. None of our patients had lactic acidosis (levels > 5 mmol/L). Age ≥ 60 was a predictor for hyperlactemia. No relationship was found between plasma metformin and lactate levels.ConclusionMetformin may be used with caution in a particular group of ESRD patients who are on APD. Metformin allows better diabetic control with significant reduction of BMI. Information on the relationship between metformin and plasma lactate levels is lacking. Peritoneal dialysis appears to be a safeguard against the development of lactic acidosis in this group of patients.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

scholarly journals Discover, analysis, and interpretation of problems and comparing satisfaction of hemodialysis and peritoneal dialysis patients: patients' perspective

2020 ◽  
Author(s):  
Ghazanfar Rafiee ◽  
Jamshid Roozbeh
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Dialysis Treatment ◽  
Patient’S Satisfaction ◽  
Exploratory Approach ◽  
Dialysis Method ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: End-stage renal disease is an irreversible and progressive loss of kidney function and it can be fatal without hemodialysis, peritoneal dialysis or kidney transplantation. Hemodialysis is a type of treatment where the patient is connected to a machine through a catheter via veins for twice or three times a week for approximately four hours. Alternatively, peritoneal dialysis is carried out with a plastic catheter insertion into the abdomen through which dialysis fluid (glucose) enters and is taken out. This study aimed to discover, analyze, interpret and compare end-stage renal disease patient's satisfaction with hemodialysis and peritoneal dialysis with an emphasis on complications and problems that was created during dialysis treatment.Methods: this study a qualitative exploratory approach was used at Shiraz hemodialysis and peritoneal dialysis centers 2017-2018. In these centers there were 345 ESRD patients who were receiving dialysis. A purposeful sample of 35 hemodialysis and 30 peritoneal dialysis patients were interviewed. The data were collected through interview. Each session lasted for 50 minutes. Initially 12 open-ended questions were developed and used to stimulate discussions in sessions. Directed content analysis was used for analyzing the transcribed data. After giving a code to each line or incidence, codes were then compared for similarity and differences, merged together, and categorized. Results: Themes of Fatigue experience, Insomnia, Wasting time, Travel and leisure time activities limitations, Hypotension, Dissatisfaction and satisfaction with hemodialysis, Peritoneal catheter problems, peritoneal dialysis difficulties and limitations, satisfaction from peritoneal dialysis emerged. Each dialysis method has its own problems. Some problems and limitations were more emphasized on by patients. Conclusion: Each dialysis method has its own problems. Some problems and limitations were more emphasized on by patients.

scholarly journals Lived Experiences of End Stage Renal Disease Patients Undergoing Continuous Ambulatory Peritoneal Dialysis Therapy

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
M. Hanif Prasetya 'Adhi ◽  
Yanny Trisyani ◽  
Etika Emaliyawati
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Lived Experiences ◽  
Final Diagnosis ◽  
Treatment Modalities ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End stage renal disease (ESRD) is a serious chronic disease that resulted from complications of chronic renal failure and a final diagnosis that requires treatment modalities such as dialysis or continuous ambulatory peritoneal dialysis (CAPD). However, CAPD is rarely selected as renal replacement therapy by ESRD patients in Indonesia. Therefore, the phenomenon associated with patients undergoing CAPD is unclear, especially in Indonesia. The purpose of this study was to explore the lived experiences of ESRD patients undergoing CAPD therapy. The research method employed qualitative descriptive phenomenology. The participants in this study were 10 ESRD patients with CAPD. Data collection utilized semi-structured interviewed and data was analyzed using the Colaizzi approach. The result of the study was explained through 6 themes. These are: 1) Condition improved with CAPD, 2) Freedom of activity, 3) Between feeling better and bored 4) Health is increased, 5) It is sustained life, 6) Resignation to accept illness. In conclusion, the patients with CAPD felt  significant positive changes in their life and CAPD is considered life-sustaining for the participants, as the majority of the symptoms was decreased significantly. Therefore, the partisipants felt their conditions improved better. The unpleasant sides of CAPD are feeling bored. The support  of the family  is important as it  produced strength and passion for patients in undergoing CAPD.

scholarly journals Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

2020 ◽  
Vol 43 (3) ◽  
pp. E44-48
Author(s):  
Yifu Li ◽  
Yan Zhang ◽  
Jinjun Wang ◽  
Wenwei Chen ◽  
Yong Cai ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Pulmonary Artery ◽  
Renal Disease ◽  
Pulmonary Artery Pressure ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Purpose: Pulmonary hypertension (PH) is a frequent and serious cardiovascular complication in patients with end-stage renal disease (ESRD) on dialysis. The purpose of this study was to investigate the prevalence of PH and its associated factors in patients with ESRD on maintenance dialysis and predialysis patients. Methods: The medical records of ESRD patients who underwent kidney transplantation between January 2011 and December 2017 were retrospectively reviewed. Demographic and clinical characteristics including echocardiographic findings before joining the waiting list for transplantation were evaluated and compared among groups divided according to dialysis or not and dialysis types. The results of transthoracic Doppler echocardiography were used to determine the pulmonary artery pressure. Pulmonary hypertension was defined as a systolic pulmonary artery pressure (sPAP) greater than 35 mmHg. Univariate and multivariate analyses were used to investigate factors associated with PH. Results: Data from 35 pre-dialysis patients with ESRD, 72 maintenance hemodialysis (HD) and 34 peritoneal dialysis (PD) patients were analysed. Pulmonary hypertension was 20.69% in pre-dialysis patients, 16.7% in HD patients and 14.7% in PD patients (P=0.957). There were negative correlations between sPAP and calcium (r=-0.230, P=0.012), Ca×P(r=-0.210, P=0.021), hemoglobin (r=-0.243, P=0.008) and a positive correlation between sPAP and cardiac output (r=0.481, P=0.000). Cardiac output (CO) was an independent risk factor of sPAP (B=1.431, confidence interval [CI] 95%: 0.687 to 2.175, P=0.000). Conclusion: Incidence of PH was not statistically different in ESRD patients on dialysis and pre-dialysis patients. Uremia may play a major role in the pathogenesis of PH in patients.

Sleep Related Respiratory Disorders in End-Stage Renal Disease Patients on Peritoneal Dialysis

1992 ◽  
Vol 12 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Nand K. Wadhwa ◽  
M. Seliger ◽  
Harly E. Greenberg ◽  
Edward Bergofsky ◽  
Wallace B. Mendelson
Keyword(s):  
Peritoneal Dialysis ◽  
Sleep Apnea ◽  
Renal Disease ◽  
Sleep Disturbance ◽  
Peritoneal Cavity ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Chronic Sleep

Study Objective To assess the possible effects of peritoneal dialysis (PD) on sleep-related respiration, which might result from dialysate bulk load in the abdomen and/or alterations in metabolic control of respiration during sleep. Design Subjective and objective measures of sleep were prospectively compared on randomly assigned nights with PD fluid (2.0 L) and without PD fluid in the peritoneal cavity in 11 end-stage renal disease (ESRD) patients on PD. Setting Tertiary-referral university hospital. Patients and Methods Fifteen consecutive patients on peritoneal dialysis who complained of chronic sleep disturbance and requested sedative were selected. Four patients declined polysomnographic studies. Consequently, 11 ESRD patients (8 males and 3 females) with a mean age of 63±4 (SEM) years were studied. Results Eight of the 11 patients reported multiple types of sleep difficulties. Polysomnographic recordings revealed significant primarily obstructive sleep apnea in 6 of 11 patients on at least 1 of 2 nights. Arterial blood pH, paO2, and paC02 did not differ between nights with and without PD fluid in the peritoneal cavity in the group as a whole. In the 6 patients with sleep apnea, Pa02 was significantly lower (p<0.05) during the night with (Pa02=78±7 mmHg) than during the night without PD fluid (Pa02=92±4 mmHg). In the apneic patients, the amount of dialysate drained in the morning was negatively correlated with the minimum arterial oxygen saturation during the night (r=-0.94; p<0.005). Conclusions This study indicates a significant relationship between PD patients with chronic sleep disturbance and sleep apnea syndrome. These data suggest that apneic patients may be susceptible to complications of dialysate bulk effect on oxygen desaturation.

scholarly journals The Effects of Hemodialysis and Peritoneal Dialysis on the Gut Microbiota of End-Stage Renal Disease Patients, and the Relationship Between Gut Microbiota and Patient Prognoses

2021 ◽  
Vol 11 ◽  
Author(s):  
Dan Luo ◽  
Wenbo Zhao ◽  
Zhiming Lin ◽  
Jianhao Wu ◽  
Hongchun Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Gut Microbiota ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Before And After ◽  
Patient Prognosis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Gut microbiota alterations occur in end-stage renal disease (ESRD) patients with or without dialysis. However, it remains unclear whether changes in gut microbiota of dialysis ESRD patients result from dialysis or ESRD, or both. Similarly, there is a dearth of information on the relationship between gut microbiota and ESRD prognoses. We collected fecal samples and tracked clinical outcomes from 73 ESRD patients, including 33 pre-dialysis ESRD patients, 19 peritoneal dialysis (PD) patients, and 21 hemodialysis (HD) patients. 16S rRNA sequencing and bioinformatics tools were used to analyze the gut microbiota of ESRD patients and healthy controls. Gut microbiota diversity was different before and after dialysis. Bacteroidetes were significantly deceased in HD patients. Twelve bacterial genera exhibited statistically significant differences, due to dialysis (all P &lt; 0.05, FDR corrected). HD reversed abnormal changes in Oscillospira and SMB53 in pre-dialysis patients. Functional predictions of microbial communities showed that PD and HD altered signal transduction and metabolic pathways in ESRD patients. Furthermore, Bacteroides and Phascolarctobacterium were associated with cardiovascular mortality. Dorea, Clostridium, and SMB53 were related to peritonitis in PD patients. This study not only demonstrated differences in gut microbiota between pre-dialysis and dialysis ESRD patients, but also firstly proposed gut bacteria may exert an impact on patient prognosis.

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