scholarly journals Geographic Variations in the Risk of Emergency First Dialysis for Patients with End Stage Renal Disease in the Bretagne Region, France

2018 ◽  
Vol 16 (1) ◽  
pp. 18 ◽  
Author(s):  
Cindy Padilla ◽  
Maxime Raffray ◽  
Adélaïde Pladys ◽  
Cécile Vigneau ◽  
Sahar Bayat
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Lower Risk ◽  
Clinical Status ◽  
Spatial Scan Statistic ◽  
Scan Statistic ◽  
Geographic Variations ◽  
Stage Renal Disease ◽  
End Stage ◽  
Rein Registry

Emergency first dialysis start considerably increases the risk of morbidity and mortality. Our objective was to identify the geographic variations of emergency first dialysis risk in patients with end-stage renal disease in the Bretagne region, France. The spatial scan statistic approach was used to determine the clusters of municipalities with significantly higher or lower risk of emergency first dialysis. Patient data extracted from the REIN registry (sociodemographic, clinical, and biological characteristics) and indicators constructed at the municipality level, were compared between clusters. This analysis identified a cluster of municipalities in western Bretagne with a significantly higher risk (RR = 1.80, p = 0.044) and one cluster in the eastern part of the region with a significantly lower risk (RR = 0.59, p < 0.01) of emergency first dialysis. The degree of urbanization (the proportion of rural municipalities: 76% versus 66%, p < 0.001) and socio-demographic characteristics (the unemployment rate: 11% versus 8%, p < 0.001, the percentage of managers in the labor force was lower: 9% versus 13% p < 0.001) of the municipalities located in the higher-risk cluster compared with the lower-risk cluster. Our analysis indicates that the patients’ clinical status cannot explain the geographic variations of emergency first dialysis incidence in Bretagne. Conversely, where patients live seems to play an important role.

scholarly journals Association between End-Stage Renal Disease and Incident Diabetes Mellitus—A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 7 (10) ◽  
pp. 343 ◽  
Author(s):  
Pin-Pin Wu ◽  
Chew-Teng Kor ◽  
Ming-Chia Hsieh ◽  
Yao-Peng Hsieh
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Lower Risk ◽  
Incident Diabetes ◽  
P Value ◽  
Comparison Cohort ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Glucose is one of the constituents in hemodialysates and peritoneal dialysates. How the dialysis associates with the incident diabetes mellitus (DM) remains to be assessed. Methods: The claim data of end-stage renal disease (ESRD) patients who initiated dialysis from and a cohort of matched non-dialysis individuals from 2000 to 2013 were retrieved from the Taiwan National Health Insurance Research Database to examine the risk of incident DM among patients on hemodialysis (HD) and peritoneal dialysis (PD). Predictors of incident DM were determined for HD and PD patients using Fine and Gray models to treat death as a competing event, respectively. Results: A total of 2228 patients on dialysis (2092 HD and 136 PD) and 8912 non-dialysis individuals were the study population. The PD and HD patients had 12 and 97 new-onset of DM (incidence rates of 15.98 and 8.69 per 1000 patient-years, respectively), while the comparison cohort had 869 DM events with the incidence rate of 15.88 per 1000 patient-years. The multivariable-adjusted Cox models of Fine and Gray method showed that the dialysis cohort was associated with an adjusted hazard ratio (HR) of 0.49 (95% CI 0.39–0.61, p value < 0.0001) for incident DM compared with the comparison cohort. The adjusted HR of incident DM was 0.46 (95% CI 0.37–0.58, p value < 0.0001) for HD and 0.84 (95% CI 0.47–1.51, p value = 0.56) for PD. Conclusions: ESRD patients were associated with a lower risk of incident DM. HD was associated with a lower risk of incident DM, whereas PD was not.

scholarly journals Lower risk of end stage renal disease in diabetic nurse

BioMedicine ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 25 ◽  
Author(s):  
Cheng-Chin Pan ◽  
Hsiu-Ling Huang ◽  
Ming-Chih Chen ◽  
Chuan-Yu Kung ◽  
Pei-Tseng Kung ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Lower Risk ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Effects of Early Frequent Nephrology Care on Emergency Department Visits among Patients with End-stage Renal Disease

2019 ◽  
Vol 16 (7) ◽  
pp. 1158
Author(s):  
Yun-Yi Chen ◽  
Likwang Chen ◽  
Jenq-Wen Huang ◽  
Ju-Yeh Yang
Keyword(s):  
Emergency Department ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Lower Risk ◽  
Early Referral ◽  
Dialysis Treatment ◽  
Nephrology Care ◽  
Stage Renal Disease ◽  
End Stage ◽  
Late Referral

In this retrospective cohort study, we examined the association between predialysis nephrology care status and emergency department (ED) events among patients with end-stage renal disease. Data pertaining to 76,702 patients who began dialysis treatment between 1999 and 2010 were obtained from the National Health Insurance Research Database of Taiwan (NHIRD). The patients were divided into three groups based on the timing of the first nephrology care visit prior to the initiation of maintenance dialysis, and the frequency of nephrologist visits (i.e., early referral/frequent consultation, early referral/infrequent consultation, late referral). At 1-year post-dialysis initiation, a large number of the patients had experienced at least one all-cause ED visit (58%), infection-related ED visit (17%), or potentially avoidable ED visit (7%). Cox proportional hazard models revealed that patients who received early frequent care faced an 8% lower risk of all-cause ED visit (HR: 0.92; 95% CI: 0.90–0.94), a 24% lower risk of infection-related ED visit (HR: 0.76; 95% CI: 0.73–0.79), and a 24% lower risk of avoidable ED visit (HR: 0.76; 95% CI: 0.71–0.81), compared with patients in the late referral group. With regard to the patients undergoing early infrequent consultations, the only marginally significant association was for infection-related ED visits. Recurrent event analysis revealed generally consistent results. Overall, these findings indicate that continuous nephrology care from early in the predialysis period could reduce the risk of ED utilization in the first year of dialysis treatment.

scholarly journals Comorbidity Profiles among Obese–Diabetic End-Stage Renal Disease Patients: Data from REIN Registry of PACA Region of France

2021 ◽  
Vol Volume 14 ◽  
pp. 617-625
Author(s):  
Asmatullah Kakar ◽  
Yosra Mouelhi ◽  
Anderson Loundou ◽  
Adeline Crémades ◽  
Stephanie Gentile
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Rein Registry
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