Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Li, Jianbo; Yu, Jinming; Huang, Naya; Ye, Hongjian; Wang, Dan; Peng, Yuan; Guo, Xiaotong; Chen, Yi; Yang, Xiao; Yu, Xueqing

doi:10.1186/s12882-020-02201-0

Cited by 2 publications

(1 citation statement)

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“…Peritoneal dialysis (PD) is an established treatment modality of kidney replacement therapy for patients with kidney failure increasing acceptance worldwide [1,2]. Despite PD technology has significantly advanced, high technique failure rates, high hospitalization rates, and high mortality rates remain tough challenges [3][4][5]. Therefore, more efforts should be made to identify the risk of PD technique failure and mortality, to act on modifiable risk factors, offer enhanced preventative strategies to vulnerable patients.…”

Section: Introductionmentioning

confidence: 99%

Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients

et al. 2021

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Background Peritoneal dialysis (PD) patients have a high incidence of poor clinical outcomes, which is related to the inflammatory and nutritional status of this population. Platelet-to-albumin ratio (PAR), recently identified as a useful biomarker to monitor inflammation and nutrition, can predict a poor prognosis in various diseases. The aim of this study was to investigate the association between PAR and technique failure and mortality in PD patients. Methods This single-center retrospective study enrolled 405 PD patients from 1 January 2011 to 31 December 2019 and collected complete demographic characteristics, clinical laboratory baseline data. The outcomes were technique failure and mortality. The associations between PAR and technique failure, death were analyzed by Cox proportional hazard models and competing risk regression models with kidney transplantation as a competing event. The areas under the curve (AUC) of receiver-operating characteristic analysis were used to determine the predictive values of PAR for technique failure and mortality. Results During a median follow-up period of 24.0 (range, 4.0–91.0) months, 139 (34.3%) PD patients experienced technique failure, 61 (15.1%) PD patients died. The patients with higher PAR levels had increased risk of technique failure and mortality. After adjustment for confounding factors, we found that high PAR levels were risk factor for both technique failure (subdistribution hazard ratio [ SHR ] 1.775; 95%CI , 1.157–2.720; p = 0.033] and mortality [ SHR 3.710; 95%CI , 1.870–7.360; p < 0.001]. The predictive ability of PAR was superior to platelet and albumin based on AUC calculations for technique failure and mortality. Conclusions PAR was a risk factor associated with technique failure and mortality in PD patients.

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Section: Introductionmentioning

confidence: 99%

Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients

et al. 2021

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Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Mohamed¹,

Jeele²

2022

IJGM

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Background End-stage renal disease (ESRD) in Somalia remains unexamined due to a lack of a national registry system, and the impact of the disease in the country is not estimated yet. The present study is the first report that aims to evaluate the epidemiological characteristics, causes, and dialysis-related factors associated with readmissions in ESRD patients who were going to routine hemodialysis. Patients and methods This cross-sectional observational study enrolled 208 patients with ESRD. Also, this study investigated patients readmitted to the hospital (n=135) after they enrolled in hemodialysis. The sociodemographic characteristics, risk factors, and comorbidities associated with these patients were reviewed. Admission site, length of hospital stay, outcome, and dialysis-related factors associated with readmissions in the first six months after being on a regular hemodialysis program were also assessed. Results The mean age of the patients was 52.7±15.0 years, 43.3% were >60 years, and 61.5% were male. The most common cause was diabetes at 39.4%, followed by hypertension (35.6%) and 12.5% for postrenal obstruction. The prevalence of 6-month hospital readmissions was 65%. The most common dialysis-related factor associated with readmissions was uremic complications due to missed hemodialysis sessions (40%), vascular access/catheter infection (20%), and anemia (17.8%) (95% CI: 0.825–5.357, OR: 3.017, p<0.04). Female cases were more vulnerable to vascular catheter site infection, anemia, and hyponatremia (p<0.001). 27.5% of the patients were admitted to the intensive care unit (ICU), and the most common reason for ICU admissions was pulmonary edema (53.8%), sepsis (42.8%), and uremia due to hemodialysis skip (26.4%) (95% CI: 1.507–13.632, OR: 2.08, p=0.01). The mortality rate was 5.2%. Conclusion The prevalence of unplanned hospital readmissions within six months was very high, and a missed hemodialysis session was identified as the leading cause. Inadequate knowledge, wrong social beliefs about the concept of dialysis and a lack of a health insurance system that covers the higher costs of each dialysis session are believed to be the causes of missed dialysis occasions.

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Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Cited by 2 publications

References 40 publications

Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients

Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

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