Renal replacement therapy and conservative management: NICE guideline (NG 107) October 2018

Arslan, Zainab; Khurram, Muhammad; Sinha, Manish D.

doi:10.1136/archdischild-2019-316892

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…In Taiwan, HD is preferred to PD among patients with ESKD, which is similar to the trend in other countries [ 16 , 17 , 18 ]. However, we hypothesized that survival outcomes may not be identical between the two groups, and advancements such as more biocompatible solutions might make PD a more favorable choice [ 14 ]. In this study, we conducted a detailed comparison between PD and HD outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Accurate comparisons of survival benefits and appropriate timing of conversion between HD and PD are lacking. Most survival benefits have been demonstrated in observational studies, which tend to have high heterogeneity [ 14 , 15 ]. These studies have provided no strong evidence comparing HD and PD in the latest guidelines [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Most survival benefits have been demonstrated in observational studies, which tend to have high heterogeneity [ 14 , 15 ]. These studies have provided no strong evidence comparing HD and PD in the latest guidelines [ 14 ]. Therefore, we evaluated and compared the adjusted survival benefit of HD and PD by using a nationwide cohort and multivariate Cox regression models.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Dialysis Modalities on All-Cause Mortality and Cardiovascular Mortality in End-Stage Kidney Disease: A Taiwan Renal Registry Data System (TWRDS) 2005–2012 Study

Zheng

Chen

et al. 2022

JPM

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Introduction: End-stage kidney disease (ESKD) patients who need renal replacement therapy need to face a dialysis modality decision: the choice between hemodialysis (HD) and peritoneal dialysis (PD). Although the global differences in HD/PD penetration are affected by health-care policies, these two modalities may exert different effects on survival in patients with ESKD. Although Taiwan did not implicate PD as first policy, we still need to compare patients’ outcomes using two modalities in a nation-wise database to determine future patients’ care and health policies. Methods: We used the nationwide Taiwan Renal Registry Data System (TWRDS) database from 2005 to 2012 and included 52,900 patients (48,371 on HD and 4529 on PD) to determine all-cause and cardiovascular mortality among ESKD patients. Results: Age-matched survival probability from all-cause mortality was significantly lower in patients on PD than in those on HD (p < 0.05). The adjusted hazard ratios of 3-year and 5-year all-cause and cardiovascular mortality were significantly higher in PD compared with HD. The presence of comorbid conditions including myocardial infarction, coronary artery disease (CAD), diabetes mellitus (DM), hypoalbuminemia, hyperferritinemia and hypophosphatemia was related with significantly higher all-cause and CV mortality in PD patients. No significant difference was noted among younger patients <45 years of age regardless of DM and/or comorbid conditions. Conclusion: Although PD did not have the survival advantage compared to HD in all dialysis populations, PD was related with superior survival in younger non-DM patients, regardless of the presence of comorbidities. Similarly, for younger ESKD patients without the risk of CV disease, both PD and HD would be suitable dialysis modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Dialysis Modalities on All-Cause Mortality and Cardiovascular Mortality in End-Stage Kidney Disease: A Taiwan Renal Registry Data System (TWRDS) 2005–2012 Study

Zheng

Chen

et al. 2022

JPM

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“…Diagnosis and treatment. Disease diagnosis, treatment, initial parameter setting of invasive mechanical ventilation, adjustment during treatment, invasive mechanical ventilation combined with inhaled nitric oxide (INO) treatment, continuous renal replacement therapy (CRRT) and the application of exogenous pulmonary surfactant (PS) (PS for Poractant Alfa Injection, Chiesi Farmaceutici S.p.A.) were all based on the published guidelines and 'Pediatric mechanical ventilation' (1,7,13,14).…”

Section: Methodsmentioning

confidence: 99%

Bronchoalveolar lavage under ultrasound monitoring of lungs for the treatment of neonatal atelectasis and lung consolidation

Feng

Zhang

2021

World Acad Sci J

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Neonatal atelectasis and pulmonary consolidation diseases are common and difficult to treat. Thus, novel treatment methods need to be explored. Although an X-ray chest radiography is feasible for the detection of neonatal atelectasis and pulmonary consolidation diseases, there is a risk of radiation damage and lung ultrasound may be used instead. The aim of the present study was to investigate the bronchoalveolar lavage (BAL) under ultrasound monitoring of lungs for the treatment of neonatal atelectasis and lung consolidation disease. For this purpose, the present study prospectively selected 73 children with severe newborn respiratory distress syndrome (NRDS), 60 children with severe neonatal pneumonia (NP), and 65 children with meconium aspiration syndrome (MAS) as the research subjects. Each disease was divided into three groups as follows: The exogenous pulmonary surfactant (PS) lavage group, the normal saline (NS) lavage group and the non-lavage group, using lung ultrasound as the imaging method for lung disease. The treatment effect, complications and differences in the oxygenation index (OI) among the three groups of each disease were compared. The results revealed that the time of lung recruitment and invasive ventilator treatment among the three groups of each disease was shorter in the PS lavage group than in the NS lavage group, and also between the PS lavage and NS lavage group compared with the non-lavage group (P<0.05). Following treatment for each disease, the PS lavage group exhibited a more rapid decline in OI than the NS lavage group, and the PS lavage group and NS lavage group exhibited a more rapid decline in OI than the non-lavage group (P<0.05). No significant differences in treatment complications were observed among the three groups of each disease (P>0.05). On the whole, the present study demonstrates that BAL under lung ultrasound monitoring is effective in the treatment of neonatal atelectasis and pulmonary consolidation diseases caused by severe NRDS, severe NP or MAS. It can decrease the invasive ventilator treatment time of neonatal atelectasis and lung consolidation more rapidly, and can rapidly decrease the OI, without increasing complications. Thus, exogenous PS lavage is more effective than NS lavage.

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“…In general, pre-dialysis care must start when GFR is below 30 ml/min 1.73 m 2 3 , the evaluation of living donor transplantation with GFR below 20 ml/min 1.73 m 2 4 and preparation for RTT i.e. the creation of vascular access GFR is less than 15 ml/min/1.73 m 2 5 – 7 . All guidelines agree on the recommendation to start RRT in the presence of uraemic symptoms or volume overload, independently of the level of GFR 3 – 9 .…”

Section: Introductionmentioning

confidence: 99%

The error of estimated GFR in predialysis care

Escamilla-Cabrera,

Luis-Lima,

Gallego-Valcarce

et al. 2024

Sci Rep

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The error of estimated glomerular filtration rate (eGFR) and its consequences in predialysis are unknown. In this prospective multicentre study, 315 predialysis patients underwent measured GFR (mGFR) by the clearance of iohexol and eGFR by 52 formulas. Agreement between eGFR and mGFR was evaluated by concordance correlation coefficient (CCC), total deviation index (TDI) and coverage probability (CP). In a sub-analysis we assessed the impact of eGFR error on decision-making as (i) initiating dialysis, (ii) preparation for renal replacement therapy (RRT) and (iii) continuing clinical follow-up. For this sub-analysis, patients who started RRT due to clinical indications (uremia, fluid overload, etc.) were excluded. eGFR had scarce precision and accuracy in reflecting mGFR (average CCC 0.6, TDI 70% and cp 22%) both in creatinine- and cystatin-based formulas. Variations -larger than 10 ml/min- between mGFR and eGFR were frequent. The error of formulas would have suggested (a) premature preparation for RTT in 14% of stable patients evaluated by mGFR; (b) to continue clinical follow-up in 59% of subjects with indication for RTT preparation due to low GFRm and (c) to delay dialysis in all asymptomatic patients (n = 6) in whom RRT was indicated based on very low mGFR. The error of formulas in predialysis was frequent and large and may have consequences in clinical care.

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Renal replacement therapy and conservative management: NICE guideline (NG 107) October 2018

Cited by 5 publications

References 7 publications

Effect of Dialysis Modalities on All-Cause Mortality and Cardiovascular Mortality in End-Stage Kidney Disease: A Taiwan Renal Registry Data System (TWRDS) 2005–2012 Study

Effect of Dialysis Modalities on All-Cause Mortality and Cardiovascular Mortality in End-Stage Kidney Disease: A Taiwan Renal Registry Data System (TWRDS) 2005–2012 Study

Bronchoalveolar lavage under ultrasound monitoring of lungs for the treatment of neonatal atelectasis and lung consolidation

The error of estimated GFR in predialysis care

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