Reverse epidemiology in peritoneal dialysis patients: the Canadian experience and review of the literature

Pliakogiannis, Theodoros; Trpeski, Lilyanna; Taşkapan, Hülya; Shah, Hemal; Ahmad, Mufazzal; Fenton, Stanley; Bargman, Joanne M.; Oreopoulos, Dimitrios G.

doi:10.1007/s11255-006-9142-1

Cited by 27 publications

(27 citation statements)

References 40 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, a BMI less than 18.5 was associated with a death hazard ratio (HR) of 1.3, (Cl:1.1-1.6). In contrast, BMI [ 30 was not associated with worse survival than that for those with normal BMI (HR = 1.009, CI = 0.89-1.14) [33].…”

Section: Body Mass Index (Bmi) and Survival On Pdmentioning

confidence: 78%

Home dialysis as a first option: a new paradigm

et al. 2009

View full text Add to dashboard Cite

Traditionally, the initial choice of dialysis for patients with end stage renal disease (ESRD) has been in-center hemodialysis (HD) or peritoneal dialysis (PD). Usually, the choice between these (PD vs. HD) has been based on the characteristics of the dialysis techniques. Obviously the choice of peritoneal dialysis implied dialysis at home, but its geographic location has been only a secondary consideration. Peritoneal dialysis has evolved as a dependable mode that gives good outcomes. This method has become more attractive with the option of overnight cyclers and the recent use of home helpers in some jurisdictions. At the same time the interest in home hemodialysis was rekindled by reports of good outcomes with short daily or nocturnal hemodialysis. Home dialysis (PD or HD) offers high quality of treatment, a high degree of patient independence, and is financially attractive. Therefore, we propose a change in our approach to the choice of the initial form of dialysis for patients with ESRD. Instead of choosing between HD and PD we should present the new patients the advantage of dialysis at home and instead of asking them to choose between peritoneal dialysis or hemodialysis, they should be offered the option to choose between dialysis at home (PD or HD) or in-hospital. This paper will review the advantages of the home-based dialysis methods and the arguments for this simple but vital change in the process of choosing the method of dialysis.

show abstract

Section: Body Mass Index (Bmi) and Survival On Pdmentioning

confidence: 78%

Home dialysis as a first option: a new paradigm

et al. 2009

View full text Add to dashboard Cite

show abstract

“…By contrast, our study identifies lower BMI as an independent predictor for ESRD in patients with stage 3–5 CKD. This seemingly paradoxical finding could be reminiscent of the ‘reverse epidemiology’ seen in the dialysis population where low BMI and the associated malnutrition were liable for an augmented hazard of death worse than for those with high BMI [32,33,34]. …”

Section: Discussionmentioning

confidence: 99%

Outcomes of Stage 3–5 Chronic Kidney Disease before End-Stage Renal Disease at a Single Center in Taiwan

et al. 2008

View full text Add to dashboard Cite

Background: Taiwan has the highest incidence of end-stage renal disease (ESRD) in the world, but little is known about the outcomes of patients with chronic kidney disease (CKD) before ESRD in Taiwan. This study investigated the rate of renal progression and predictors for ESRD and death in a prospective cohort of patients under usual nephrologic care at a single center. Methods: A total of 433 patients at CKD stage 3–5 short of dialysis were recruited from nephrology clinics. Patients were monitored for up to 36 months or until ESRD, death or loss to follow-up. Glomerular filtration rates (GFR) were calculated by the Modification of Diet in Renal Disease abbreviated formula. Results: At baseline, mean age was 65.6 years, 61.7% were male, 33.3% were diabetic and 29.1% had cardiovascular diseases (CVD). At the end of follow-up, 123 patients (28.4%) had advanced to ESRD and 41 (9.5%) had died. Mean annual declines in GFR were 2.24, 4.22, and 3.23 ml/min/1.73 m² for stages 3, 4, and 5, respectively. By Cox regression model, patients with CVD, lower BMI and higher systolic BP were more likely to develop ESRD. Older patients with CVD and lower systolic BP were more likely to die. Conclusion: In this CKD cohort, patients were more likely to develop ESRD than cardiovascular death. The rate of GFR decline and predictors of ESRD were comparable to those reported in Western countries. Thus, the high incidence of ESRD in Taiwan may be attributed, at least in part, to lower cardiovascular mortality.

show abstract

“…Nevertheless, it is not clear whether BMI is associated with increased mortality in all populations. For example, increased BMI has not been associated with death in patients with infection admitted to a surgical ⁄ trauma intensive care unit [8], peritoneal dialysis patients [9] or hospitalized frail elderly patients [10]. The aim of the present study was to assess the effect of BMI on total and cardiovascular mortality in a very elderly population with diabetes mellitus.…”

Section: Introductionmentioning

confidence: 93%

Body mass index and risk of all‐cause and cardiovascular mortality in hospitalized elderly patients with diabetes mellitus

et al. 2009

View full text Add to dashboard Cite

Aims Obesity is linked to increased morbidity and mortality risk in both the general population and in patients with diabetes mellitus; however, recent reports suggest that, in hospitalized elderly individuals, the association between body mass index (BMI) and mortality may be inverse. The present study sought to investigate the association between BMI and survival in hospitalized elderly individuals with diabetes mellitus.Methods The medical records of 470 patients (226 males, mean age of 81.5 ± 7.0 years) admitted to an acute geriatric ward between 1999 and 2000 were reviewed. Of the 140 patients with diabetes mellitus, 122 had more than 6 months of follow-up and were included in this analysis. Patients were followed up until 31 August 2004. Mortality data were extracted from death certificates.Results During a mean follow-up of 3.7 ± 1.6 years, 69 (56.6%) subjects died, 31 (25.4%) from cardiovascular causes. Those who died from any cause had lower baseline BMI than those who survived (24.0 ± 4.0 vs. 27.1 ± 4.3 kg ⁄ m 2 ; P < 0.0001). Similarly, those who died of cardiovascular causes had lower baseline BMI than those who did not (23.7 ± 3.6 vs. 25.9 ± 4.5, P = 0.01). BMI was inversely associated with all-cause [relative risk (RR) 0.89, 95% confidence interval (CI) 0.83-0.96, P = 0.002] and cardiovascular death (RR 0.83, 95% CI 0.74-0.93, P = 0.002) even after controlling for age, sex, smoking, dyslipidaemia and reason for hospital admission.Conclusions In very elderly subjects with diabetes mellitus, increased BMI was associated with reduced mortality risk. Diabet. Med. 26, 253-259 (2009)

show abstract

Reverse epidemiology in peritoneal dialysis patients: the Canadian experience and review of the literature

Cited by 27 publications

References 40 publications

Home dialysis as a first option: a new paradigm

Home dialysis as a first option: a new paradigm

Outcomes of Stage 3–5 Chronic Kidney Disease before End-Stage Renal Disease at a Single Center in Taiwan

Body mass index and risk of all‐cause and cardiovascular mortality in hospitalized elderly patients with diabetes mellitus

Contact Info

Product

Resources

About