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  • Oxford University Press (OUP)  (21)
  • Chen, Junzhe  (21)
Materialart
Verlag/Herausgeber
  • Oxford University Press (OUP)  (21)
Sprache
Erscheinungszeitraum
  • 1
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)
    Kurzfassung: Since December 2019, patients undergoing maintenance dialysis have been significantly affected by COVID-19, facing higher risk of death than general population. However, current evidences assess the mortality of patients with COVID-19 remains incomplete. We performed meta-analyses of overall mortality in dialysis patients after SARS-CoV-2 infection. In addition, this study investigated the differences among different races,viral variants, hemodialysis and peritoneal dialysis with COVID-19. At the same time, the mortality rate of dialysis patients with the COVID-19 after vaccination was also observed. Method We performed a meta-analysis with literature searching in PubMed, EMBASE, Web of Science and Cochrane databases, published between December 1, 2019 and January 10,2023. Two authors separately screened the titles and abstracts of the documents and ruled out irrelevant articles. Fixed effects model and random effects model were used for calculating heterogeneity. Results A total of 83 studies included 7278 died from confirmed COVID-19 cases in a pool of 42925 dialysis patients. Overall mortality of COVID-19 in dialysis patients was 22% (95%Confidence Interval [CI]:19%-25%, p & lt;0.01; I2 = 96.74%) from 2020 to 2022. In subgroup analysis, compared with ancestral COVID-19 (23%,95%CI:20%-25%,p & lt;0.01; I2 = 93.01%) and alpha variant (30%, 95% CI:21%-54%,p & lt;0.01;I2 = 95.35%),omicron variant (4%,95%CI:0-14%,p = 0.09; I2 = 0) had a lower morality significantly (Figure 1). The mortality for Asian and non-Asian were 20% (95% CI:16%-25%,p & lt;0.01;I2 = 96.6%) and 24% (95%CI:20%-27%,p & lt;0.01; I2 = 96.32%) respectively. The odds of death for maintenance hemodialysis and peritoneal dialysis were similar (odd ratio [OR] 1.30,95%CI:0.88-1.93,p = 0.191,I2 = 0). Furthermore, we also compared vaccination with unvaccination, and found out that vaccination was associated with lower mortality (OR = 0.18, 95%CI:0.11-0.28,p & lt;0.01;I2 = 71.4%) (Figure 2). Conclusion Patients undergoing maintenance dialysis with COVID-19 have a higher morality. These findings suggest that the mortality of omicron variant may be lower than other variants. In our study, there's no significant difference in mortality between hemodialysis and peritoneal dialysis patients with COVID-19. Moreover, vaccines have a good protective effect on dialysis patients.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Kurzfassung: Angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril–valsartan is a landmark drug in heart failure with reduced ejection fraction (HFrEF), however, it remains unclear in patients with heart failure with preserved ejection fraction (HFpEF), especially the data of ARNI treatment on peritoneal dialysis (PD) patients with HFpEF are lacking. The present study was designed to determine the efficacy and safety of sacubitril–valsartan in patients with HFpEF undergoing peritoneal dialysis. Method We assigned end stage renal disease (ESRD)patients, receiving peritoneal dialysis for 3 months, with New York Heart Association (NYHA) class II to IV heart failure, left ventricular ejection fraction ≥ 50%, and elevated level of N-terminal pro–B-type natriuretic peptide (NT-proBNP) to receive sacubitril/valsartan treatment. Patients were regularly followed up after medication treatment. Wilcoxon matched-pair signed-rank (2 samples) tests were applied to investigate the alterations in Clinical and biochemical parameters as the efficacy before and after taking sacubitril–valsartan, and safety was also assessed. Results Twenty-one patients were recruited in this study. Compared with baseline levels, NT-proBNP levels (p=0.002) and heart rate (p=0.031) were markedly decreased after treatment with sacubitril/valsartan, signs and symptoms of heart failure (21/21 versus 15/21, p=0.021) and NYHA classification were notably improved after 3-12 months follow-up. Conclusion The present data suggested that sacubitril/valsartan treatment in the patients with HFpEF undergoing peritoneal dialysis was effective and safe, which is the first study about sacubitril/valsartan treatment for the PD patients with HFpEF, and it may bring the hope for these patients due to no other effective methods at present.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2020
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)
    Kurzfassung: It is well known that serum uric acid (SUA) plays an important role both in patients with and without chronic kidney disease (CKD). However, the effect of SUA on renal outcomes of CKD patients, especially with asymptomatic hyperuricemia, remains controversial. Therefore, our study explores the relationship between SUA and adverse events in early CKD (stage 1-3) patients in a real-world setting. Method This multi-center real-world study analyzed the data from Chinese Renal Data System (CRDS). Eligible CKD patients (eGFR) (estimated glomerular filtration rate≥30 mL/min/1.73 m2) were enrolled. The primary endpoint is the decline of renal function defined as at least 40% decrease in eGFR. The secondary endpoints include onset of composite cardiovascular events and all-cause mortality. A multivariable cox regression model were used and the associations between levels of mean SUA and all endpoints were evaluated on a continuous scale with restricted cubic spline (RCS) curves based on Cox proportional hazards models. Kaplan-Meier survival curves were used to illustrate the ability of SUA to predict the end points. Results 25,202 adults (mean [SD] age, 52.59 [17.90] years, 8,212 male [46.1%], 9,604 female [53.9%] ) were included in this study. During a median follow-up period of 2.61 years, 3,451 (15.9%) at least 40% decreased in eGFR. After adjustment for confounders, higher uric acid concentrations were independently associated with the higher risk for the decline of renal function [Per SD increment adjusted hazard ratio [aHR]: 1.41, 95%CI 1.36-1.47] ; composite cardiovascular events [Per SD increment [aHR]: 1.04, 95%CI 1.01-1.07] , all-cause mortality [Per SD increment [aHR]:1.32, 95%CI 1.14-1.54] . RCS curves showed that HRs for renal function progression, all-cause mortality and composite cardiovascular events increased significantly with the increase of SUA concentration in CKD patients. Results were consistent in stratified analyses. The KM curves suggested that patients with asymptomatic hyperuricemia had a substantially worse survival rate for renal function. Conclusion SUA is an independent risk factor for the decline of renal function, cardiovascular events and all-cause mortality in early CKD patients (stage 1-3). Treatment of asymptomatic hyperuricemia may be a potential avenue to improve outcomes in CKD patients.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2019
    In:  Nephrology Dialysis Transplantation Vol. 34, No. Supplement_1 ( 2019-06-01)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 34, No. Supplement_1 ( 2019-06-01)
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2019
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Kurzfassung: This article aims to detect the expression of urine angiotensinogen (uAGT) in patients with chronic kidney disease (CKD) and its correlation with clinical and renal pathology. Method Patients who diagnosed with CKD and undergoing renal biopsy for the first visit to Sun Yat-sen Memorial Hospital from March 1st ,2018 to October 1st, 2019 were enrolled. First morning urine samples from CKD patients before renal biopsy and healthy volunteers as controls were collected during the same period. These samples were tested for uAGT by ELISA. Linear regression analysis was used to explore the correlation between uAGT and clinical indicators as well as renal pathology in CKD patients. The receiver operating curve (ROC curve) was used to explore the diagnostic value of uAGT for CKD stage 3 or above and glomerular sclerosis ratio & gt;50%. Results A total of 133 CKD patients with 59 (44.4%) in stage 1, 31 (23.3%) in CKD stage 2, 17 (12.8%) in stage 3, 17 (12.8%) in stage 4 and 9 (6.7%) in stage 5 were included in our study. At the same time, 20 healthy volunteers were included as control. uAGT levels of CKD patients were significantly higher than healthy controls(275.0 vs 774.2,P & lt;0.001). Compared with CKD stage 1-2 patients, uAGT levels in patients with stage CKD 3 or above were significantly increased, and the difference was statistically significant (P & lt;0.001) (Table 1). The result of multivariate linear regression analysis showed that uAGT levels in CKD patients were positively correlated with 24h urine protein (beta = 0.193, P = 0.012) and negatively correlated with eGFR (beta = -0.489, P & lt;0.001) (Table 2). We also demonstrated that uAGT was positively correlated with the ratio of glomerular sclerosis(P = 0.003) (Table 3). Our results showed that the area under the curve (AUC)of uAGT for the diagnosis of renal function with CKD stage 3 or above was 0.789 (Figure 1) with the cut-off value was1959.9pg/ml. The sensitivity and specificity were 51.2% and 97.3% respectively, Furthermore, the positive predictive value (PPV) was 88.0% and negative predictive value (NPV) was 82.95%.The AUC of uAGT for the diagnosis of renal pathological glomerular sclerosis ratio & gt;50% was 0.677 (Figure 2).The cut-off value of uAGT was 2131.8pg/ml.The sensitivity and specificity were 50% and 89.5% respectively. Meanwhile, the PPV was 41.67% and the NPV was 92.25%. Conclusion uAGT was significantly increased in CKD patients, which is closely related with the urinary protein, eGFR, and renal pathology.The specific cut-off value of uAGT can be used as a predictive indicator of advanced CKD stage and severe glomerular sclerosis.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2020
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2015
    In:  Nephrology Dialysis Transplantation Vol. 30, No. suppl_3 ( 2015-05), p. iii115-iii116
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 30, No. suppl_3 ( 2015-05), p. iii115-iii116
    Materialart: Online-Ressource
    ISSN: 1460-2385 , 0931-0509
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2015
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2018
    In:  Nephrology Dialysis Transplantation Vol. 33, No. suppl_1 ( 2018-05-01), p. i422-i422
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 33, No. suppl_1 ( 2018-05-01), p. i422-i422
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2018
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Kurzfassung: Acute kidney injury (AKI) is a widely-discussed complication associated with the radical cystectomy which is the gold standard for the management of invasive bladder cancer. Until now, few studies investigate the new criteria named Acute Kidney Diseases and Disorders(AKD) as the complication of radical cystectomy. In this study, we evaluated the incidence, risk factors of AKD and evaluate its impact on chronic kidney disease (CKD) in patients after radical cystectomy. Method A total of 279 patients who underwent radical cystectomy at Sun Yat-sen Memorial Hospital, Guangzhou, China, from January 2006 to June 2019 were evaluated, including 168 patients for Robotic-assisted Laparoscopic Radical Cystectomy (RLRC) and 111 patients for Laparoscopic Radical Cystectomy(LRC). AKD was diagnosed according to the classification scheme proposed in the 2012 KDIGO guideline. Logistic regression modeling was used to explore risk factors of AKD, while risk factors associated with CKD in AKD patients were investigated using Kaplan-Meier analysis, respectively. Results The overall incidence of AKD after radical cystectomy was 34.1% (95 out of 279) ,the incidences differ significantly between the RLRC and LRC groups (67 [39.9%] vs 28 [25.2%] , P=0.011). Among 279 patients, risk factors associated with postoperative AKD included RLRC (OR 2.067, 95%CI 1.188 to 3.595, P=0.010), Age (years) (OR 1.046, 95%CI 1.018 to 1.074, P=0.001), baseline eGFR & lt;60(ml/(min.1.73m2) (OR 2.662, 95%CI 1.355 to 5.230, P=0.004), Further subgroup analysis identified age, operation time & lt;250(min) as important risk factors of AKD in RLRC patients but not in LRC patients. Of 211 patients with a preoperative estimated glomerular filtration rate (eGFR) of & gt; 60 ml/min/1.73 m2, CKD developed in 16.0% (21/ 131) of patients in the non-AKD group and 36.3% (29/ 80) of patients in the AKD group. Kaplan-Meier analysis(shown in figure 1) identified that AKD is associated with higher CKD rates in those patients (P & lt;0.001). Conclusion One-third of bladder cancer patients developed AKD after after radical cystectomy. RLRC, Age, baseline eGFR & lt;60(ml/(min.1.73m2) were independent risk factors for postoperative AKD in all patients. Occurance of AKD could increase the risk of new-onset CKD in the long run. Though the use of RLRC is now well established, we should be aware that it may increase the risk of postoperative AKD, especially for patients who are old and with lower eGFR .Besides, we should try to improve the management of those AKD patients with aim toward preventing further development of CKD.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2020
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2019
    In:  Nephrology Dialysis Transplantation Vol. 34, No. Supplement_1 ( 2019-06-01)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 34, No. Supplement_1 ( 2019-06-01)
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2019
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
  • 10
    Online-Ressource
    Online-Ressource
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)
    Kurzfassung: Interleukin-6 (IL-6) is a key mediators of inflammation and has been linked to the severity and mortality of COVID-19-Omicron in the general population. With higher mortality rates observed in maintenance hemodialysis (MHD) patients infected with COVID-19-Omicron, the study aimed to examine the correlation between IL-6 levels and mortality in this patient population and to indentify the optimal IL-6 level for predicting the risk of death. Method The retrospective observational study was conducted in MHD patients diagnosed with COVID-19-Omicron infection between December 01, 2022 and January 31, 2023 at the Third Affiliated Hospital of Southern Medical University during the first wave of infection in COVID-19-Omicron outbreak in China. Clinical and biochemical data were collected during the infection, IL-6 levels of the patients were measured before consecutive dialysis sessions by a commercial kit. The Cox model was used to investigate the risk factors of mortality, meanwhile, ROC curve to determine the cut off value of IL-6 levels on mortality. Results A total of 162 MHD patients infected with COVID-19-Omicron were included in this study. During a median follow-up period of 40 days, 10 (6.2%) deaths occurred due to COVID-19 infection. IL-6 levels were significantly higher in patients who died. Univariate Cox regression analyses showed that the risk factors associated with death included IL-6 levels (HR: 1.009; p & lt;0.001), C-reactive protein (HR: 1.01; p = 0.016), serum potassium (HR: 2.258; p = 0.015, procalcitonin(PCT) (HR: 1.01; p = 0.048), and the Charlson comornidity index(CCI)(HR: 1.34; p = 0.002). However, in multivariate analysis, only IL-6 levels was independently associated with all-cause mortality(HR: 1.01; p = 0.001).The ROC curve and Kaplan-Meier survival analysis revealed a significantly worse survival risk among MHD patients with higher serum IL-6 levels (≥104.87 pg/mL) (sensitivity:100%; specificity:78.2%; AUC: 0.92; p = 0.001). Conclusion Serum IL-6 levels greater than 104.87 pg/mL were associated with an increased risk of all-cause mortality in MHD patients infected with COVID-19-Omicron. Hemoperfusion or hemofiltration to remove IL-6 may provide appropriate treatment options for hemodialysis patients with COVID-19-Omicron.
    Materialart: Online-Ressource
    ISSN: 0931-0509 , 1460-2385
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 1465709-0
    Standort Signatur Einschränkungen Verfügbarkeit
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