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  • 1
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    The predictive study of the relation between elevated low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality in peritoneal dialysis
    Springer Science and Business Media LLC ; 2020
    In:  Lipids in Health and Disease Vol. 19, No. 1 ( 2020-12)
    Details
    In: Lipids in Health and Disease, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2020-12)
    Abstract: The low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio constitutes a strong risk predictor of cardiovascular events. However, the association between this ratio and cardiovascular death in peritoneal dialysis (PD) patients is uncertain. The study aimed to investigate whether a high LDL-C/HDL-C ratio could predict both cardiovascular and all-cause mortalities in patients on PD. Methods A total of 1616 incident patients on PD included from January 1, 2006 to December 31, 2013 were followed up with until 31 December 2018 in this single-center prospective cohort study. Participants were divided into three categories according to LDL-C/HDL-C ratio tertile. The primary endpoint was cardiovascular mortality; the secondary endpoint was all-cause mortality. Results The mean age of the study cohort was 47.5 years and the mean body mass index (BMI) was 21.6 kg/m 2 . During a median follow-up period of 47.6 months, 492 patients died, including 246 (50.0%) due to cardiovascular disease (CVD). A multivariate analysis revealed that the highest LDL-C/HDL-C ratio tertile was significantly associated with increased CVD mortality [hazard ratio (HR): 1.69, 95% CI: 1.24–2.29; P =  0.001] and all-cause mortality (HR: 1.46, 95% CI: 1.18–1.81; P =  0.001) relative to the lowest tertile. After adjusting for covariates, the HRs of cardiovascular and all-cause mortalities were 1.84 (95% CI: 1.25–2.71; P =  0.002) and 1.35 (95% CI: 1.03–1.77; P =  0.032). Subgroup analysis showed that the risk of CVD death rose with a higher LDL-C/HDL-C ratio among PD patients who were female, younger than 65 years old, without being malnourished (BMI ≥ 18.5 kg/m 2 or albumin ≥35 g/L), and with a history of diabetes or CVD, respectively. Conclusions A high LDL-C/HDL-C ratio is an independent risk factor for both cardiovascular and all-cause mortalities among PD patients.
    Type of Medium: Online Resource
    ISSN: 1476-511X
    URL: Article
    DOI: 10.1186/s12944-020-01240-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2091381-3
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  • 2
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    Ten-year survival of patients treated with peritoneal dialysis: A prospective observational cohort study
    SAGE Publications ; 2020
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 40, No. 6 ( 2020-11), p. 573-580
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 40, No. 6 ( 2020-11), p. 573-580
    Abstract: Few studies evaluated over 5-year outcomes of dialysis patients. This study examined 10-year all-cause mortality and death-censored technique failure in a cohort of incident peritoneal dialysis (PD) individuals. Methods: Five hundred and thirty-three incident PD individuals from 2006 to 2008 were prospectively followed up for more than 10 years until 2018. Clinical characteristics at PD initiation were collected. The primary outcome was all-cause mortality, and the secondary outcome was death-censored technique failure. Cox hazards models were fit using clinical characteristics at PD initiation. Results: The mean age starting PD for these participants was 48 ± 16 years; 130 (24%) patients had diabetic nephropathy. During follow-up, 208 patients died, and 84 patients experienced technique failures. The 1, 3, 5, and 10 years’ survival rates for incident PD patients were 93%, 81%, 64%, and 36%, respectively, and the technical survival rates were 98%, 93%, 85%, and 62%, respectively. Mortality risk was much higher after 3 years on PD. The peritonitis rate was 0.19 episodes per patient-year, and 7 (1.3%) patients had encapsulating peritoneal sclerosis (EPS) giving an incidence rate of 3.1 of 1000 patient-years. The main causes of death were cardiovascular events (97 of 208, 47%), and technique failure was mainly due to peritonitis (41 of 84, 49%). Older age, higher Charlson comorbidity index, and lower level of education were strongly associated with mortality, and diabetic nephropathy was an independent risk factor for technique failure. Conclusions: The 10-year’s survival and technique survival rates of incident PD patients were 36% and 62%. Long-term PD can be continued successfully with improved outcomes and low risk for EPS.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/0896860820927534
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2075957-5
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  • 3
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    Risk factors and clinical outcomes of encapsulating peritoneal sclerosis: A case–control study from China
    SAGE Publications ; 2022
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 42, No. 5 ( 2022-09), p. 505-512
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 42, No. 5 ( 2022-09), p. 505-512
    Abstract: Encapsulating peritoneal sclerosis (EPS) is an uncommon, but serious complication in patients with continuous ambulatory peritoneal dialysis (PD) who have a considerable mortality rate. This study aimed to identify risk factors and outcomes of EPS in Chinese patients on PD. Methods: Sixteen patients on PD who met the International Society for Peritoneal Dialysis criteria for diagnosis of EPS in the First Affiliated Hospital of Sun Yat-Sen University from 1997 to 2018 were included. Patients without EPS were matched for age, sex and the duration of PD and selected at a 1:3 ratio for the controls. A case–control study was conducted to analyse the clinical profile and risk factors associated with EPS in patients. Results: The prevalence of EPS in patients on PD in our centre was 0.55%. The percentage of EPS significantly increased with the duration of PD. In univariate regression analysis, a history of peritonitis (odds ratios (OR): 2.83; 95% confidence interval (CI): 0.82–9.68; p = 0.08), peritoneal glucose exposure (OR: 1.12; 95% CI: 1.03–1.22; p 〈 0.01) and a high peritoneal transport status (OR: 14.70; 95% CI: 1.85–117.02; p 〈 0.01) were associated with EPS in patients on PD. However in the multivariate model, only a high peritoneal transport status (adjusted odds ratios (aOR): 13.65; 95% CI: 1.69–109.96; p = 0.01) was independently associated with EPS. Conclusion: The rate of EPS significantly increases with the duration of PD. Progressive peritoneal dysfunction, especially a high peritoneal transport status, is associated with a higher risk of EPS in this population.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/08968608211029224
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 4
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    The centre-calculated cutoff value is better for identifying fast peritoneal solute transfer of patients on peritoneal dialysis than the traditional value: a retrospective cohort study
    Oxford University Press (OUP) ; 2023
    In:  Clinical Kidney Journal ( 2023-08-21)
    Details
    In: Clinical Kidney Journal, Oxford University Press (OUP), ( 2023-08-21)
    Abstract: The mean 4-h dialysate to plasma ratio of creatinine (4-h D/Pcr) is a vital cutoff value for recognizing the fast peritoneal solute transfer rate (PSTR) in patients on peritoneal dialysis (PD); however, it shows a noticeable centre effect. We aimed to investigate our centre-calculated cutoff value (CCV) of 4-h D/Pcr and compare it with the traditional cutoff value (TCV) (0.65). Methods In this study, we enrolled incident PD patients at our centre from 2008 to 2019, and divided them into fast or non-fast PSTR groups according to baseline 4-h D/Pcr–based CCV or TCV. We compared the efficiency of the fast PSTR recognized by two cutoff values in predicting mortality, ultrafiltration (UF) insufficiency and technical survival. Results In total, 1905 patients were enrolled, with a mean 4-h D/Pcr of 0.71 ± 0.11. Compared with TCV (0.65), CCV (0.71) showed superiority in predicting mortality of PD patients [hazard ratio (HR) 1.27, 95% confidence interval (CI) 1.02–1.59 vs HR 1.24, 95% CI 0.97–1.59]. The odds ratio (OR) of the fast PSTR in centre classification was slightly higher than traditional classification in predicting UF insufficiency (OR 1.67, 95% CI 1.25–2.24 vs OR 1.60, 95% CI 1.15–2.22). Additionally, the restricted cubic splines 4-h D/Pcr has an S-shaped association with mortality and UF insufficiency, and the inflection points of 4-h D/Pcr were 0.71 (equal to CCV). Conclusions The CCV of 4-h D/Pcr for identifying fast PSTR was 0.71. It was superior to TCV in predicting mortality and UF insufficiency.
    Type of Medium: Online Resource
    ISSN: 2048-8505 , 2048-8513
    URL: Article
    DOI: 10.1093/ckj/sfad197
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2656786-6
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  • 5
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    Mesenteric elasticity assessed by shear wave elastography and its relationship with peritoneal function in peritoneal dialysis patients
    Oxford University Press (OUP) ; 2023
    In:  Clinical Kidney Journal Vol. 16, No. 1 ( 2023-01-24), p. 69-77
    Details
    In: Clinical Kidney Journal, Oxford University Press (OUP), Vol. 16, No. 1 ( 2023-01-24), p. 69-77
    Abstract: We evaluated the mesenteric elasticity in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) using shear wave elastography (SWE) and investigated its relationships with peritoneal function. Methods Patients were recruited in our peritoneal dialysis (PD) centre between 15 July 2019 and 31 December 2021 and followed up to 31 March 2022. Twelve chronic kidney disease (CKD) patients and nineteen healthy people were included as controls. Correlation, linear regression and Cox regression analyses were applied. Results Of the 218 PD patients, 104 (47.8%) were male. Their mean age was 48.0 ± 13.2 years and the median PD duration was 59.0 months [interquartile range (IQR) 17.0–105]. The median mesenteric SWE value was 8.15 kPa (IQR 5.20–16.1). The mesenteric SWE values of patients with a PD duration of & lt;3 months [5.20 kPa (IQR 3.10–7.60)] were not significantly different from those of CKD patients [4.35 kPa (IQR 2.63–5.20), P = .17] and healthy controls [3.60 kPa (IQR 2.90–5.10), P = .13] but were lower than those of patients with a PD duration of 3 months–5 years [6.40 kPa (IQR 4.10–10.5), P  & lt; .001], 5–10 years [11.9 kPa (IQR 7.40–18.2), P  & lt; .001] and & gt;10 years [19.3 kPa (IQR 11.7–27.3), P  & lt; .001]. Longer PD duration (β = 0.58, P  & lt; .001), high effluent interleukin-6 (β = 0.61, P = .001) and low effluent cancer antigen 125 (β = −0.34, P = .03) were independently associated with low mesenteric elasticity. The mesenteric SWE value was independently correlated with the dialysate:plasma creatinine ratio (β = 0.39, P = .01) and negatively correlated with the total daily fluid volume removed (β = −0.17, P = .03). High mesenteric SWE values were an independent risk factor for death-censored technique failure [adjusted hazard ratio 4.14 (95% confidence interval 1.25–13.7), P = .02). Conclusions SWE could be used to non-invasively characterize peritoneal textural changes, which were closely associated with changes in peritoneal function.
    Type of Medium: Online Resource
    ISSN: 2048-8505 , 2048-8513
    URL: Article
    DOI: 10.1093/ckj/sfac192
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 6
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    Urgent-start peritoneal dialysis for patients with end stage renal disease: a 10-year retrospective study
    Springer Science and Business Media LLC ; 2019
    In:  BMC Nephrology Vol. 20, No. 1 ( 2019-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-019-1408-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
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  • 7
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    Association of baseline, longitudinal serum high-sensitive C-reactive protein and its change with mortality in peritoneal dialysis patients
    Springer Science and Business Media LLC ; 2017
    In:  BMC Nephrology Vol. 18, No. 1 ( 2017-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2017-12)
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-017-0624-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
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  • 8
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    Roles of peritoneal clearance and residual kidney removal in control of uric acid in patients on peritoneal dialysis
    Springer Science and Business Media LLC ; 2020
    In:  BMC Nephrology Vol. 21, No. 1 ( 2020-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD. Methods This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine. Results In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1 ± 6.2 vs. 42.0 ± 8.0 L/week/1.73m 2 ; P  = 0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0 ± 7.0 vs. 36.4 ± 5.6 L/week/1.73 m 2 ; P   〈  0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93–0.99] . Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), − 0.32; 95% CI, − 6.42 to − 0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m 2 ) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β − 0.24; 95%CI − 7.26 to − 0.99), lower body mass index (β − 0.29; 95%CI − 0.98 to − 0.24), higher transporter status (β 0.24; 95%CI 0.72–5.88) and greater dialysis dose (β 0.24; 95%CI 0.26–3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1 kg/m 2 decrease in body mass index (OR 0.79; 95% CI 0.63–0.99), each 1 g/dL decrease in albumin level (OR 0.08; 95%CI 0.01–0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11–2.19) were associated with greater peritoneal UA clearance ( 〉  39.8 L/week/1.73m 2 ). Conclusions For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-020-01800-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 9
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    Current status of exercise and its impact on quality of life in patients undergoing peritoneal dialysis in the post-COVID-19 period

    Dustri-Verlgag Dr. Karl Feistle ; 2023
    In:  Clinical Nephrology
    Details
    In: Clinical Nephrology, Dustri-Verlgag Dr. Karl Feistle
    Type of Medium: Online Resource
    ISSN: 0301-0430
    URL: Article
    DOI: 10.5414/CN111194
    Language: English
    Publisher: Dustri-Verlgag Dr. Karl Feistle
    Publication Date: 2023
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  • 10
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    Higher Eosinophils Predict Death-Censored Technique Failure in Peritoneal Dialysis Patients
    S. Karger AG ; 2020
    In:  International Archives of Allergy and Immunology Vol. 181, No. 10 ( 2020), p. 765-773
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 181, No. 10 ( 2020), p. 765-773
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Eosinophilia (eosinophil fraction of leukocytes & #x3e;5%), an indicative parameter for bioincompatibility in various circumstances, is well established in hemodialysis. However, change in eosinophil count (EOC) and its association with death-censored technique failure among peritoneal dialysis (PD) patients remain unclear. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We compared eosinophils before and after PD initiation among 1,432 eligible continuous ambulatory PD patients regularly followed up in our PD center during 2007–2018. Risk factors of early-stage eosinophilia were examined by the logistic regression test. The relationship of early-stage eosinophilia and EOC with death-censored technique failure was examined using the Cox proportional hazards model for overall patients and for men and women separately. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 After PD initiation, the EOC and percentage of patients with eosinophilia were significantly increased compared with baseline. Being male (odds ratio [OR]: 2.26; 95% confidence interval [CI] : 1.55–3.31; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and higher EOC at baseline (100 cells/μL increase, OR: 1.62; 95% CI: 1.45–1.82; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) were risk factors of early-stage eosinophilia after PD initiation. During follow-up, 204 death-censored technique failures were recorded. In fully adjusted models, each with 100 cells/μL increase in EOC, the adjusted hazard ratios (HRs) of technique failure were 1.11 (95% CI: 1.03–1.20; 〈 i 〉 p 〈 /i 〉 = 0.009) in the whole cohort, 1.29 (95% CI: 1.10–1.51; 〈 i 〉 p 〈 /i 〉 = 0.002) in women, and 1.07 (95% CI: 0.97–1.17; 〈 i 〉 p 〈 /i 〉 = 0.196) in men. Eosinophilia was significantly associated with the risk of technique failure for women (HR: 2.24; 95% CI: 1.07–4.70; 〈 i 〉 p 〈 /i 〉 = 0.033), which was especially significant for women aged & #x3c;55 years (HR: 7.61; 95% CI: 1.88–30.90; 〈 i 〉 p 〈 /i 〉 = 0.005). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 EOC was increased significantly after PD initiation, and increased numbers of eosinophils were associated with higher death-censored technique failure in PD patients, especially women.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000509085
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482722-0
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