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The 2006 K/DOQI guidelines for peritoneal dialysis adequacy are not adequate.

https://arctichealth.org/en/permalink/ahliterature166065
Source
Blood Purif. 2007;25(1):103-5
Publication Type
Article
Date
2007
Author
James F Winchester
Nikolas Harbord
Patrick Audia
Alan Dubrow
Stephen Gruber
Donald Feinfeld
Richard Amerling
Author Affiliation
Division of Nephrology and Hypertension, Beth Israel Medical Center, 350 East 17th Street, New York, NY 10003, USA. jwinches@bethisraelny.org
Source
Blood Purif. 2007;25(1):103-5
Date
2007
Language
English
Publication Type
Article
Keywords
Body mass index
Canada
Humans
Metabolic Clearance Rate
Peritoneal Dialysis - methods - standards
Practice Guidelines as Topic - standards
Randomized Controlled Trials as Topic
Reproducibility of Results
United States
Urea - metabolism
Abstract
The 2006 National Kidney Foundation K/DOQI guidelines have lowered the peritoneal dialysis adequacy standard of Kt/V(urea) from 2.1 to 1.7 in anuric patients, largely based on the patient survival results of 2 clinical trials in Mexico and Hong Kong. It is our contention that the guidelines may be misleading since they have chosen to ignore the bias in these trials and have ignored the adverse outcomes in control groups in the trials on which the guidelines are based, as well as the body size of the subjects in these trials. Body size has changed in the US and Canada over the last few decades and there are similar changes worldwide. We suggest that the minimum targets for peritoneal dialysis be reinstituted at the previous standard Kt/V(urea) of 2.0.
PubMed ID
17170545 View in PubMed
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Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

https://arctichealth.org/en/permalink/ahliterature298110
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Author
Satu Mäkelä
Markku Asola
Henrik Hadimeri
James Heaf
Maija Heiro
Leena Kauppila
Susanne Ljungman
Mai Ots-Rosenberg
Johan V Povlsen
Björn Rogland
Petra Roessel
Jana Uhlinova
Maarit Vainiotalo
Maria K Svensson
Heini Huhtala
Heikki Saha
Author Affiliation
Tampere University Hospital, Tampere, Finland satu.m.makela@pshp.fi.
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Ankle Brachial Index
Aorta, Abdominal - diagnostic imaging
Aortic Diseases - diagnosis - epidemiology - etiology
Cause of Death - trends
Critical Illness - mortality - therapy
Denmark - epidemiology
Estonia - epidemiology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Peritoneal Dialysis - adverse effects - mortality
Prognosis
Prospective Studies
Renal Dialysis
Risk factors
Survival Rate - trends
Sweden - epidemiology
Ultrasonography, Doppler
Vascular Calcification - diagnosis - epidemiology - etiology
Abstract
Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.
We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.
The median AACS was 11 (range 0 - 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low ( 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS = 7 (p
PubMed ID
29386304 View in PubMed
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[A clinic for prevention of progression of kidney failure].

https://arctichealth.org/en/permalink/ahliterature164390
Source
J Ren Care. 2006 Jul-Sep;32(3):153-6
Publication Type
Article
Author
A. Brousseau
Author Affiliation
Centre Hospitalier Ambulatoire Régionale de Laval, Québec, Kanada. abrousse_charl@ssss.gouv.qc.ca
Source
J Ren Care. 2006 Jul-Sep;32(3):153-6
Language
German
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Albuminuria - diagnosis - prevention & control
Body mass index
Canada - epidemiology
Disease Progression
Exercise
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension - epidemiology - prevention & control
Kidney Failure, Chronic - diagnosis - epidemiology - prevention & control - therapy
Male
Middle Aged
Outpatient Clinics, Hospital
Patient care team
Patient Education as Topic
Peritoneal dialysis
Primary Prevention
Quebec
Renal Dialysis
Smoking Cessation
Time Factors
Abstract
Prevention in nephrology is only possible with the cooperation of patients and their families. The nurse plays a considerable role in working with patients and is a major player in the team, responsible for follow-up of the patient, where the earliest interventions can help delay and sometimes avoid dialysis. The hypertension clinic is the beginning of a continuum until dialysis. This paper describes three clinics that are managed in the renal service and indicates how they contribute to offering optimal care to a renal population.
PubMed ID
17393810 View in PubMed
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Active treatment of uremia in the city of Göteborg 1966-1977.

https://arctichealth.org/en/permalink/ahliterature246366
Source
Scand J Urol Nephrol Suppl. 1980;54:16-21
Publication Type
Article
Date
1980
Author
J. Ahlmén
L E Gelin
H. Brynger
H. Bucht
Source
Scand J Urol Nephrol Suppl. 1980;54:16-21
Date
1980
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Biometry
Female
Humans
Kidney Failure, Chronic - mortality - therapy
Kidney Transplantation
Male
Middle Aged
Peritoneal dialysis
Retrospective Studies
Sweden
Abstract
137 patients were actively treated because of chronic uremia, during 1966 to 1977 in the city of Göteborg. One year patient survival increased from 51% (1966 to 1968) to 81% (1975 to 1977). Peritoneal dialysis decreased as the initial mode of treatment, and only 3% of the patients started dialysis treatment with this mode of therapy in the last 3-year period. Mean age of the actively treated patients was 44 years. A decreasing mean age of the actively treated patients was found towards the end of the period, reflecting more liberal criteria for accepting young patients with different systemic diseases. If the initial mode of treatment was dialysis, 1-year patient survival in the last 3-year period was 77%.
PubMed ID
7013035 View in PubMed
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[Active treatment of uremia in the study county of Vejle. Epidemiology 1979-1994 and future perspectives]

https://arctichealth.org/en/permalink/ahliterature34751
Source
Ugeskr Laeger. 1996 Jun 24;158(26):3759-63
Publication Type
Article
Date
Jun-24-1996
Author
P. Vestergaard
A. Frøland
J H Kristiansen
Author Affiliation
Medicinsk afdeling, Fredericia Sygehus.
Source
Ugeskr Laeger. 1996 Jun 24;158(26):3759-63
Date
Jun-24-1996
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Denmark - epidemiology
English Abstract
Female
Forecasting
Humans
Incidence
Kidney Failure, Chronic - epidemiology - surgery - therapy
Kidney Transplantation - statistics & numerical data - trends
Male
Middle Aged
Peritoneal Dialysis - statistics & numerical data - trends
Peritoneal Dialysis, Continuous Ambulatory - statistics & numerical data - trends
Prevalence
Prospective Studies
Renal Dialysis - statistics & numerical data - trends
Uremia - epidemiology - surgery - therapy
Abstract
We studied 275 renal replacement therapy (RRT) patients in a Danish county (population 329,000) from January 1st 1979 to June 30th 1994. Incidence, prevalence and age of new patients increased. The fraction of patients with diabetic nephropathy also increased. Patient survival remained constant (five-year survival 62% for patients observed for more than 90 days). The total number of new patients entering haemodialysis and peritoneal dialysis seemed to be reaching a constant level, that could be calculated using a logistic function. The fraction of patients leaving therapy remained constant over the years and was higher for peritoneal dialysis than for haemodialysis (32 vs. 20% per year). The future prevalence can be estimated by combining these two last findings.
Notes
Comment In: Ugeskr Laeger. 1996 Sep 2;158(36):5044-58928247
PubMed ID
8686069 View in PubMed
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Adapting the Charlson Comorbidity Index for use in patients with ESRD.

https://arctichealth.org/en/permalink/ahliterature184742
Source
Am J Kidney Dis. 2003 Jul;42(1):125-32
Publication Type
Article
Date
Jul-2003
Author
Brenda R Hemmelgarn
Braden J Manns
Hude Quan
William A Ghali
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. bhemmelg@ucalgary.ca
Source
Am J Kidney Dis. 2003 Jul;42(1):125-32
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Aged
Alberta - epidemiology
Comorbidity
Diagnosis-Related Groups
Female
Humans
Kidney Failure, Chronic - epidemiology - therapy
Life tables
Likelihood Functions
Male
Middle Aged
Multivariate Analysis
Peritoneal dialysis
Proportional Hazards Models
Renal Dialysis
Risk Adjustment
Severity of Illness Index
Survival Analysis
Abstract
Accurate prediction of survival for patients with end-stage renal disease (ESRD) and multiple comorbid conditions is difficult. In nondialysis patients, the Charlson Comorbidity Index has been used to adjust for comorbidity. The purpose of this study is to assess the validity of the Charlson index in incident dialysis patients and modify the index for use specifically in this patient population.
Subjects included all incident hemodialysis and peritoneal dialysis patients starting dialysis therapy between July 1, 1999, and November 30, 2000. These 237 patients formed a cohort from which new integer weights for Charlson comorbidities were derived using Cox proportional hazards modeling. Performance of the original Charlson index and the new ESRD comorbidity index were compared using Kaplan-Meier survival curves, change in likelihood ratio, and the c statistic.
After multivariate analysis and conversion of hazard ratios to index weights, only 6 of the original 18 Charlson variables were assigned the same weight and 6 variables were assigned a weight higher than in the original Charlson index. Using Kaplan-Meier survival curves, we found that both the original Charlson index and the new ESRD comorbidity index were associated with and able to describe a wide range of survival. However, the new study-specific index had better validated performance, indicated by a greater change in the likelihood ratio test and higher c statistic.
This study indicates that the original Charlson index is a valid tool to assess comorbidity and predict survival in patients with ESRD. However, our modified ESRD comorbidity index had slightly better performance characteristics in this population.
PubMed ID
12830464 View in PubMed
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Adverse outcomes among Aboriginal patients receiving peritoneal dialysis.

https://arctichealth.org/en/permalink/ahliterature141916
Source
CMAJ. 2010 Sep 21;182(13):1433-9
Publication Type
Article
Date
Sep-21-2010
Author
Manish M Sood
Paul Komenda
Amy R Sood
Martina Reslerova
Mauro Verrelli
Chris Sathianathan
Loretta Eng
Amanda Eng
Claudio Rigatto
Author Affiliation
Departments of Medicine, St. Boniface Hospital, Winnipeg, Man. msood@sbgh.mb.ca
Source
CMAJ. 2010 Sep 21;182(13):1433-9
Date
Sep-21-2010
Language
English
Publication Type
Article
Keywords
Adult
Continental Population Groups
Female
Humans
Indians, North American - statistics & numerical data
Logistic Models
Male
Manitoba
Peritoneal Dialysis - adverse effects
Proportional Hazards Models
Rural Population
Treatment Outcome
Urban Population
Abstract
The Aboriginal population in Canada experiences high rates of end-stage renal disease and need for dialytic therapies. Our objective was to examine rates of mortality, technique failure and peritonitis among adult aboriginal patients receiving peritoneal dialysis in the province of Manitoba. We also aimed to explore whether differences in these rates may be accounted for by location of residence (i.e., urban versus rural).
We included all adult patients residing in the province of Manitoba who received peritoneal dialysis during the period from 1997-2007 (n = 727). We extracted data from a local administrative database and from the Canadian Organ Replacement Registry and the Peritonitis Organism Exit-sites/Tunnel infections (POET) database. We used Cox and logistic regression models to determine the relationship between outcomes and Aboriginal ethnicity. We performed Kaplan-Meier analyses to examine the relationship between outcomes and urban (i.e., 50 km or less from the primary dialysis centre in Winnipeg) versus rural (i.e., more than 50 km from the centre) residency among patients who were aboriginal.
One hundred sixty-one Aboriginal and 566 non-Aboriginal patients were included in the analyses. Adjusted hazard ratios for mortality (HR 1.476, CI 1.073-2.030) and adjusted time to peritonitis (HR 1.785, CI 1.352-2.357) were significantly higher among Aboriginal patients than among non-Aboriginal patients. We found no significant differences in mortality, technique failure or peritonitis between urban- or rural-residing Aboriginal patients.
Compared with non-Aboriginal patients receiving peritoneal dialysis, Aboriginal patients receiving peritoneal dialysis had higher mortality and faster time to peritonitis independent of comorbidities and demographic characteristics. This effect was not influenced by place of residence, whether rural or urban.
Notes
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PubMed ID
20660579 View in PubMed
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264 records – page 1 of 27.