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Censo Brasileiro de Diálise, 2009; Brazilian Dialysis Census, 2009

SESSO, Ricardo de Castro Cintra; LOPES, Antonio Alberto; THOMÉ, Fernando Saldanha; LUGON, Jocemir Ronaldo; BURDMANN, Emmanuel A
Fonte: Sociedade Brasileira de Nefrologia Publicador: Sociedade Brasileira de Nefrologia
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
36.33%
INTRODUÇÃO: Dados nacionais sobre diálise crônica são fundamentais para o planejamento do tratamento. OBJETIVO: Apresentar dados do censo anual da SBN sobre os pacientes com doença renal crônica em diálise de manutenção a 1º de janeiro de 2009. MÉTODOS: Levantamento de dados de unidades de diálise de todo o país. A coleta de dados foi feita utilizando questionário preenchido pelas unidades de diálise do Brasil cadastradas na SBN. RESULTADOS: Das unidades consultadas, 437 (69,8%) responderam ao censo. Em janeiro de 2009, o número estimado de pacientes em diálise foi de 77.589. As estimativas das taxas de prevalência e de incidência de insuficiência renal crônica em tratamento dialítico foram de 405 e 144 pacientes por milhão da população, respectivamente. O número estimado de pacientes que iniciaram tratamento em 2009 foi de 27.612. A taxa anual de mortalidade bruta foi de 17,1%. Dos pacientes prevalentes, 39,9% tinham idade > 60 anos, 89,6% estavam em hemodiálise e 10,4% em diálise peritoneal, 30.419 (39,2%) estavam em fila de espera para transplante, 27% eram diabéticos, 37,9% tinham fósforo sérico > 5,5 mg/dL e 42,8% hemoglobina < 11 g/dL. Cateter venoso foi usado como acesso vascular em 12,4% dos pacientes em hemodiálise. CONCLUSÕES: A prevalência de pacientes em diálise tem apresentado aumento progressivo embora em 2009 as estimativas sejam inferiores às de 2008. Os dados chamam atenção para indicadores da qualidade diálise de manutenção que necessitam ser melhorados. E destacam a importância do censo anual para o planejamento da assistência dialítica.; INTRODUCTION: National dialysis data are fundamental for treatment planning. OBJECTIVE: To report data of the annual survey of the Brazilian Society of Nephrology about chronic renal failure patients on dialysis in January 2009. METHODS: A survey based on data of dialysis units from the whole country. The data collection was performed by using a questionnaire filled out by the dialysis units in Brazil. RESULTS: 427 (69.8%) of the dialysis units in the country answered the questionnaire. National data were estimated for the overall dialysis population. In January 2009...

Análise da ocorrência de peritonites e infecções relacionadas ao cateter de diálise peritoneal em pacientes pediátricos em diálise peritoneal crônica; Peritonitis and catheter related infections in children undergoing chronic peritoneal dialysis

Lanzarini, Vivian Viégas
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 18/02/2008 PT
Relevância na Pesquisa
36.28%
Introdução: Diálise peritoneal (DP) é a modalidade de diálise mais utilizada em pacientes pediátricos portadores de doença renal crônica (DRC) em todo o mundo. Peritonites e infecções de óstio e túnel do cateter de diálise peritoneal constituem as duas primeiras causas de morbidade e falha de tratamento em pacientes em programa de diálise peritoneal. Objetivo: Caracterizar o perfil dos episódios de peritonites e infecções de óstio e túnel nos pacientes em programa de diálise peritoneal crônica na Unidade de Nefrologia Pediátrica do Instituto da Criança do HC FMUSP. Métodos: Avaliou-se o período compreendido entre janeiro de 1994, quando foi iniciado o programa de diálise peritoneal crônica nessa unidade, e dezembro de 2005. Foram incluídos todos os pacientes que estiveram em programa de diálise peritoneal crônica no período, cujos prontuários estivessem acessíveis para análise. Realizou-se revisão dos prontuários quanto aos dados demográficos dos pacientes, peso e estatura ao início e ao final do programa de diálise, etiologia e evolução clinica de cada episódio infeccioso, e presença de fatores de risco para peritonites e infecções relacionadas ao cateter de DP. Realizou-se análise descritiva dos dados gerais...

Modelling competing risks in nephrology research: an example in peritoneal dialysis

Teixeira, L.; Rodrigues, A.; Carvalho, M.; Cabrita, A.; Mendonça, D.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2013 ENG
Relevância na Pesquisa
36.36%
BACKGROUND: Modelling competing risks is an essential issue in Nephrology Research. In peritoneal dialysis studies, sometimes inappropriate methods (i.e. Kaplan-Meier method) have been used to estimate probabilities for an event of interest in the presence of competing risks. In this situation a competing risk analysis should be preferable. The objectives of this study are to describe the bias resulting from the application of standard survival analysis to estimate peritonitis-free patient survival and to provide alternative statistical approaches taking competing risks into account. METHODS: The sample comprises patients included in a university hospital peritoneal dialysis program between October 1985 and June 2011 (n = 449). Cumulative incidence function and competing risk regression models based on cause-specific and subdistribution hazards were discussed. RESULTS: The probability of occurrence of the first peritonitis is wrongly overestimated using Kaplan-Meier method. The cause-specific hazard model showed that factors associated with shorter time to first peritonitis were age (>=55 years) and previous treatment (haemodialysis). Taking competing risks into account in the subdistribution hazard model, age remained significant while gender (female) but not previous treatment was identified as a factor associated with a higher probability of first peritonitis event. CONCLUSIONS: In the presence of competing risks outcomes...

Demographic and clinical characteristics of patients receiving dialysis in Portugal: a nationwide multicentre survey

Lopes, J; Abreu, F; Almeida, E; Carvalho, B; Carmo, C; Carvalho, D; Barber, E; Costa, F; Silva, G; Boquinhas, H; Silva, J; Inchaustegui, L; Dias, L; Batista, M; Neves, P; Mendes, T
Fonte: Sociedade Portuguesa de Nefrologia Publicador: Sociedade Portuguesa de Nefrologia
Tipo: Artigo de Revista Científica
Publicado em //2006 ENG
Relevância na Pesquisa
36.41%
Background. Data on human immunodeficiency virus (HIV) infected patients receiving dialysis in Portugal is scarce. Methods. This nationwide epidemiological survey retrospectively evaluates HIV-infected patients on chronic dialysis in Portugal between 1997 and 2002. Results. Sixty-six patients were evaluated (mean age: 39.1±1.6 years, 47 men, 35 black African). Sixty-two patients started dialysis and 4 patients who were receiving dialysis had HIV seroconversion. Eighty-five percent of patients were treated in Lisbon. The annual incidence of HIV-infected patients on chronic dialysis was 0.5% in 1997 and 0.9% in 2002. Seventy-eight percent of patients were HIV-1 infected , 13% had hepatitis B and 31% hepatitis C. Sexual contact was the mode of transmission of HIV in 53% of cases. Four patients had biopsy-proved HIV-associated nephropathy. Ninety-five percent of patients were on chronic hemodialysis. Fifty percent of patients had acquired immunodeficiency syndrome. At follow-up, 12 patients died. HIV-infected CKD patient survival after starting dialysis was 80% at 3 years. Conclusion. The incidence of HIV-infected patients on chronic dialysis in Portugal has almost doubled. Widespread use of highly active antiretroviral therapy and the increasing number of black Africans from former overseas Portuguese colonies now living in Portugal are possible reasons for this large increase.

Cancer incidence before and after kidney transplantation

Vajdic, C.; McDonald, S.; McCredie, M.; van Leeuwen, M.; Stewart, J.; Law, M.; Chapman, J.; Webster, A.; Kaldor, J.; Grulich, A.
Fonte: Amer Medical Assoc Publicador: Amer Medical Assoc
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
36.43%
Context: Immune suppression after organ transplantation is associated with a markedly increased risk of nonmelanoma skin cancer and a few virus-associated cancers. Although it is generally accepted that other cancers do not occur at increased rates, there have been few long-term population-based cohort studies performed. Objective: To compare the incidence of cancer in patients receiving immune suppression after kidney transplantation with incidence in the same population in 2 periods before receipt of immune suppression: during dialysis and during end-stage kidney disease before renal replacement therapy (RRT). Design, Setting, and Participants: A population-based cohort study of 28 855 patients with end-stage kidney disease who received RRT, with 273 407 person-years of follow-up. Incident cancers (1982-2003) were ascertained by record linkage between the Australia and New Zealand Dialysis and Transplant Registry and the Australian National Cancer Statistics Clearing House. Main Outcome Measure: Standardized incidence ratios (SIRs) of cancer, using age-specific, sex-specific, calendar year–specific, and state/territory–specific population cancer incidence rates. Results:The overall incidence of cancer, excluding nonmelanoma skin cancer and those cancers known to frequently cause end-stage kidney disease...

Associations of dialysis modality and infectious mortality in incident dialysis patients in Australia and New Zealand

Johnson, D.; Dent, H.; Hawley, C.; McDonald, S.; Rosman, J.; Brown, F.; Bannister, K.; Wiggins, K.
Fonte: W B Saunders Co Publicador: W B Saunders Co
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.5%
Background: The aim of the present investigation is to compare rates, types, causes, and timing of infectious death in incident peritoneal dialysis (PD) and hemodialysis (HD) patients in Australia and New Zealand. Study Design: Observational cohort study using the Australian and New Zealand Dialysis and Transplant Registry data. Setting & Participants: The study included all patients starting dialysis therapy between April 1, 1995, and December 31, 2005. Predictor: Dialysis modality. Outcomes & Measurements: Rates of and time to infectious death were compared by using Poisson regression, Kaplan-Meier, and competing risks multivariate Cox proportional hazards model analyses. Results: 21,935 patients started dialysis therapy (first treatment PD, n = 6,020; HD, n = 15,915) during the study period, and 1,163 patients (5.1%) died of infectious causes (PD, 529 patients; 7.6% versus HD, 634 patients; 4.2%). Incidence rates of infectious mortality in PD and HD patients were 2.8 and 1.7/100 patient-years, respectively (incidence rate ratio PD versus HD, 1.66; 95% confidence interval [CI], 1.47 to 1.86). After performing competing risks multivariate Cox analyses allowing for an interaction between time on study and modality because of identified nonproportionality of hazards...

Frequencies of hepatitis B and C infections among haemodialysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data

Johnson, D.; Dent, H.; Yao, Q.; Tranaeus, A.; Huang, C.C.; Han, D.S.; Jha, V.; Wang, T.; Kawaguchi, Y.; Qian, J.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.3%
Background: The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in peritoneal dialysis (PD) and haemodialysis (HD) patients in the Asia-Pacific region. Methods: The study included the most recent period-prevalent data recorded in the national or regional dialysis registries of the 10 Asia-Pacific countries/areas (Australia, New Zealand, Japan, China, Taiwan, Korea, Thailand, Hong Kong, Malaysia and India), where such data were available. Longitudinal data were also available for all incident Australian and New Zealand patients commencing dialysis between 1 April 1995 and 31 December 2005. Rates of HCV and HBV infections were compared by chi-square, Poisson regression and Kaplan–Meier survival analyses, as appropriate. Results: Data were obtained on 201 590 patients (HD 173 788; PD 27 802). HCV seroprevalences ranged between 0.7% and 18.1% across different countries and were generally higher in HD versus PD populations (7.9% ± 5.5% versus 3.0% ± 2.0%, P = 0.01). Seroconversion rates on dialysis were also significantly higher in HD patients (incidence rate ratio PD versus HD 0.33...

The pattern of excess cancer in dialysis and transplantation

Stewart, J.; Vajdic, C.; van Leeuwen, M.; Amin, J.; Webster, A.; Chapman, J.; McDonald, S.; Grulich, A.; McCredie, M.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.27%
Background. After transplantation, cancer risk varies from no increase for several common cancers to a many-fold increase for a number of, chiefly virus-associated, cancers. The smaller excess of cancer in dialysis has been less well described, but two studies suggested that impaired immunity might be responsible. Methods. In a population-based cohort study of 28 855 patients who received renal replacement therapy (RRT), we categorized incident cancers as end-stage kidney disease (ESKD) related, immune deficiency related, not related to immune deficiency, or of uncertain status, according to whether they were, or were not, increased in published reports of cancer in ESKD prior to starting RRT, organ transplantation or human immunodeficiency virus infection. Standardized incidence ratios for, and excess burdens of, cancer were calculated for all persons normally resident in Australia starting treatment by dialysis or renal transplantation from 1982 to 2003. Results. The risk for ESKD-related cancers was increased 4-fold in dialysis and during transplant function. For immune deficiency-related cancers, the increase was 1.5 (95% CI 1.3–1.6) times in dialysis, and 5-fold after transplantation. ESKD- or immune deficiency-related cancers contributed to ~90% of the excess burden of cancer...

Association of dialysis modality and cardiovascular mortality in incident dialysis patients

Johnson, D.; Dent, H.; Hawley, C.; McDonald, S.; Rosman, J.; Brown, F.; Bannister, K.; Wiggins, K.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.48%
Background and objectives: The aim of the investigation presented here was to compare the rates, causes, and timing of cardiovascular (CV) death in incident peritoneal dialysis (PD) and hemodialysis (HD) patients. Design, setting, participants, & measurements: The study included all adult Australian and New Zealand patients commencing dialysis between January 1, 1997 and December 31, 2007. Rates of and times to CV death were compared by incident rate ratios, cumulative incidence, and multivariable Cox proportional hazards model analyses. Dialysis modality was included in the model as a time-varying covariate, and a competing risks approach was used to obtain cause-specific hazard ratios. Results: Of the 24,587 patients who commenced dialysis (first treatment PD n = 6521; HD n = 18,066) during the study, 5669 (21%) died from CV causes [PD 2044 (28%) versus HD 3625 (21%)]. The incidence rates of CV mortality in PD and HD patients were 9.99 and 7.96 per 100 patient-years, respectively (incidence rate ratio PD versus HD, 1.25; 95% confidence interval 1.12 to 1.32). PD was consistently associated with an increased hazard of CV death compared with HD after 1 yr of treatment. This increased risk in PD patients was largely accounted for by an increased risk of death due to myocardial infarction. Conclusions: Dialysis modality is significantly associated with the risk...

Encapsulating peritoneal sclerosis: incidence, predictors, and outcomes

Johnson, D.; Cho, Y.; Livingston, B.; Hawley, C.; McDonald, S.; Brown, F.; Rosman, J.; Bannister, K.; Wiggins, K.
Fonte: Blackwell Publishing Inc Publicador: Blackwell Publishing Inc
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
36.47%
Encapsulating peritoneal sclerosis is a complication of peritoneal dialysis characterized by persistent, intermittent, or recurrent adhesive bowel obstruction. Here we examined the incidence, predictors, and outcomes of encapsulating peritoneal sclerosis (peritoneal fibrosis) by multivariate logistic regression in incident peritoneal dialysis patients in Australia and New Zealand. Matched case–control analysis compared the survival of patients with controls equivalent for age, gender, diabetes, and time on peritoneal dialysis. Of 7618 patients measured over a 13-year period, encapsulating peritoneal sclerosis was diagnosed in 33, giving an incidence rate of 1.8/1000 patient-years. The respective cumulative incidences of peritoneal sclerosis at 3, 5, and 8 years were 0.3, 0.8, and 3.9%. This condition was independently predicted by younger age and the duration of peritoneal dialysis, but not the rate of peritonitis. Twenty-six patients were diagnosed while still on peritoneal dialysis. Median survival following diagnosis was 4 years and not statistically different from that of 132 matched controls. Of the 18 patients who died, only 7 were attributed directly to peritoneal sclerosis. Our study shows that encapsulating peritoneal sclerosis is a rare condition...

Risk of tuberculosis in dialysis patients: a nationwide cohort study

Dobler, C.; McDonald, S.; Marks, G.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
36.5%
BACKGROUND: The ability to identify individuals at increased risk of developing tuberculosis (TB) has important implications for public health policy and patient care. We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people on chronic hemo- or peritoneal dialysis. METHODOLOGY/PRINCIPAL FINDINGS: Cases of TB disease in patients receiving chronic dialysis were identified by record linkage using the Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) and State and Territory TB notification databases 2001 to 2006. Main outcome measure was the relative risk of TB in people on dialysis, adjusted for TB incidence in country of birth, sex, age and indigenous status. A total of 6,276 cases of active TB were reported among 19,855,283 people living in Australia between 2001 and 2006. Among 14,506 patients on dialysis, 37 had a notification for TB disease after commencing dialysis, of whom 28 were culture positive. The incidence of TB was 66.8/100,000/year (95% CI 47.7 to 93.2) among people on dialysis and 5.7/100,000/year (95% CI 5.5 to 5.8) in the general population. The adjusted relative risk (aRR) of TB in people on dialysis was 7.8 (95% CI 3.3 to 18.7)...

Effect of dialysis modality on survival of hepatitis C-infected ESRF patients

Bose, B.; McDonald, S.; Hawley, C.; Brown, F.; Badve, S.; Wiggins, K.; Bannister, K.; Boudville, N.; Clayton, P.; Johnson, D.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
36.28%
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in end-stage renal failure (ESRF) patients. Despite a lower incidence and risk of transmission of HCV infection with peritoneal dialysis (PD), the optimal dialysis modality for HCV-infected ESRF patients is not known. The aim of this study was to evaluate the impact of dialysis modality on the survival of HCV-infected ESRF patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study included all adult incident ESRF patients in Australia and New Zealand who commenced dialysis between January 1, 1994, and December 31, 2008, and were HCV antibody-positive at the time of dialysis commencement. Time to all-cause mortality was compared between hemodialysis (HD) and PD according to modality assignment at day 90, using Cox proportional hazards model analysis. RESULTS: A total of 424 HCV-infected ESRF patients commenced dialysis during the study period and survived for at least 90 days (PD n = 134; HD n = 290). Mortality rates were comparable between PD and HD in the first year (10.7 versus 13.8 deaths per 100 patient-years, respectively; adjusted hazard ratio [HR] 0.65, 95% CI 0.34 to 1.26) and thereafter (20 versus 15.9 deaths per 100 patient-years...

Risk factors for dialysis withdrawal: An analysis of the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, 1999-2008

Chan, H.; Clayton, P.; McDonald, S.; Agar, J.; Jose, M.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.27%
BACKGROUND AND OBJECTIVES: Dialysis withdrawal (DW) in patients with ESRD is increasing in importance. This study assessed causes of death and risk factors for DW in Australia and New Zealand in the first year of dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective observational cohort study included all adult Australians and New Zealanders beginning renal replacement therapy in 1999-2008. RESULTS: A total of 24,884 patients with 10,073 deaths were included. Deaths from cardiac and social causes (predominantly DW) accounted for 38% and 28% of all deaths, respectively. Cumulative incidence of DW was 3.5% at 1 year (95% confidence interval [CI], 3.3%-3.8%), 9.0% at 3 years (95% CI, 8.6%-9.4%), and 13.4% at 5 years (95% CI, 12.8%-13.9%). In multivariate analysis, predictors for DW in the first year were older age (subhazard ratio [SHR], 1.70 per decade [95% CI, 1.59-1.83]; P<0.001), late referral (SHR, 1.83 [95% CI, 1.59-2.11]; P<0.001), comorbid conditions (SHR, 1.33 per each additional comorbid condition [95% CI, 1.25-1.41]; P<0.001), and diabetes (SHR, 1.16 [95% CI, 1.00-1.34]; P=0.05). Negative predictors for DW included male sex (SHR, 0.75 [95% CI, 0.66-0.87]; P<0.001), indigenous ethnicity (SHR, 0.74 [95% CI...

Daily variation in death in patients treated by long-term dialysis: comparison of in-center hemodialysis to peritoneal and home hemodialysis

Krishnasamy, R.; Badve, S.; Hawley, C.; McDonald, S.; Boudville, N.; Brown, F.; Polkinghorne, K.; Bannister, K.; Wiggins, K.; Clayton, P.; Johnson, D.
Fonte: W B Saunders Co Publicador: W B Saunders Co
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.31%
BACKGROUND: There has been little study to date of daily variation in cardiac death in dialysis patients and whether such variation differs according to dialysis modality and session frequency. STUDY DESIGN: Observational cohort study using ANZDATA (Australia and New Zealand Dialysis and Transplant) Registry data. Setting & Participants: All adult patients with end-stage kidney failure treated by dialysis in Australia and New Zealand who died between 1999 and 2008. PREDICTORS: Timing of death (day of week), dialysis modality, hemodialysis (HD) session frequency, and demographic, clinical, and facility variables. OUTCOMES & MEASUREMENTS: Cardiac and noncardiac mortality. RESULTS: 14,636 adult dialysis patients died during the study period (HD, n = 10,338; peritoneal dialysis [PD], n = 4,298). Cardiac death accounted for 40% of deaths and was significantly more likely to occur on Mondays in in-center HD patients receiving 3 or fewer dialysis sessions per week (n = 9,503; adjusted OR, 1.26; 95% CI, 1.14-1.40; P < 0.001 compared with the mean odds of cardiac death for all days of the week). This daily variation in cardiac death was not seen in PD patients, in-center HD patients receiving more than 3 sessions per week (n = 251), or home HD patients (n = 573). Subgroup analyses showed that deaths related to hyperkalemia and myocardial infarction also were associated with daily variation in risk in HD patients. This pattern was not seen for vascular...

Estimating the total incidence of kidney failure in Australia including individuals who are not treated by dialysis or transplantation

Sparke, C.; Moon, L.; Green, F.; Mathew, T.; Cass, A.; Chadban, S.; Chapman, J.; Hoy, W.; McDonald, S.
Fonte: W B Saunders Co Publicador: W B Saunders Co
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.29%
BACKGROUND: To date, incidence data for kidney failure in Australia have been available for only those who start renal replacement therapy (RRT). Information about the total incidence of kidney failure, including non-RRT-treated cases, is important to help understand the burden of kidney failure in the community and the characteristics of patients who die without receiving treatment. STUDY DESIGN: Data linkage study of national observational data sets. SETTING & PARTICIPANTS: All incident treated cases recorded in the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) probabilistically linked to incident untreated kidney failure cases derived from national death registration data for 2003-2007. PREDICTOR: Age, sex, and year. OUTCOMES: Kidney failure, a combination of incident RRT or death attributed to kidney failure (without RRT). MEASUREMENTS: Total incidence of kidney failure (treated and untreated) and treatment rates. RESULTS: There were 21,370 incident cases of kidney failure in 2003-2007. The incidence rate was 20.9/100,000 population (95% CI, 18.3-24.0) and was significantly higher among older people and males (26.1/100,000 population; 95% CI, 22.5-30.0) compared with females (17.0/100,000 population; 95% CI...

Association of biocompatible peritoneal dialysis solutions with peritonitis risk, treatment, and outcomes

Cho, Y.; Badve, S.; Hawley, C.; McDonald, S.; Brown, F.; Boudville, N.; Bannister, K.; Clayton, P.; Johnson, D.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.33%
BACKGROUND AND OBJECTIVES: The effect of biocompatible peritoneal dialysis (PD) solutions on PD-related peritonitis is unclear. This study sought to evaluate the relationship between use of biocompatible solutions and the probability of occurrence or clinical outcomes of peritonitis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study included all incident Australian patients receiving PD between January 1, 2007, and December 31, 2010, using Australia and New Zealand Dialysis and Transplant Registry data. All multicompartment PD solutions of neutral pH were categorized as biocompatible solutions. The independent predictors of peritonitis and the use of biocompatible solutions were determined by multivariable, multilevel mixed-effects Poisson and logistic regression analysis, respectively. Sensitivity analyses, including propensity score matching, were performed. RESULTS: Use of biocompatible solutions gradually declined (from 7.5% in 2007 to 4.2% in 2010), with preferential use among smaller units and among younger patients without diabetes mellitus. Treatment with biocompatible solution was associated with significantly greater overall rate of peritonitis (0.67 versus 0.47 episode per patient-year; incidence rate ratio, 1.49; 95% confidence interval [CI]...

Peritoneal dialysis in rural Australia

Gray, N.; Grace, B.; McDonald, S.
Fonte: Biomed Central Publicador: Biomed Central
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.27%
BACKGROUND Australians living in rural areas have lower incidence rates of renal replacement therapy and poorer dialysis survival compared with urban dwellers. This study compares peritoneal dialysis (PD) patient characteristics and outcomes in rural and urban Australia. METHODS Non-indigenous Australian adults who commenced chronic dialysis between 1 January 2000 and 31 December 2010 according to the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were investigated. Each patient’s residence was classified according to the Australian Bureau of Statistics remote area index as major city (MC), inner regional (IR), outer regional (OR), or remote/very remote (REM). RESULTS A total of 7657 patients underwent PD treatment during the study period. Patient distribution was 69.0% MC, 19.6% IR, 9.5% OR, and 1.8% REM. PD uptake increased with increasing remoteness. Compared with MC, sub-hazard ratios [95% confidence intervals] for commencing PD were 1.70 [1.61-1.79] IR, 2.01 [1.87-2.16] OR, and 2.60 [2.21-3.06] REM. During the first 6 months of PD, technique failure was less likely outside MC (sub-hazard ratio 0.47 [95% CI: 0.35-0.62], P < 0.001), but no difference was seen after 6 months (sub-hazard ratio 1.05 [95% CI: 0.84-1.32]...

Study of the incidence of dialysis in São Paulo, the largest Brazilian city

Cordeiro,Antonio Carlos; Carrero,Juan Jesús; Qureshi,Abdul Rashid; Cunha,Ricardo Ferreira da; Lindholm,Bengt; Castro,Isac de; Noronha,Irene Lourdes
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
Relevância na Pesquisa
56.63%
OBJECTIVES: Chronic kidney disease is a major public health problem worldwide. In Brazil, approximately 100,000 patients (January 2012) receive renal replacement therapy. Nevertheless, data on dialysis incidence in the Brazilian population are scarce. This study aims to analyze the incidence of patients starting dialysis therapy in São Paulo City, the largest Brazilian metropolis. METHOD: This cohort study analyzed data from 9,994 patients starting hemodialysis or peritoneal dialysis funded by the Brazilian Public Health System during a 5-year period (2007-2011). Patient data for this study (recorded as electronic files) were obtained from the São Paulo City's Dialysis Regulatory Bureau, which regulates the allocation of patients requiring dialytic therapy. RESULTS: The dialysis incidence rates were 178, 174, 170, 185 and 188 per million population for the years 2007, 2008, 2009, 2010 and 2011, respectively. The incidence rates increased with age. Hypertension and diabetes were the main etiologies diagnosed. Hemodialysis was the chosen dialysis modality in the majority of patients (92.6%), whereas the percentage of patients referred for peritoneal dialysis decreased from 10.1% to 5.5%. CONCLUSION: The incidence of patients starting renal replacement therapy from 2007-2011 in São Paulo was stable but higher than the projected incidence for the entire country. The authors emphasize the need for further studies of the incidence of dialysis in the Brazilian population and for the creation of a Brazilian registry of dialysis patients...

Study of the incidence of dialysis in São Paulo, the largest Brazilian city

Cordeiro, Antonio Carlos; Carrero, Juan Jesús; Qureshi, Abdul Rashid; Cunha, Ricardo Ferreira da; Lindholm, Bengt; Castro, Isac de; Noronha, Irene Lourdes
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/06/2013 ENG
Relevância na Pesquisa
36.61%
OBJECTIVES: Chronic kidney disease is a major public health problem worldwide. In Brazil, approximately 100,000 patients (January 2012) receive renal replacement therapy. Nevertheless, data on dialysis incidence in the Brazilian population are scarce. This study aims to analyze the incidence of patients starting dialysis therapy in São Paulo City, the largest Brazilian metropolis. METHOD: This cohort study analyzed data from 9,994 patients starting hemodialysis or peritoneal dialysis funded by the Brazilian Public Health System during a 5-year period (2007-2011). Patient data for this study (recorded as electronic files) were obtained from the São Paulo City's Dialysis Regulatory Bureau, which regulates the allocation of patients requiring dialytic therapy. RESULTS: The dialysis incidence rates were 178, 174, 170, 185 and 188 per million population for the years 2007, 2008, 2009, 2010 and 2011, respectively. The incidence rates increased with age. Hypertension and diabetes were the main etiologies diagnosed. Hemodialysis was the chosen dialysis modality in the majority of patients (92.6%), whereas the percentage of patients referred for peritoneal dialysis decreased from 10.1% to 5.5%. CONCLUSION: The incidence of patients starting renal replacement therapy from 2007-2011 in São Paulo was stable but higher than the projected incidence for the entire country. The authors emphasize the need for further studies of the incidence of dialysis in the Brazilian population and for the creation of a Brazilian registry of dialysis patients...

Acute kidney injury in critically ill children: incidence and risk factors for mortality

Martin,Sandra Mariel; Balestracci,Alejandro; Aprea,Valeria; Bolasell,Cecilia; Wainsztein,Raquel; Debaisi,Gustavo; Rosón,Gerardo
Fonte: Archivos argentinos de pediatría Publicador: Archivos argentinos de pediatría
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
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36.34%
Introduction. Acute kidney injury is a common complication associated with an increase in mortality in children who require intensive care. The objective of this study was to determine the incidence of acute kidney injury and identify risk factors for mortality in critically ill patients hospitalized in our facility. Patients and Methods. This was a prospective and observational study conducted at the Intensive Care Unit (ICU) of Hospital Pedro de Elizalde between 2005 and 2009. All patients with acute kidney injury were included, and those with chronic renal failure, prerenal acute kidney injury, hepatorenal syndrome, newborn infants, and postoperative cardiovascular surgery patients were excluded. The sample was divided into survivors and deceased patients so as to identify risk factors for mortality using univariate and multivariate analyses, taking their clinical characteristics as predictive variable, and death at the ICU as the outcome variable. Results. Out of 1496 patients, 66 developed acute kidney injury (4.4%). The cause was secondary in 72.8% of cases, and due to primary kidney disease in 27.2% of cases. Mortality rate was 44% (29 patients). The univariate analysis showed that the presence of anuria (p= 0.0003; OR: 7.01; 95% CI: 2.3-21.35) and the need of dialysis (p= 0.0009; OR: 6.35; 95% CI: 2.03-9.88) were signifcantly higher in deceased patients. The multiple regression analysis identifed that the need of dialysis (p = 0.0002; OR: 5.94; 95% CI: 1.85-19.04) was an independent risk factor for mortality. Conclusions. The incidence of acute kidney injury in critically ill children was 4.4%...