دورية أكاديمية
End-stage renal disease at dialysis initiation: Epidemiology and mortality risks during the first year of hemodialysis.
| العنوان: | End-stage renal disease at dialysis initiation: Epidemiology and mortality risks during the first year of hemodialysis. |
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| المؤلفون: | Mesbahi T; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Barbouch S; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Najjar M; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Fattoum S; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Jebali H; Department of Nephrology, La Rabta Hospital, Tunis, Tunisia., Trabelsi R; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Bacha MM; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Smaoui W; Department of Nephrology, La Rabta Hospital, Tunis, Tunisia., Karoui C; Department of Nephrology, Mahmoud El Matri Hospital, Ariana, Tunisia., Hamida FB; Department of Research Laboratory of Kidney Diseases (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia., Hedri H; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Rais L; Department of Nephrology, La Rabta Hospital, Tunis, Tunisia., Ounissi M; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia., Zouaghi MK; Department of Nephrology, La Rabta Hospital, Tunis, Tunisia., Abdallah TB; Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia. |
| المصدر: | Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia [Saudi J Kidney Dis Transpl] 2021 Sep-Oct; Vol. 32 (5), pp. 1407-1417. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Medknow Country of Publication: Saudi Arabia NLM ID: 9436968 Publication Model: Print Cited Medium: Internet ISSN: 1319-2442 (Print) Linking ISSN: 13192442 NLM ISO Abbreviation: Saudi J Kidney Dis Transpl Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2007- : Mumbai : Medknow Original Publication: Riyadh : Saudi Center for Organ Transplantation, c1994- |
| مواضيع طبية MeSH: | Kidney Failure, Chronic*/diagnosis , Kidney Failure, Chronic*/epidemiology , Kidney Failure, Chronic*/therapy , Renal Insufficiency, Chronic*, Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Renal Dialysis/adverse effects ; Time Factors |
| مستخلص: | Chronic kidney disease (CKD) treated by hemodialysis (HD) is a worldwide major public health problem. Its incidence is getting higher and higher, leading to an alarming social and economic impact. The survival of these patients is significantly low, especially during the first year of treatment. The purpose of our study was to identify the epidemiological and clinico-biological characteristics of patients at the HD initiation and to reveal the predictive factors of mortality at three months and one year of HD. This is a prospective, analytical, and descriptive study dealing with 229 patients with an end-stage renal disease (ESRD), followed up in the Nephrology Department of Charles Nicolle Hospital and La Rabta Hospital in Tunisia, that was started HD between January and June 2017. A multivariate logistic regression analysis allowed us to identify the independent predictors of mortality at three months and one year. The average age was 60.2 ± 15.3 years, with a gender ratio of 1.41. Seventy-eight percent of patients had more than two comorbidities, 59% had diabetes, and 88% had hypertension. Diabetic nephropathy was the leading etiology of kidney disease (48.9%), while 11% of nephropathies were of unknown etiology. Only 58% were early referred to a nephrologist. The average glomerular filtration rate at HD initiation was 6.06 ± 2.33 mL/min/1.73 m 2 . Hypocalcemia and hyperphosphatemia were noted, respectively, in 60.8% and 84.9% of cases. Anemia was objectified in 98.6% of cases. HD was started in an emergency in 56.8% of cases. One of the most urgent indications was acute pulmonary edema (APE) for 43.8% of patients. Only 10.5% of patients had functional arteriovenous fistula at the dialysis initiation. Patients were hemodialyzed one, two, or three sessions per week, respectively, in 23.2%, 26.6%, and 50.2% of cases. The crude mortality rate was 25% and 13% in, respectively, one year and three months of HD. On multivariate analysis, we identified heart failure and insufficient dialysis dose per week as predictive factors of mortality at the 1 st year of HD. C-reactive protein more than 21 mg/L, insufficient dialysis per week, modified Charlson Comorbidity Index less than 6, and APE at the dialysis initiation were identified as predictive factors of three-month mortality. Despite the short period of study, this work revealed the alarming conditions of patients at HD initiation. This critical situation is due to the delay in CKD diagnosis, the late nephrologist referral, and the lack of preparation before HD initiation. |
| تواريخ الأحداث: | Date Created: 20220509 Date Completed: 20220511 Latest Revision: 20220511 |
| رمز التحديث: | 20240829 |
| DOI: | 10.4103/1319-2442.344761 |
| PMID: | 35532711 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1319-2442 |
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| DOI: | 10.4103/1319-2442.344761 |