International Journal of Nephrology最新文献

{"title":"Ameliorative Effect of <i>Olea europaea</i> Leaf Extract on Cisplatin-Induced Nephrotoxicity in the Rat Model.","authors":"Doa'a Ibrahim,&nbsp;Abdulsalam Halboup,&nbsp;Mohammed Al Ashwal,&nbsp;Amani Shamsher","doi":"10.1155/2023/2074498","DOIUrl":"https://doi.org/10.1155/2023/2074498","url":null,"abstract":"<p><strong>Background: </strong><i>Olea europaea</i> leaf extract (OELE) has potential health benefits and protects against cytotoxicity. This study investigated the possible ameliorative effect of OELE on cisplatin-induced nephrotoxicity in rats.</p><p><strong>Methods: </strong>Rats were assigned into six groups; two groups received 150 mg/kg or 300 mg/kg of OELE, one group received a single dose of cisplatin (6 mg/kg) IP on the first day of the experiment, two groups received a single dose of cisplatin 150 mg/kg or 300 mg/kg of OELE on the first day then starting from the fifth day for 10 consecutive days, and one group acted as a control. <i>Results and Conclusion</i>. The findings showed that cisplatin-induced nephrotoxicity was evidenced by a significant increase in serum creatinine blood urea nitrogen (BUN) and a significant decrease in estimated creatinine clearance and potassium level, which corresponded with the alterations in the histopathology of the renal tissue. OELE significantly ameliorated the nephrotoxic effects of cisplatin as dose-dependent.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Growing Challenge of Chronic Kidney Disease: An Overview of Current Knowledge.","authors":"Rikke Borg,&nbsp;Nicholas Carlson,&nbsp;Jens Søndergaard,&nbsp;Frederik Persson","doi":"10.1155/2023/9609266","DOIUrl":"https://doi.org/10.1155/2023/9609266","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is becoming one of the world's most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium-glucose cotransporter 2 inhibitors, there are now new effective treatments to add to standard therapy. This will also be relevant for primary care physicians as many patients with CKD have their family physician as their primary health care professional handling kidney function preservation. In the future, more precise and less invasive diagnostic methods may not only improve the determination of the underlying cause of CKD but may also carry information regarding which treatment to use (i.e. personalized medicine). This could lead to a reduced number of preventive treatments per individual, while at the same time improving the prognosis. This review summarizes ongoing efforts in this area.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Anaemia on Outcomes, Admissions, and Costs in Patients with Chronic Kidney Disease in Two Public Nephrology Practices in Queensland: A CKD.QLD Registry Study.","authors":"Jianzhen Zhang,&nbsp;Vishal Diwan,&nbsp;Zaimin Wang,&nbsp;Helen G Healy,&nbsp;Sree Krishna Venuthurupalli,&nbsp;Rajitha Abeysekera,&nbsp;Wendy E Hoy","doi":"10.1155/2023/8720293","DOIUrl":"https://doi.org/10.1155/2023/8720293","url":null,"abstract":"<p><strong>Aim: </strong>Anaemia among patients with chronic kidney disease (CKD) leads to poor overall outcomes. This study explores anaemia and its impact on nondialysis CKD (NDD-CKD) patients.</p><p><strong>Methods: </strong>2,303 adults with CKD from two CKD.QLD Registry sites were characterised at consent and followed until start of kidney replacement therapy (KRT), death, or censor date. Mean follow-up was 3.9 (SD 2.1) years. Analysis explored the impact of anaemia on death, KRT start, cardiovascular events (CVE), admissions, and costs in these NDD-CKD patients.</p><p><strong>Results: </strong>At consent, 45.6% patients were anaemic. Males were more often anaemic (53.6%) than females, and anaemia was significantly more common over the age of 65 years. The prevalence of anaemia was highest among CKD patients with diabetic nephropathy (27.4%) and renovascular disease (29.2%) and lowest in patients with genetic renal disease (3.3%). Patients with admissions for gastrointestinal bleeding had more severe anaemia, but accounted for only the minority of cases overall. Administration of ESAs, iron infusions, and blood transfusions were all correlated with more severe degrees of anaemia. The number of hospital admissions, length of stay, and hospital costs were all strikingly higher with more severe degrees of anaemia. Adjusted hazard ratios (CI 95%) of patients with moderate and severe anaemia vs. no anaemia for subsequent CVE, KRT, and death without KRT were 1.7 (1.4-2.0), 2.0 (1.4-2.9), and 1.8 (1.5-2.3), respectively.</p><p><strong>Conclusion: </strong>Anaemia is associated with higher rates of CVE, progression to KRT and death in NDD- CKD patients, and with greater hospital utilisation and costs. Preventing and treating anaemia should improve clinical and economic outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose.","authors":"Jorge Rico-Fontalvo,&nbsp;José Correa-Guerrero,&nbsp;María Cristina Martínez-Ávila,&nbsp;Rodrigo Daza-Arnedo,&nbsp;Tomás Rodriguez-Yanez,&nbsp;Amilkar Almanza-Hurtado,&nbsp;José Cabrales,&nbsp;Carmen Julia Mendoza-Paternina,&nbsp;Alvaro Frías-Salazar,&nbsp;Julio Morales-Fernández","doi":"10.1155/2023/6059079","DOIUrl":"https://doi.org/10.1155/2023/6059079","url":null,"abstract":"<p><p>Renal hyperfiltration (RHF) is a prevalent phenomenon in critically ill patients characterized by augmented renal clearance (ARC) and increased of elimination of renally eliminated medications. Multiple risk factors had been described and potential mechanisms may contribute to the occurrence of this condition. RHF and ARC are associated with the risk of suboptimal exposure to antibiotics increasing the risk of treatment failure and unfavorable patient outcomes. The current review discusses the available evidence related to the RHF phenomenon, including definition, epidemiology, risk factors, pathophysiology, pharmacokinetic variability, and considerations for optimizing the dosage of antibiotics in critically ill patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9086353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Disparity in Expression of Sarcopenia in Haemodialysis Recipients: Analysis from the FITNESS Cohort.","authors":"Benjamin M Anderson,&nbsp;Daisy V Wilson,&nbsp;Muhammad Qasim,&nbsp;Gonzalo Correa,&nbsp;Felicity Evison,&nbsp;Suzy Gallier,&nbsp;Charles J Ferro,&nbsp;Thomas A Jackson,&nbsp;Adnan Sharif","doi":"10.1155/2023/5885059","DOIUrl":"https://doi.org/10.1155/2023/5885059","url":null,"abstract":"<p><strong>Background: </strong>There has been little exploration of the interplay between sarcopenia and frailty in haemodialysis, particularly regarding gender difference. We aimed to (1) assess whether ultrasound-derived low muscle mass (LMM) and sarcopenia are more common in male or female haemodialysis recipients; (2) assess whether age influences any observed gender difference, and (3) explore the interplay between sarcopenia, frailty, and gender in haemodialysis recipients.</p><p><strong>Methods: </strong>This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis with frailty phenotype (FP) scores. Bilateral anterior thigh thickness (BATT) was obtained according to an established ultrasound protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, LMM, and sarcopenia with a priori covariables, stratified by gender.</p><p><strong>Results: </strong>In total of 223 studies, participants had ultrasound measurements. Males showed greater prevalence of LMM. On adjusted analyses, LMM was associated with lower hand grip strength in males (<i>β</i> = -4.17; 95% C.I. -7.57 to -0.77; <i>P</i>=0.02), but not females (<i>β</i> = -1.88; 95% C.I. -5.41 to 1.64; <i>P</i>=0.29). LMM was also associated with slower walking speed in both males (<i>β</i> = -0.115; 95% C.I. -0.258 to -0.013; <i>P</i>=0.03) and females (<i>β</i> = -0.152; 95% C.I. -0.300 to -0.005; <i>P</i>=0.04). Sarcopenia was associated with greater odds of frailty on adjusted models in males (OR = 9.86; 95% C.I. 1.8 to 54.0; <i>P</i>=0.01), but not females (OR = 5.16; 95% C.I. 0.22 to 124; <i>P</i>=0.31).</p><p><strong>Conclusions: </strong>The clinical expression and significance of sarcopenia differ substantially between males and females on haemodialysis. Further work is required to elucidate underlying mechanisms and guide tailored treatment.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10094972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Standardized Brazilian Green Propolis Extract (EPP-AF®) on Inflammation in Haemodialysis Patients: A Clinical Trial.","authors":"Marcelo Augusto Duarte Silveira,&nbsp;Hayna Malta-Santos,&nbsp;Jéssica Rebouças-Silva,&nbsp;Flávio Teles,&nbsp;Erica Batista Dos Santos Galvão,&nbsp;Sergio Pinto de Souza,&nbsp;Fábio Ricardo Dantas Dutra,&nbsp;Marcel Miranda Dantas Gomes,&nbsp;Maurício Brito Teixeira,&nbsp;Luis Filipe Miranda Rebelo da Conceição,&nbsp;Carolina Sa Nascimento,&nbsp;Carolina Kymie Vasques Nonaka,&nbsp;Rodrigo Silva Cezar,&nbsp;Paulo Benigno Pena Batista,&nbsp;Andresa Aparecida Berretta,&nbsp;Valeria M Borges,&nbsp;Rogerio da Hora Passos","doi":"10.1155/2022/1035475","DOIUrl":"https://doi.org/10.1155/2022/1035475","url":null,"abstract":"<p><strong>Background: </strong>Patients on haemodialysis (HD) present a significant inflammatory status, which has a pronounced negative impact on their outcomes. Propolis is a natural resin with anti-inflammatory and immunomodulatory properties. We assessed the safety and impact of a standardized Brazilian green propolis extract (EPP-AF®) on the inflammatory status in patients under conventional HD.</p><p><strong>Methods: </strong>Patients were assigned to receive 200 mg/day of EPP-AF® for 4 weeks followed by 4 weeks without the drug, and changes in plasma levels of interleukins (ILs), interferon gamma (IFN-<i>γ</i>), tumour necrosis factor-alpha (TNF-<i>α</i>), and high-sensitivityc-reactive protein (HsCRP) were measured. A heatmap was used to illustrate trends in data variation.</p><p><strong>Results: </strong>In total, 37 patients were included in the final analysis. Patients presented an exacerbated inflammatory state at baseline. During EPP-AF® use, there was a significant reduction in IFN-<i>γ</i> (<i>p</i>=0.005), IL-13 (<i>p</i>=0.04 2), IL-17 (<i>p</i>=0.039), IL-1ra (<i>p</i>=0.008), IL-8 (<i>p</i>=0.009), and TNF-<i>α</i> (<i>p</i>  <  0.001) levels compared to baseline, and significant changes were found in Hs-CRP levels. The heatmap demonstrated a pattern of pronounced proinflammatory status at baseline, especially in patients with primary glomerulopathies, and a clear reduction in this pattern during the use of EPP-AF®. There was a tendency to maintain this reduction after suspension of EPP-AF®. No significant side effects were observed.</p><p><strong>Conclusion: </strong>Patients under haemodialysis presented a pronounced inflammatory status, and EPP-AF® was demonstrated to be safe and associated with a significant and maintained reduction in proinflammatory cytokines in this population. This trial is registered with Clinicaltrials.gov NCT04072341.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40461190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Denervation Influences Angiotensin II Types 1 and 2 Receptors.","authors":"Hajaralsadat Hosseini-Dastgerdi,&nbsp;Fatemeh Kharazmi,&nbsp;Ali-Asghar Pourshanazari,&nbsp;Mehdi Nematbakhsh","doi":"10.1155/2022/8731357","DOIUrl":"https://doi.org/10.1155/2022/8731357","url":null,"abstract":"<p><p>The sympathetic and renin-angiotensin systems (RAS) are two critical regulatory systems in the kidney which affect renal hemodynamics and function. These two systems interact with each other so that angiotensin II (Ang II) has the presynaptic effect on the norepinephrine secretion. Another aspect of this interaction is that the sympathetic nervous system affects the function and expression of local RAS receptors, mainly Ang II receptors. Therefore, in many pathological conditions associated with an increased renal sympathetic tone, these receptors' expression changes and renal denervation can normalize these changes and improve the diseases. It seems that the renal sympathectomy can alter Ang II receptors expression and the distribution of RAS receptors in the kidneys, which influence renal functions.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Direct Immunofluorescence Test on Paraffin-Embedded Blocks in Comparison with Frozen Section Blocks in Renal Biopsies.","authors":"Sahand Mohammadzadeh,&nbsp;Fatemeh Aghakhaninejad,&nbsp;Fariborz Azad,&nbsp;Dorna Derakhshan,&nbsp;Neda Soleimani","doi":"10.1155/2022/4974031","DOIUrl":"https://doi.org/10.1155/2022/4974031","url":null,"abstract":"<p><strong>Background: </strong>In several published research, the evaluation of renal disorders using immunofluorescence on formalin-fixed, paraffin-embedded (FFPE) tissue sections versus immunofluorescence on frozen sections was compared. Each technique's accuracy varies greatly. This study's objective was to assess IF-P as a potential replacement for IF-F in the diagnosis of renal biopsy specimens.</p><p><strong>Materials and methods: </strong>To show immunoglobulin IgA, IgG, IgM, and C3 immune deposits, proteinase K digestion of paraffin-embedded renal biopsy was standardized and used in 51 renal biopsies. Sensitivity, specificity, false-positive, and false-negative values were calculated.</p><p><strong>Results: </strong>IF-P showed a sensitivity of 93.1%, 76.9%, 63.6%, and 33.3%, and a specificity of 100%, 97.3%, 95%, and 100% for IgG, IgA, IgM, and C3, respectively. Compared to cases that had both routine IF and IF-P, 50 of 51 showed either the same amount of staining for the diagnostic immunoglobulin/complement or a small amount of difference. In most of the cases (49 of 51), diagnostic findings were found.</p><p><strong>Conclusion: </strong>IF-P is a sensitive and precise approach for assessing immune deposits in renal tissue biopsies. We come to the conclusion that IF-P serves as a beneficial salvage immunohistochemistry method for renal biopsies that do not contain enough cortical tissue for IF-F.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33527729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Mortality in Adults with Acute Kidney Injury Requiring Dialysis: A Cohort Analysis.","authors":"Charles Kangitsi Kahindo,&nbsp;Olivier Mukuku,&nbsp;Vieux Momeme Mokoli,&nbsp;Ernest Kiswaya Sumaili,&nbsp;Stanis Okitotsho Wembonyama,&nbsp;Zacharie Kibendelwa Tsongo","doi":"10.1155/2022/7418955","DOIUrl":"https://doi.org/10.1155/2022/7418955","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) requiring renal replacement therapy is accompanied by considerable mortality. This present study evaluated predictors of mortality at initiation of hemodialysis (HD) in AKI patients in Goma (in the Democratic Republic of the Congo (DRC)).</p><p><strong>Methods: </strong>A single-centre cohort survey evaluated the clinical profile and survival rates of AKI patients admitted to HD in the only HD centre in Goma, North Kivu province (DRC). Data were collected from patients who underwent HD for AKI. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. The survival study used the Kaplan-Meier curve. Predictors of mortality were evaluated using Cox regression.</p><p><strong>Results: </strong>Of the 131 eligible patients, the mean age was 43.69 ± 16.56 years (range: 18-90 years). Men represented 54.96% of the cohort. The overall HD mortality rate was 25.19% (<i>n</i> = 33). In multivariate analysis, independent predictors of mortality in AKI stage 3 patients admitted to HD were as follows: age ≥ 60 years (adjusted hazard ratio (AHR) = 15.89; 95% CI: 3.98-63.40; <i>p</i> < 0.0001), traditional herbal medicine intake (AHR = 5.10; 95% CI: 2.10-12.38; <i>p</i> < 0.0001), HIV infection (AHR = 5.55; 95% CI: 1.48-20.73; <i>p</i>=0.011), anemia (AHR = 9.57; 95% CI: 2.08-43.87; <i>p</i>=0.004), hyperkalemia (AHR = 6.23; 95% CI: 1.26-30.72; <i>p</i>=0.025), respiratory distress (AHR = 4.66; 95% CI: 2.07-10.50; <i>p</i> < 0.0001), and coma (AHR = 11.39; 95% CI: 3.51-36.89; <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Initiation of hemodialysis with AKI has improved survival in patients with different complications.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time on Therapy of Automated Peritoneal Dialysis with and without Remote Patient Monitoring: A Cohort Study.","authors":"Mauricio Sanabria,&nbsp;Jasmin Vesga,&nbsp;Bengt Lindholm,&nbsp;Angela Rivera,&nbsp;Peter Rutherford","doi":"10.1155/2022/8646775","DOIUrl":"https://doi.org/10.1155/2022/8646775","url":null,"abstract":"<p><strong>Background: </strong>Remote patient monitoring (RPM) of patients undergoing automated peritoneal dialysis (APD-RPM) may potentially enhance time on therapy due to possible improvements in technique and patient survival.</p><p><strong>Objective: </strong>To evaluate the effect of APD-RPM as compared to APD without RPM on time on therapy.</p><p><strong>Methods: </strong>Adult incident APD patients undergo APD for 90 days or more in the Baxter Renal Care Services (BRCS) Colombia network between January 1, 2017, and June 30, 2019, with the study follow-up ending June 30, 2021. The exposure variable was APD-RPM vs. APD-without RPM. The outcomes of time on therapy and mortality rate over two years of follow-up were estimated in the full sample and in a matched population according to the exposure variable. A propensity score matching (PSM) 1:1 without replacement utilizing the nearest neighbor within caliper (0.035) was used and created a pseudopopulation in which the baseline covariates were well balanced. Fine & Gray multivariate analysis was performed to assess the effect of demographic, clinical, and laboratory variables on the risk of death, adjusting for the competing risks of technique failure and kidney transplantation.</p><p><strong>Results: </strong>In the matched sample, the time on APD therapy was significantly longer in the RPM group than in the non-RPM group, 18.95 vs. 15.75 months, <i>p</i> < 0.001. The mortality rate did not differ between the two groups: 0.10 events per patient-year in the RPM group and 0.12 in the non-RPM group, <i>p</i>=0.325.</p><p><strong>Conclusion: </strong>Over two years of follow-up, the use of RPM vs. no RPM in APD patients was associated with a significant increase in time on therapy, by 3.2 months. This result indicates that RPM-supported APD therapy may improve the clinical effectiveness and the overall quality of APD.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40335859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}