Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study
Objectives The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for al...
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| Format: | Article |
| Language: | English |
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Korean Society for Preventive Medicine
2018-07-01
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| Series: | Journal of Preventive Medicine and Public Health |
| Subjects: | |
| Online Access: | http://www.jpmph.org/upload/pdf/jpmph-51-4-205.pdf |
| _version_ | 1819178852363010048 |
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| author | Chinakorn Sujimongkol Cholatip Pongskul Supannee Promthet |
| author_facet | Chinakorn Sujimongkol Cholatip Pongskul Supannee Promthet |
| author_sort | Chinakorn Sujimongkol |
| collection | DOAJ |
| description | Objectives The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously. |
| first_indexed | 2024-12-22T21:49:08Z |
| format | Article |
| id | doaj.art-8acd7d63e75a4e8d8e8d8571d6fa951c |
| institution | Directory Open Access Journal |
| issn | 1975-8375 2233-4521 |
| language | English |
| last_indexed | 2024-12-22T21:49:08Z |
| publishDate | 2018-07-01 |
| publisher | Korean Society for Preventive Medicine |
| record_format | Article |
| series | Journal of Preventive Medicine and Public Health |
| spelling | doaj.art-8acd7d63e75a4e8d8e8d8571d6fa951c2022-12-21T18:11:25ZengKorean Society for Preventive MedicineJournal of Preventive Medicine and Public Health1975-83752233-45212018-07-0151420521210.3961/jpmph.18.0661973Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort StudyChinakorn Sujimongkol0Cholatip Pongskul1Supannee Promthet2 Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand Division of Nephrology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, ThailandObjectives The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.http://www.jpmph.org/upload/pdf/jpmph-51-4-205.pdfDeathGlucoseKidney diseasesPeritoneal dialysisSurvival rateThailand |
| spellingShingle | Chinakorn Sujimongkol Cholatip Pongskul Supannee Promthet Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study Journal of Preventive Medicine and Public Health Death Glucose Kidney diseases Peritoneal dialysis Survival rate Thailand |
| title | Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study |
| title_full | Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study |
| title_fullStr | Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study |
| title_full_unstemmed | Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study |
| title_short | Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study |
| title_sort | regimen related mortality risk in patients undergoing peritoneal dialysis using hypertonic glucose solution a retrospective cohort study |
| topic | Death Glucose Kidney diseases Peritoneal dialysis Survival rate Thailand |
| url | http://www.jpmph.org/upload/pdf/jpmph-51-4-205.pdf |
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