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İkinci Basamak Devlet Hastanesi Nefroloji Kliniği Periton Diyaliz Hastalarının Klinik Sonuçları

Clinical Outcomes of Peritoneal Dialysis Patients at a Secondary State Hospital Nephrology Clinic

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1001.06

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
OBJECTIVE: We present our experience with demographics, clinical and biochemical outcomes, and factors affecting mortality in ESRD patients treated with peritoneal dialysis (PD) during a 12-year period (1997–2009) at secondary state hospital’s nephrology clinic. MATE RIAL and methods: After excluding patients younger than age 15 at the initiation of PD, those who had follow-ups at less than three months, outcomes were analyzed for 313 patients. The demographic, clinical, and biochemical data were collected from the patients’ medical records. Res ults: The mean age at the start of PD was 51.9 ± 17.6 years and the mean PD duration was 27.5 ± 27.1 months (median: 20, range: 3–166). Hypertension was the most common cause of ESRD (36.1%), followed by diabetes mellitus (31.3%). Among these 313 patients, 58 (18.5%) died. Patients’ survival rates were 93.3%, 85%, and 72.4%, at one, three, and five years, respectively. A higher educational level (p=0.045), lower age (p=0.002), higher baseline creatinine (p=0.045), and higher baseline albumin level (p=0.003) were found to affect patients’ survival. Technique survival rates were 89.1%, 84%, and 74.1% at one, three and five years, respectively. Technique failure was associated with peritonitis rate (p=0.03). ConclusI on: Our results suggest that patients’ and technique survival rates and the factors affecting mortality in our patients at a secondary state hospital’s nephrology clinic were similar to those at a tertiary care university hospital’s nephrology clinic in Turkey.
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Abstract (Original Language): 
Amaç : İkinci basamak tedavi kurumu olarak kliniğimizde 12 yıl boyunca (1997–2009) periton diyaliz tedavisi uygulanan son dönem böbrek yetmezlikli hastaların demografik, klinik ve biyokimyasal özellikleri ve mortaliteyi etkileyen faktörlerini sunmaktayız. GEREÇ ve YÖNTEMLER: Periton diyalizine başlama yaşı 15’in altında olan ve üç aydan daha kısa süre izlenen hastaların çıkarılmasından sonra toplam 313 hastanın sonuçları değerlendirildi. Hastaların demografik, klinik ve biyokimyasal özellikleri tıbbi hasta dosyalarından kaydedildi. Sonuç: Ortalama periton diyalizine başlama yaşı 51,9 ± 17.6, periton diyaliz süresi 27,5 ± 27,1 ay idi (ortanca: 20, aralık: 3–166). Son dönem böbrek yetmezliğinin en sık nedeni hipertansiyon (%36,1) ve bunu izleyen diyabetes mellitus (%31,3) idi. 313 hastanın 58’i öldü (%18,5). Hasta sağ kalım oranı birinci, üçüncü ve beşinci yılda sırayla %93,3, %85 ve %72,4 olarak bulundu. Yüksek eğitim düzeyi (p=0,045), genç yaş (p=0,002), yüksek bazal kreatinin düzeyi (p=0,045), ve yüksek bazal serum albumin düzeyi (p=0,003) hasta sağ kalımını etkileyen faktörler olarak saptandı. Teknik sağ kalım oranları birinci, üçüncü ve beşinci yılda sırayla %89,1, %84 ve %74,1 olarak bulundu. Teknik yetersizlik peritonit hızıyla ilişkili saptandı (p=0.03). Tar tışma : Bizim sonuçlarımız ikinci basamak sağlık kuruluşu nefroloji kliniği olarak hasta ve teknik sağkalım oranları ve hasta mortalitesini etkileyen faktörlerin Türkiye’deki üçüncü basamak üniversite hastanelerinin sonuçlarına benzediğini göstermektedir.
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  • Turkish

REFERENCES

References: 

1. Grassmann A, Gioberge S, Moeller S, Brown G: ESRD patients in
2004: Global overview of patient numbers, treatment modalities and
associated trends. Nephrol Dial Transplant 2005; 20: 2587-2593
2. Collins AJ, Hao W, Xia H, Ebben JP, Everson SE, Constantini EG,
Ma JZ: Mortality risks of peritoneal dialysis and hemodialysis. Am
J Kidney Dis 1999; 34: 1065-1074
3. Vonesh EF, Synder JJ, Foley RN, Collins AJ: Mortality studies
comparing peritoneal dialysis and hemodialysis: What do they tell
us? Kidney Int Suppl 2006; 103: 3-11
4. Ataman R, Burton PR, Gokal R, Brown CB, Marsh FB, Walls J:
Long-term CAPD-some U.K. experience. Clin Nephrol 1988;
30(Suppl 1): 71-75
5. Shinzato T, Nakai S, Akiba T, Yamagami S, Yamazaki C, Kitaoka T,
Kubo K, Maeda K, Morii H: Report of the annual statistical survey
of the Japanese Society for Dialysis Therapy in 1996. Kidney Int
1999; 55: 700-712
6. Cueto-Manzano AM, Quintana-Pina E, Correa-Rotter R: Longterm
CAPD survival and analysis of mortality risk factors: 12-year
experience of a single Mexican center. Perit Dial Int 2001; 21:
148-153
7. Verger C, Ryckelynck JP, Duman M, Veniez G, Lobbedaz T,
Boulanger E, Moranne O: French Peritoneal Dialysis Registry
(RDPLF): Outline and main results. Kidney Int Suppl 2006; 103:
12-20
8. Collins AJ, Kasiske B, Herzog C, Chavers B, Foley R, Gilbertson
D, Grimm R, Liu J, Louis T, Manning W, McBean M, Murray A, St
Peter W, Xue J, Fan Q, Guo H, Li Q, Li S, Qiu Y, Li S, Roberts T,
Skeans M, Snyder J, Solid C, Wang C, Weinhandl E, Zhang R, Arko
C, Chen SC, Dalleska F, Daniels F, Dunning S, Ebben J, Frazier
E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Berrini D,
Constantini E, Everson S, Eggers P, Agodoa L: Excerpts from the
United States Renal Data System 2006 Annual Data Report. Am J
Kidney Dis 2007; 49(1 Suppl1): A6-7, 1-296
9. Han SH, Lee SC, Ahn SV, Lee JE, Hoi HY, Kim BS, Kang SW, Choi
KH, Han DS, Lee HY: Improving outcome of CAPD: Twenty-five
years’ experience in a single Korean center. Perit Dial Int 2007; 27:
432-440
10. Sipahioglu MH, Aybal A, Unal A, Tokgoz B, Oymak O, Utas C:
Patient and technique survival and factors affecting mortality on
peritoneal dialysis in Turkey: 12 years’ experience in a single center.
Perit Dial Int 2008; 28: 238-245
11. Han SH, Lee JE, Kim DK, Moon SJ, Kim HW, Chang JH, Kim BS,
Kang SW, Choi KH, Lee HY, Han DS: Long-term clinical outcomes
of peritoneal dialysis patients: Single center experience from Korea.
Perit Dial Int 2008; 28(S3): 21-26
12. Utas C; Turkish Multicenter Peritoneal Dialysis Study Group:
Patient and technique survival on CAPD in Turkey. Perit Dial Int
2001; 21: 602-606
13. Registry of The Nepfrology, Dialysis and Transplantation in
Turkey, Registry 2007. Istanbul: Turkish Society of Nephrology,
2007. Available at:http://tsn.org.tr/documents/registry/TND%20
Registry%20kure%20son.pdf
14. Yoshino M, Kuhlmann MK, Kotanko P, Greenwood RN, Pisoni
RL, Port FK, Jager KJ, Homel P, Augustijn H, de Charro FT,
Collart F, Erek E, Finne P, Garcia-Garcia G, Grönhagen-Riska C,
Ioannidis GA, Ivis F, Leivestad T, Løkkegaard H, Lopot F, Jin DC,
Kramar R, Nakao T, Nandakumar M, Ramirez S, van der Sande
FM, Schön S, Simpson K, Walker RG, Zaluska W, Levin NW:
International differences in dialysis mortality reflect background
general population atherosclerotic cardiovascular mortality. J Am
Soc Nephrol 2006; 17: 3510-3519
15. Van Dijk PC, Zwinderman AH, Dekker FW, Schon S, Stel VS,
Finne P, Jager KJ: Effect of general population mortality on the
north-south mortality gradient in patients on replacement therapy in
Europe. Kidney Int 2007; 71: 53-59
16. Nolph KD, Cutler SJ, Steinberg SM, Novak JW, Hirschman GH:
Factors associated with morbidity and mortality among patients on
CAPD. ASAIO Trans 1987; 33: 57-65
17. Struijk DG, Krediet RT, Koomen GC, Boeschoten EW, Arisz L:
The effect of serum albumin at the start of continuous ambulatory
peritoneal dialysis treatment on patient survival. Perit Dial Int 1994;
14: 121-126
18. Genestier S, Hedelin G, Schaffer P, Faller B: Prognostic factors in
CAPD patients: A retrospective study of a 10-year period. Nephrol
Dial Transplant 1995; 10: 1905-1911
19. Davies SJ, Russell L, Bryan J, Phillips L, Russell GI: Comorbidity,
urea kinetics, and appetite in continuous ambulatory peritoneal
dialysis patients: Their interrelationship and prediction of survival.
Am J Kidney Dis 1995; 26: 353-361
20. Davies SJ, Phillips L, Russell GI: Peritoneal solute transport
predicts survival on CAPD independently of residual renal function.
Nephrol Dial Transplant 1998; 13: 962-968
21. Jager KJ, Merkus MP, Dekker FW, Boeschoten EW, Tijssen JG,
Stevens P, Bos WJ, Krediet RT: Mortality and technique failure
in patients starting chronic peritoneal dialysis: Results of the
Netherlands Cooperative Study on the Adequacy of Dialysis.
NECOSAD Study Group. Kidney Int 1999; 55: 1476-1485
22. Ates K, Nergizoglu G, Keven K, Sen A, Kutlay S, Erturk S, Duman
N, Karatan O, Ertug AE: Effect of fluid and sodium removal on
mortality in peritoneal dialysis patients. Kidney Int 2001; 60:
767-776
23. Culleton BF, Hemmelgarn BR: Is chronic kidney disease a
cardiovascular disease risk factor? Semin Dial 2003; 16: 95-100
24. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B,
Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ,
Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW; American Heart
Association Councils on Kidney in Cardiovascular Disease, High
Blood Pressure Research, Clinical Cardiology, and Epidemiology
and Prevention: Kidney disease as a risk factor for development
of cardiovascular disease: A statement from the American Heart
Association Councils on Kidney in Cardiovascular Disease, High
Blood Pressure Research, Clinical Cardiology, and Epidemiology
and Prevention. Hypertension 2003; 42: 1050-1065
25. Borovnicar DJ, Wong KC, Kerr PG, Stroud DB, Xiong DW, Strauss
BJ, Atkins RC: Total body protein status assessed by different
estimates of fat-free mass in adult peritoneal dialysis patients. Eur J
Clin Nutr 1996; 50: 607-616
26. K/DOQI, National Kidney Foundation: Clinical practice guidelines
for nutrition in chronic renal failure. Am J Kidney Dis 2000; 35(6
Suppl 2): 1-140
27. Avram MM, Mittman N, Bonomini L, Chattopadhyay J, Fein P:
Markers for survival in dialysis: A seven-year prospective study.
Am J Kidney Dis 1995; 26: 209-219
28. Avram MM, Goldwasser P, Erroa M, Fein PA: Predictors of
survival in continuous ambulatory peritoneal dialysis patients:
The importance of prealbumin and other nutritional and metabolic
markers. Am J Kidney Dis 1994; 23: 91-98
29. Avram MM, Fein PA, Bonomini L, Mittman N, Loutoby R,
Avram DK, Chattopadhyay J: Predictors of survival in continuous
ambulatory peritoneal dialysis patients: A five-year prospective
study. Perit Dial Int 1996; 16(Suppl 1): 190-194
30. Avram MM, Bonomini LV, Sreedhara R, Mittman N: Predictive
value of nutritional markers (albumin, creatinine, cholesterol, and
hematocrit) for patients on dialysis for up to 30 years. Am J Kidney
Dis 1996; 28: 910-917
31. Burkart JM: Adequacy of peritoneal dialysis. In: Gokal R, Khanna
R, Krediet R, Nolph K, eds. Textbook of Peritoneal Dialysis. 2nd ed.
Dordrecht. The Netherlands: Kluwer Academic Publishers: 2000;
465-498
32. de Mutsert R, Grootendorst DC, Indemans F, Boeschoten EW,
Krediet RTR, Dekker FW: Association between serum albumin and
mortality in dialysis patients in partly explained by inflammation,
and not by malnutrition. J Ren Nutr 2009; 19(2): 127-135
33. Fried LF, Bernardini J, Johnston JR, Piraino B: Peritonitis influences
mortality in peritoneal dialysis patients. J Am Soc Nephrol 1996; 7:
2176-2182
34. Chung SH, Heimburger O, Lindholm B, Lee HB: Peritoneal dialysis
patients survival: A comparison between a Swedish and a Korean
centre. Nephrol Dial Transplant 2005; 20: 1207-1213
35. Choi P, Nemati E, Banerjee A, Preston E, LevyJ, Brown E: Peritoneal
dialysis catheter removal for acute peritonitis: A retrospective
analysis of factors associated with catheter removal and prolonged
postoperative hospitalization. Am J Kidney Dis 2004; 43: 103-111
36. Perez Fontan M, Rodriguez-Cormona A, Garcia-Naveiro R, Rosales
M, Villaverde P, Valdes F: Peritonitis-related mortality in patients
undergoing chronic peritoneal dialysis. Perit Dial Int 2005; 25:
274-284
37. Viglino G, Cancarini G, Catizone L, Cocchi R, de Vecchi A, Lupo A,
Salomone M, Segoloni GP, Giangrande A: The impact of peritonitis
on CAPD results. Adv Perit Dial 1992; 8: 269-275
38. Woodrow G, Turney JH, Brownjohn AM: Technique failure in
peritoneal dialysis and its impact on patient survival. Perit Dial Int
1997; 17: 360-364
39. Kim DK, Yoo TH, Ryu DR, Xu ZG, Kim HJ, Choi KH, Lee HY,
Han DS, Kang SW: Changes in causative organisms and their
antimicrobial susceptibilities in CAPD peritonitis: A single center’s
experience over one decade. Perit Dial Int 2004; 24: 424-32

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