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de Arriba G, Avila GG, Guinea MT, Alia IM, Herruzo JA, Ruiz BR, Tejeiro RD, Rubio MEL, Poyatos CV, Roldán CG. Mortality of hemodialysis patients is associated with their clinical situation at the start of treatment. Nefrologia 2021; 41:461-466. [PMID: 36165115 DOI: 10.1016/j.nefroe.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 11/09/2020] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Previous reports have shown very high mortality among hemodialyisis patients. Our goal was to analyze the mortality of patients in the Renal Registry of Patients who remained exclusively on hemodialysis treatment. METHODS The cohort of patients who started treatment in the community of Castilla-La Mancha between 2010 and 2012 and remained on hemodialysis treatment was analysed until the end of 2017. Age, sex, primary kidney disease, vascular access, hemoglobin, Charlson index and serum albumin were included. RESULTS Mortality rate was 63,4% after 5 years and 76% at the end of the study, with no difference between males and females, and was linked to an older age, urgent onset or in those with acute deterioration of chronic kidney disease, the use of catheters or albumin less than 3.5 g/dl. CONCLUSIONS Mortality in patients who remain on hemodialysis is very high and is associated with non-modifiable factors such as age but also others that we can prevent or treat such as type of vascular access or nutrition status at the beginning of treatment.
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Affiliation(s)
- Gabriel de Arriba
- Hospital Universitario de Guadalajara, Guadalajara, Spain; Departamento de Medicina y Especialidades Médicas de la Universidad de Alcalá, Madrid, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain.
| | - Gonzalo Gutiérrez Avila
- Consejería de Sanidad, Junta de Comunidades de Castilla-La Mancha, Toledo, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Marta Torres Guinea
- Hospital Virgen de la Salud de Toledo, Toledo, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Inmaculada Moreno Alia
- Consejería de Sanidad, Junta de Comunidades de Castilla-La Mancha, Toledo, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - José Antonio Herruzo
- Centros de Diálisis Asyter, Toledo, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Begoña Rincón Ruiz
- Hospital Virgen de la Luz de Cuenca, Cuenca, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Rafael Díaz Tejeiro
- Hospital Virgen de la Salud de Toledo, Toledo, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Maria Esperanza López Rubio
- Hospital General Universitario de Albacete, Albacete, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Carmen Vozmediano Poyatos
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
| | - Carmina Gómez Roldán
- Hospital General Universitario de Albacete, Albacete, Spain; Registro de Enfermos Renales de Castilla-La Mancha (RERCLM), Spain
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2
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Hemke AC, Heemskerk MBA, van Diepen M, Kramer A, de Meester J, Heaf JG, Abad Diez JM, Torres Guinea M, Finne P, Brunet P, Vikse BE, Caskey FJ, Traynor JP, Massy ZA, Couchoud C, Groothoff JW, Nordio M, Jager KJ, Dekker FW, Hoitsma AJ. Performance of an easy-to-use prediction model for renal patient survival: an external validation study using data from the ERA-EDTA Registry. Nephrol Dial Transplant 2018; 33:1786-1793. [PMID: 29346645 DOI: 10.1093/ndt/gfx348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background An easy-to-use prediction model for long-term renal patient survival based on only four predictors [age, primary renal disease, sex and therapy at 90 days after the start of renal replacement therapy (RRT)] has been developed in The Netherlands. To assess the usability of this model for use in Europe, we externally validated the model in 10 European countries. Methods Data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry were used. Ten countries that reported individual patient data to the registry on patients starting RRT in the period 1995-2005 were included. Patients <16 years of age and/or with missing predictor variable data were excluded. The external validation of the prediction model was evaluated for the 10- (primary endpoint), 5- and 3-year survival predictions by assessing the calibration and discrimination outcomes. Results We used a data set of 136 304 patients from 10 countries. The calibration in the large and calibration plots for 10 deciles of predicted survival probabilities showed average differences of 1.5, 3.2 and 3.4% in observed versus predicted 10-, 5- and 3-year survival, with some small variation on the country level. The concordance index, indicating the discriminatory power of the model, was 0.71 in the complete ERA-EDTA Registry cohort and varied according to country level between 0.70 and 0.75. Conclusions A prediction model for long-term renal patient survival developed in a single country, based on only four easily available variables, has a comparably adequate performance in a wide range of other European countries.
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Affiliation(s)
- Aline C Hemke
- Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.,Dutch Renal Replacement Registry, Leiden, The Netherlands
| | | | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Johan de Meester
- Department of Nephrology, Dialysis, and Hypertension, AZ Nikolaas, Sint-Niklaas, Belgium
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | | | | | - Patrik Finne
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Philippe Brunet
- Centre de Nephrologie et Transplantation Renale, Hospital de la Conception, Aix Marseille Université, AP-HM, Marseille, France
| | - Bjørn E Vikse
- Department of Medicine, Haugesund Hospital, Haugesund, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Fergus J Caskey
- UK Renal Registry, Southmead Hospital, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jamie P Traynor
- Scottish Renal Registry, Information Services Division Scotland, Glasgow, UK
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, Paris, France
| | - Cécile Couchoud
- Renal Epidemiology and Information Network (REIN) Registry, French Biomedical Agency, Saint-Denis-la-Plaine, France
| | - Jaap W Groothoff
- Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.,Nephrology and Dialysis Unit, AULSS 6, Padua, Italy
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Andries J Hoitsma
- Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.,Division of Nephrology, University Nijmegen Medical Centre, Nijmegen, The Netherlands
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4
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Kramer A, Pippias M, Stel VS, Bonthuis M, Abad Diez JM, Afentakis N, Alonso de la Torre R, Ambuhl P, Bikbov B, Bouzas Caamaño E, Bubic I, Buturovic-Ponikvar J, Caskey FJ, Castro de la Nuez P, Cernevskis H, Collart F, Comas Farnés J, Garcia Bazaga MDLÁ, De Meester J, Ferrer Alamar M, Finne P, Garneata L, Golan E, G Heaf J, Hemmelder M, Ioannou K, Kantaria N, Kolesnyk M, Kramar R, Lassalle M, Lezaic V, Lopot F, Macário F, Magaz A, Martín-Escobar E, Metcalfe W, Ots-Rosenberg M, Palsson R, Piñera Celestino C, Resić H, Rutkowski B, Santiuste de Pablos C, Spustová V, Stendahl M, Strakosha A, Süleymanlar G, Torres Guinea M, Varberg Reisæter A, Vazelov E, Ziginskiene E, Massy ZA, Wanner C, Jager KJ, Noordzij M. Renal replacement therapy in Europe: a summary of the 2013 ERA-EDTA Registry Annual Report with a focus on diabetes mellitus. Clin Kidney J 2016; 9:457-69. [PMID: 27274834 PMCID: PMC4886899 DOI: 10.1093/ckj/sfv151] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 12/11/2015] [Indexed: 12/14/2022] Open
Abstract
Background This article provides a summary of the 2013 European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report (available at http://www.era-edta-reg.org), with a focus on patients with diabetes mellitus (DM) as the cause of end-stage renal disease (ESRD). Methods In 2015, the ERA-EDTA Registry received data on renal replacement therapy (RRT) for ESRD from 49 national or regional renal registries in 34 countries in Europe and bordering the Mediterranean Sea. Individual patient data were provided by 31 registries, while 18 registries provided aggregated data. The total population covered by the participating registries comprised 650 million people. Results In total, 72 933 patients started RRT for ESRD within the countries and regions reporting to the ERA-EDTA Registry, resulting in an overall incidence of 112 per million population (pmp). The overall prevalence on 31 December 2013 was 738 pmp (n = 478 990). Patients with DM as the cause of ESRD comprised 24% of the incident RRT patients (26 pmp) and 17% of the prevalent RRT patients (122 pmp). When compared with the USA, the incidence of patients starting RRT pmp secondary to DM in Europe was five times lower and the incidence of RRT due to other causes of ESRD was two times lower. Overall, 19 426 kidney transplants were performed (30 pmp). The 5-year adjusted survival for all RRT patients was 60.9% [95% confidence interval (CI) 60.5–61.3] and 50.6% (95% CI 49.9–51.2) for patients with DM as the cause of ESRD.
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Affiliation(s)
- Anneke Kramer
- Department of Medical Informatics, Academic Medical Center , ERA-EDTA Registry, University of Amsterdam , 1100 DE Amsterdam , The Netherlands
| | - Maria Pippias
- Department of Medical Informatics, Academic Medical Center , ERA-EDTA Registry, University of Amsterdam , 1100 DE Amsterdam , The Netherlands
| | - Vianda S Stel
- Department of Medical Informatics, Academic Medical Center , ERA-EDTA Registry, University of Amsterdam , 1100 DE Amsterdam , The Netherlands
| | - Marjolein Bonthuis
- Department of Medical Informatics, Academic Medical Center , ESPN/ERA-EDTA Registry, Universiteit van Amsterdam , Amsterdam , The Netherlands
| | | | - Nikolaos Afentakis
- Hellenic Renal Registry, Board of Registry, Coordination and Control of RRT , General Hospital of Athens 'G. Gennimatas' , Athens , Greece
| | | | - Patrice Ambuhl
- Swiss Dialysis Registry, Renal Division, Stadtspital Waid Zürich , Zurich , Switzerland
| | - Boris Bikbov
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation; Department of Nephrology Issues of Transplanted Kidney, Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation
| | | | - Ivan Bubic
- Department of Nephrology, Dialysis and Transplantation, Clinical Hospital Center Rijeka , School of Medicine University of Rijeka , Rijeka , Croatia
| | - Jadranka Buturovic-Ponikvar
- Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Pablo Castro de la Nuez
- Information System of Regional Transplant Coordination in Andalucia (SICATA) , Andalucia , Spain
| | - Harijs Cernevskis
- Department of Internal Medicine , Riga Stradins University , Riga , Latvia
| | | | - Jordi Comas Farnés
- Catalan Renal Registry, Catalan Transplant Organization, Health Department , Generalitat of Catalonia , Barcelona , Spain
| | - Maria de Los Ángeles Garcia Bazaga
- Dirección General de Salud Pública, Servicio Extremeño de Salud , Consejería de Sanidad y Políticas Sociales, Junta de Extremadura , Spain
| | - Johan De Meester
- Department of Nephrology, Dialysis and Hypertension , Dutch-speaking Belgian Renal Registry (NBVN) , Sint-Niklaas , Belgium
| | - Manuel Ferrer Alamar
- Técnico Registro de Enfermos Renales Comunitat Valenciana, Servicio de Estudios Epidemiológicos y Registros Sanitarios, Subdirección General Epidemiología, Dirección General Salut Pública, Consellería Sanitat , Valencian Region , Spain
| | - Patrik Finne
- Abdominal Center, Nephrology and Finnish Registry for Kidney Diseases , Helsinki University Central Hospital , Helsinki , Finland
| | - Liliana Garneata
- "Carol Davila" University of Medicine and Pharmacy , "Dr C Davila" Teaching Hospital of Nephrology, Romanian Renal Registry , Bucharest , Romania
| | - Eliezer Golan
- Department of Nephrology and Hypertension , Meir Medical Center, Kfar-Saba and Sackler Faculty of Medicine , Tel-Aviv , Israel
| | - James G Heaf
- Department of Medicine , Roskilde Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Marc Hemmelder
- Nefrovisie Renine, Dutch Renal Registry , Leiden , The Netherlands
| | - Kyriakos Ioannou
- Nephrology Department , Nicosia General Hospital , Nicosia , Cyprus
| | - Nino Kantaria
- Department of Internal Medicine , Tbilisi State Medical University , Tbilisi , Georgia
| | | | | | | | - Visnja Lezaic
- Department of Nephrology, Clinical Centre of Serbia , Belgrade University , Belgrade , Serbia
| | - Frantisek Lopot
- General University Hospital and 1st Medical Faculty, Department of Medicine , Charles University , Prague - Strahov , Czech Republic
| | - Fernando Macário
- Portuguese Society of Nephrology, Nephrology Department , University Hospital of Coimbra , Coimbra , Portugal
| | - Angela Magaz
- Unidad de Información Sobre Pacientes Renales de la Comunidad Autónoma del País Vasco (UNIPAR) , Basque Country , Spain
| | - Eduardo Martín-Escobar
- Registro Español de Enfermos Renales (REER), Organización Nacional de Trasplantes , Madrid , Spain
| | - Wendy Metcalfe
- Scottish Renal Registry, Meridian Court , Glasgow , Scotland
| | - Mai Ots-Rosenberg
- Department of Internal Medicine , Tartu University , Tartu , Estonia
| | - Runolfur Palsson
- Division of Nephrology, Landspitali - National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Halima Resić
- Clinic for Hemodialysis, Clinical Center , University of Sarajevo , Sarajevo , Bosnia and Herzegovina
| | - Boleslaw Rutkowski
- Polish Renal Registry, Department of Nephrology, Transplantology and Internal Medicine , Medical University , Gdansk , Poland
| | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiología, Consejería de Sanidad , IMIB-Arrixaca , Murcia , Spain
| | | | - Maria Stendahl
- Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden; Swedish Renal Registry, Jönköping, Sweden
| | - Ariana Strakosha
- Service of Nephrology, Dialysis and Transplant , University Hospital Center , Tirana , Albania
| | - Gültekin Süleymanlar
- Division of Nephrology, Department of Medicine, Medical School , Akdeniz University , Antalya , Turkey
| | - Marta Torres Guinea
- Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-La Mancha , Hospital Virgen de la Salud , Castilla-La Mancha , Spain
| | - Anna Varberg Reisæter
- Norwegian Renal Registry, Renal Unit, Department for Transplant Medicine , Oslo University Hospital, Rikshospitalet , Oslo , Norway
| | - Evgueniy Vazelov
- Dialysis Clinic , "Alexandrovska" University Hospital , Sofia Medical University , Sofia , Bulgaria
| | - Edita Ziginskiene
- Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Lithuanian Nephrology, Dialysis and Transplantation Association, Nephrological Clinic, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt/Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, CESP, Team 5, Villejuif, France
| | - Christoph Wanner
- Division of Nephrology , University Clinic , University of Würzburg , Würzburg , Germany
| | - Kitty J Jager
- Department of Medical Informatics, Academic Medical Center , ERA-EDTA Registry, University of Amsterdam , 1100 DE Amsterdam , The Netherlands
| | - Marlies Noordzij
- Department of Medical Informatics, Academic Medical Center , ERA-EDTA Registry, University of Amsterdam , 1100 DE Amsterdam , The Netherlands
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Saracho R, Martín Escobar E, Comas Farnés J, Arcos E, Mazuecos Blanca A, Gentil Govantes MÁ, Castro de la Nuez P, Zurriaga Ó, Ferrer Alamar M, Bouzas Caamaño E, García Falcón T, Portolés Pérez J, Herrero Calvo JA, Chamorro Jambrina C, Moina Eguren Í, Rodrigo de Tomás MT, Abad Díez JM, Sánchez Miret JI, Alvarez Lipe R, Díaz Tejeiro R, Moreno Alía I, Torres Guinea M, Huarte Loza E, Artamendi Larrañaga M, Fernández Renedo C, González Fernández R, Sánchez Álvarez E, Alonso de la Torre R. Clinical evolution of chronic renal patients with HIV infection in replacement therapy. Nefrologia 2015; 35:457-64. [PMID: 26409500 DOI: 10.1016/j.nefro.2015.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 06/05/2015] [Accepted: 06/30/2015] [Indexed: 11/17/2022] Open
Abstract
Patients on renal replacement therapy (RRT) infected with the human immunodeficiency virus (HIV) are a special group with growing interest. In order to study the epidemiological data of HIV+ patients on RRT in Spain, we collected individual information from 2004-2011 (period of use of highly active antiretroviral therapy [HAART] in the Autonomous Communities of Andalusia, Aragon, Asturias, Catalonia, Valencia, Castilla la Mancha, Castilla León, Galicia, Madrid, La Rioja and the Basque Country, comprising 85% of the Spanish population. A total of 271 incident and 209 prevalent patients were analysed. They were compared with the remaining patients on RRT during the same period. The annual incidence was 0.8 patients per one million inhabitants, with a significant increase during the follow-up period. The proportion of prevalent HIV+ patients was 5.1 per 1,000 patients on RRT (95% confidence interval [CI] 4.4-5.8. Although glomerular diseases constituted the majority of cases (42%), diabetic nephropathy was the cause in 14% of patients. The nation-wide totals for these percentages were 13 and 25%, respectively. Compared to the total of patients in treatment, the risk of death was significantly higher in the HIV+ group: hazard ratio (HR) adjusted for age, sex and diabetes was 2.26 (95% CI 1.74 - 2.91). Hepatitis C coinfection increased the risk of death in the HIV+ group (HR 1.77; 95% CI 1.10 - 2.85). The probability of kidney transplantation in HIV+ was only 17% after 7 years, comparing with total RTT patients (HR 0.15; 95% CI: 0.10-0.24). Despite the use of HAART, the incidence of HIV+ patients on dialysis has increased; their mortality still exceeds non-HIV patients, and they have a very low rate of transplantation. It is necessary to further our knowledge of this disease in order to improve results.
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Affiliation(s)
- Ramón Saracho
- Coordinación de Registros, Sociedad Española de Nefrología.
| | | | - Jordi Comas Farnés
- Registre de Malalts Renals de Catalunya, Organització Catalana de Trasplantaments
| | - Emma Arcos
- Registre de Malalts Renals de Catalunya, Organització Catalana de Trasplantaments
| | | | | | | | - Óscar Zurriaga
- Registre de Malalts Renals de la Comunidad Valenciana (REMRENAL)
| | | | | | | | | | | | | | | | | | | | | | | | - Rafael Díaz Tejeiro
- Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-La Mancha
| | | | - Marta Torres Guinea
- Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-La Mancha
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