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11 pages, 255 KiB

Open AccessArticle

Risk of COVID-19 and Cost Burden in End-Stage Renal Disease Patients and Policy Implications for Managing Nephrology Services during the COVID-19 Pandemic

by Seda Behlul and Macide Artac Ozdal

Healthcare 2022, 10(12), 2351; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10122351 - 23 Nov 2022

Cited by 2 | Viewed by 1120

Abstract

The aim of this study was to evaluate the risk of COVID-19 in end-stage renal disease (ESRD) patients, the cost burden of the COVID-19 pandemic on the management of ESRD and the cost of catheter infections. In this multicentre, retrospective study, data were [...] Read more.

The aim of this study was to evaluate the risk of COVID-19 in end-stage renal disease (ESRD) patients, the cost burden of the COVID-19 pandemic on the management of ESRD and the cost of catheter infections. In this multicentre, retrospective study, data were obtained from the records of four dialysis centres providing care for ESRD patients in Northern Cyprus. Of the 358 ESRD patients that were receiving haemodialysis (HD) 13 were diagnosed with COVID-19. The average cost of HD treatment per patient was $4822.65 in 2019 and $3759.45 in 2020 (p ≤ 0.001). The average control cost of HD treatment per patient was $618.80 in 2019 and $474.03 in 2020 (p ≤ 0.001). The outpatient treatment costs of catheter infections were not significantly different in 2019 (before) compared to 2020 (after) the pandemic ($54.61 in 2019 compared to $54.74 in 2020, p = 0.793). However, the inpatient treatment costs were significantly greater before the pandemic compared to after the pandemic ($315.33 in 2019 compared to $121.03 in 2020, p = 0.015). The costs for monitoring COVID-19 transmission in patients having ESRD management were significantly higher in HD compared to in peritoneal dialysis (PD) and transplants. Since there is a high risk of transmission of infections in the hospital environment during a pandemic, it is important to implement alternative ESRD management methods, such as enhancing transplants in populations, switching to PD, and implementing home dialysis programmes to reduce the risk of infection and associated complications, as well as the health costs associated with infection monitoring. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

12 pages, 1314 KiB

Open AccessArticle

Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis

by Miquel Sitjar-Suñer, Rosa Suñer-Soler, Carme Bertran-Noguer, Afra Masià-Plana, Natalia Romero-Marull, Glòria Reig-Garcia, Francesc Alòs and Josefina Patiño-Masó

Healthcare 2022, 10(11), 2144; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10112144 - 28 Oct 2022

Cited by 1 | Viewed by 1416

Abstract

The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. Objectives: To study the quality of [...] Read more.

The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. Objectives: To study the quality of life, morbidity and mortality of people receiving renal replacement therapy over a five-year period. Design: A longitudinal multicentre study of a cohort of people with chronic kidney disease. Methods: Patients from the Girona health area receiving peritoneal dialysis were studied, gathering data on sociodemographic and clinical variables through an ad hoc questionnaire, quality of life using the SF-36 questionnaire, and social support with the MOS scale. Results: Mortality was 47.2%. Physical functioning was the variable that worsened most in comparison with the first measurement (p = 0.035). Those receiving peritoneal dialysis (p = 0.068) and transplant recipients (p = 0.083) had a better general health perception. The social functioning of transplant recipients improved (p = 0.008). Conclusions: People with chronic kidney disease had a high level of mortality. The dimension of physical functioning worsens over the years. Haemodialysis is the therapy that most negatively effects general health perception. Kidney transplantation has a positive effect on the dimensions of energy/vitality, social functioning and general health perception. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

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7 pages, 237 KiB

Open AccessArticle

Identification of High-Risk Groups in Urinalysis: Lessons from the Longitudinal Analysis of Annual Check-Ups

by Keiichi Matsuzaki, Tomohiro Ohigashi, Takashi Sozu, Mami Ishida, Daisuke Kobayashi, Hitoshi Suzuki, Yusuke Suzuki and Takashi Kawamura

Healthcare 2022, 10(9), 1704; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10091704 - 06 Sep 2022

Cited by 1 | Viewed by 1506

Abstract

Background: For effective screening in urinalysis, information on high-risk groups is needed; however, there is a lack of evidence in young adults in particular. The aim of this study was to provide information on urinalysis in young adults and to identify high-risk groups [...] Read more.

Background: For effective screening in urinalysis, information on high-risk groups is needed; however, there is a lack of evidence in young adults in particular. The aim of this study was to provide information on urinalysis in young adults and to identify high-risk groups of urinalyses using multi-year data obtained from annual large-scale check-ups. Method: We used annual health check-up data collected from 2011 to 2016 at Kyoto University in Japan. Eligible participants were those aged 18–39 years who underwent annual health check-ups for four consecutive years between 2011 and 2016. We conducted descriptive analyses and calculated the risk ratios (RRs) for urinary abnormalities in the fourth year of urinalysis. Results: In total, 13,640 participants (10,877 men, 79.7%) met the eligibility criteria. The mean prevalence rates of proteinuria, haematuria and glucosuria were 1.61% (men: 1.63%; women: 1.53%), 1.48% (men: 0.53%; women: 5.22%) and 0.46% (men: 0.52%; women: 0.25%), respectively. Participants with urinary abnormalities at least once in the initial 3 years had a higher risk of urinary abnormalities in the fourth year than participants with no abnormal findings in the initial 3 years; the risk ratios (RRs) of proteinuria, haematuria and glucosuria were 3.5 (95% confidence interval (CI) = 3.2–3.7), 12.2 (95% CI = 11.7–12.7) and 42.6 (95% CI = 37.7–48.1), respectively. The RRs of all urinary abnormalities in the fourth year increased as the frequency of urinary abnormalities over the preceding 3 years increased. In haematuria, differences of the RR were observed between men and women. Conclusion: We clarified the prevalence of urinary abnormalities in young adults and high-risk groups of urinary abnormalities. Our findings support the need for multi-year annual urinalysis. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

8 pages, 238 KiB

Open AccessArticle

Psychometric Properties and Effects on Health Outcomes of the Patient Assessment of Chronic Illness Care (PACIC) in Korean Hemodialysis Patients

by Ae-Rim Seo, Bo-Kyoung Kim and Ki-Soo Park

Healthcare 2022, 10(6), 1149; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10061149 - 20 Jun 2022

Viewed by 1234

Abstract

Background: The satisfaction of patients receiving integrated care with End-Stage Renal Disease (ESRD) is widely advocated and patients with ESRD have special health needs, but few studies have investigated whether integrated care was associated with health outcomes. Our aims were to evaluate the [...] Read more.

Background: The satisfaction of patients receiving integrated care with End-Stage Renal Disease (ESRD) is widely advocated and patients with ESRD have special health needs, but few studies have investigated whether integrated care was associated with health outcomes. Our aims were to evaluate the psychometric properties of the Korean-translated patient assessment of chronic illness care (PACIC) in patients with ESRD, and to evaluate whether PACIC evaluated by patients was associated with health outcomes. Methods: ESRD patients on hemodialysis (n = 172) at 2 dialysis centers. Data quality, internal consistency and correlation between items and scales were assessed. To test the external validity, the association between PACIC and the health behaviour and outcomes of hemodialysis patients was analyzed. Results: The mean score of the PACIC items was 3.0. The item-scale correlation (0.67–0.85) and test-retest correlation (0.72–0.82) regarding scales for internal consistency showed excellent consistency. Total PACIC score was significantly associated with dietary self-efficacy (β = 0.22) and serum potassium (Exp(B) = 1.65). Higher overall PACIC score was significantly associated with higher physical health status (β = 3.52). Conclusions: The Korean-translated PACIC questionnaire is a tool with reliability and validity. Comprehensive treatment strategies for ESRD patients may improve their health behaviors and outcomes. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

11 pages, 999 KiB

Open AccessArticle

Ankle–Brachial Index Predicts Long-Term Renal Outcomes in Acute Stroke Patients

by Tsung-Lin Lee, Yu-Ming Chang, Chi-Hung Liu, Hui-Chen Su, Pi-Shan Sung, Sheng-Hsiang Lin and Chih-Hung Chen

Healthcare 2022, 10(5), 913; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10050913 - 13 May 2022

Viewed by 3118

Abstract

Renal dysfunction is common after stroke. We aimed to investigate the clinical predictability of the ankle–brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) on poststroke renal deterioration. A total of 956 consecutive participants with acute ischemic stroke between 1 July 2016, and [...] Read more.

Renal dysfunction is common after stroke. We aimed to investigate the clinical predictability of the ankle–brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) on poststroke renal deterioration. A total of 956 consecutive participants with acute ischemic stroke between 1 July 2016, and 31 December 2017 were enrolled and a final of 637 patients were recruited for final analysis. By using the group-based trajectory model (GBTM), the patients’ renal function trajectories were grouped into the low, intermediate, and high categories (LC, IC, and HC). Significant deterioration in the slope was noted in the IC (p < 0.001) and LC (p = 0.002) groups but was nonsignificant in the HC (p = 0.998) group. Abnormal ABI (ABI ≤ 0.9) was independently related to LC (adjusted odds ratio: 2.40; 95% CI, 1.16–4.95; p = 0.019) and was also independently associated with increased risks of a ≥30% decline in eGFR (adjusted hazard ratio [aHR], 2.28; 95% CI, 1.29–4.05; p = 0.005), a doubling of serum creatinine (aHR, 3.60; 95% CI, 1.93–8.34; p < 0.001) and ESRD (HR, 3.28; 95% CI, 1.23–8.74; p = 0.018). However, baPWV did not have a significant relationship with any of the renal outcomes. Patients with a lower ABI during acute stroke should receive regular renal function tests and should be closely monitored to improve poststroke renal care. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

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15 pages, 49363 KiB

Open AccessArticle

3D Low-Cost Equipment for Automated Peritoneal Dialysis Therapy

by Samuel Rivero-Urzua, Juan Carlos Paredes-Rojas, Sergio Rodrigo Méndez-García, Fernando Eli Ortiz-Hernández, Armando Oropeza-Osornio and Christopher René Torres-SanMiguel

Healthcare 2022, 10(3), 564; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10030564 - 17 Mar 2022

Cited by 3 | Viewed by 2887

Abstract

A breakthrough in peritoneal dialysis (PD) therapy occurred in 1977 with the development of continuous ambulatory peritoneal dialysis (CAPD). Its simplicity, low cost, and ease with which CAPD could be performed on patients at home contributed to the popularity of this procedure. However, [...] Read more.

A breakthrough in peritoneal dialysis (PD) therapy occurred in 1977 with the development of continuous ambulatory peritoneal dialysis (CAPD). Its simplicity, low cost, and ease with which CAPD could be performed on patients at home contributed to the popularity of this procedure. However, there is a need for continuous improvement in building optimal systems for incident chronic kidney disease (CKD) patients. This research showed the design and construction of a simplified prototype of low-cost automated peritoneal dialysis (APD) equipment that meets international standards to automatically regulate infusion and fluid drainage in and out of a patient with low margins of error. Experimental tests allowed the adjustment of the RPM values concerning the flow rate provided. In addition, thanks to the pressure sensor, it was possible to observe a fluctuation ranging from 9 to 13 kPa, which is within the permissible average specified in the catalogs of medical instruments and equipment. Furthermore, a turbidity sensor was added to decrease the possibility of presenting peritonitis. The results showed absolute values of flow, angular velocity, and pressure that it could deliver for use in APD therapies. Finally, the construction of the APD equipment is presented generally, showing the electronic and mechanical components that constitute it. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

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14 pages, 248 KiB

Open AccessArticle

Bone Marrow Hypocellularity in Patients with End-Stage Kidney Disease

by Chia-Chen Hsieh, Ming-Jen Chan, Yi-Jiun Su, Jen-Fen Fu, I-Kuan Wang, Chao-Yu Chen, Cheng-Hao Weng, Wen-Hung Huang, Ching-Wei Hsu and Tzung-Hai Yen

Healthcare 2021, 9(11), 1452; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9111452 - 27 Oct 2021

Cited by 3 | Viewed by 4120

Abstract

Background. Anemia and pancytopenia are not uncommon in patients with chronic kidney disease (CKD). Nevertheless, there is insufficient literature analyzing bone marrow pathology in patients with CKD or end-stage kidney disease (ESKD) receiving dialysis. Methods. This observational cohort study included 22 patients with [...] Read more.

Background. Anemia and pancytopenia are not uncommon in patients with chronic kidney disease (CKD). Nevertheless, there is insufficient literature analyzing bone marrow pathology in patients with CKD or end-stage kidney disease (ESKD) receiving dialysis. Methods. This observational cohort study included 22 patients with ESKD and 23 patients with CKD that received bone marrow biopsy and aspiration at Chang Gung Memorial Hospital. Demographic, hematological, and biochemical data were collected at the time of bone marrow study for analysis. Results. Bone marrow aspiration demonstrated that patients with ESKD had a lower percentage of blasts than patients with CKD (0.52 ± 0.84 versus 1.06 ± 0.78 %, p = 0.033). Bone marrow biopsy revealed that the overall incidence of hypocellular bone marrow was 55.6%. Furthermore, patients with ESKD had higher proportion of hypocellular bone marrow than patients with CKD (72.7% versus 39.1%, p = 0.023). In a multivariate logistic regression model, it was revealed that ESKD status (odds ratio 9.43, 95% confidence interval 1.66–53.63, p = 0.011) and megakaryocyte count within bone marrow (odds ratio 0.48, 95% confidence interval 0.29–0.79, p = 0.004) were significant predictors for bone marrow hypocellularity. Conclusion. Bone marrow hypocellularity is common in patients with kidney dysfunction. Hypocellular marrow occurs more frequently in patients with ESKD than patients with CKD. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

8 pages, 4169 KiB

Open AccessArticle

Assessing the Relationship between Helicobacter pylori and Chronic Kidney Disease

by Koichi Hata, Teruhide Koyama, Etsuko Ozaki, Nagato Kuriyama, Shigeto Mizuno, Daisuke Matsui, Isao Watanabe, Ritei Uehara and Yoshiyuki Watanabe

Healthcare 2021, 9(2), 162; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9020162 - 03 Feb 2021

Cited by 3 | Viewed by 2335

Abstract

The relationship between Helicobacter pylori infection and/or gastric disorders and chronic kidney disease (CKD) has not been elucidated. We investigated the relationship between Helicobacter pylori and/or atrophic gastritis (AG) and chronic kidney disease. In total, 3560 participants (1127 men and 2433 women) were [...] Read more.

The relationship between Helicobacter pylori infection and/or gastric disorders and chronic kidney disease (CKD) has not been elucidated. We investigated the relationship between Helicobacter pylori and/or atrophic gastritis (AG) and chronic kidney disease. In total, 3560 participants (1127 men and 2433 women) were eligible for this cross-sectional study. We divided participants into four study groups: with/without Helicobacter pylori infection and with/without AG. The HP (+) AG (−) group demonstrated a significant association with CKD compared with the HP (−) AG (−) group (adjusted odds ratio, 1.443; 95% confidence interval, 1.047–1.989). In contrast, the HP (+) AG (+) group showed significantly lower adjusted odds of CKD than the HP (−) AG (−) group (adjusted odds ratio, 0.608; 95% confidence interval, 0.402–0.920). H. pylori infection without AG might be associated with CKD in these participants. Conversely, the HP (+) AG (+) group had lower odds of CKD. Uncovering an association between gastric and renal conditions could lead to development of new treatment strategies. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

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21 pages, 1429 KiB

Open AccessReview

by Patrick Yihong Wu, Szu-Ying Lee, Ke-Vin Chang, Chia-Ter Chao and Jenq-Wen Huang

Healthcare 2021, 9(8), 979; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9080979 - 01 Aug 2021

Cited by 6 | Viewed by 3125

Abstract

Vascular calcification (VC) involves the deposition of calcium apatite in vascular intima or media. Individuals of advanced age, having diabetes mellitus or chronic kidney disease (CKD) are particularly at risk. The pathogenesis of CKD-associated VC evolves considerably. The core driver is the phenotypic [...] Read more.

Vascular calcification (VC) involves the deposition of calcium apatite in vascular intima or media. Individuals of advanced age, having diabetes mellitus or chronic kidney disease (CKD) are particularly at risk. The pathogenesis of CKD-associated VC evolves considerably. The core driver is the phenotypic change involving vascular wall constituent cells toward manifestations similar to that undergone by osteoblasts. Gender-related differences are observed regarding the expressions of osteogenesis-regulating effectors, and presumably the prevalence/risk of CKD-associated VC exhibits gender-related differences as well. Despite the wealth of data focusing on gender-related differences in the risk of atherosclerosis, few report whether gender modifies the risk of VC, especially CKD-associated cases. We systematically identified studies of CKD-associated VC or its regulators/modifiers reporting data about gender distributions, and extracted results from 167 articles. A significantly higher risk of CKD-associated VC was observed in males among the majority of original investigations. However, substantial heterogeneity exists, since multiple large-scale studies yielded neutral findings. Differences in gender-related VC risk may result from variations in VC assessment methods, the anatomical segments of interest, study sample size, and even the ethnic origins of participants. From a biological perspective, plausible mediators of gender-related VC differences include body composition discrepancies, alterations involving lipid profiles, inflammatory severity, diversities in matrix Gla protein (MGP), soluble Klotho, vitamin D, sclerostin, parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23), and osteoprotegerin levels. Based on our findings, it may be inappropriate to monotonously assume that male patients with CKD are at risk of VC compared to females, and we should consider more background in context before result interpretation. Full article

(This article belongs to the Special Issue Prevention and Management of Kidney Injury)

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