Methods: This is a cohort study where prevalent ESRD patients' details were recorded between May 2012 and October 2012. Their records were matched with national death record at the end of year 2015 to identify the deceased patients within three years. Four models were formulated with two models were based on logistic regression models but with different number of predictors and two models were developed based on risk scoring technique. The preferred models were validated by using sensitivity and specificity analysis.
Results: A total of 1332 patients were included in the study. Majority succumbed due to cardiovascular disease (48.3%) and sepsis (41.3%). The identified risk factors were mode of dialysis (P < 0.001), diabetes mellitus (P < 0.001), chronic heart disease (P < 0.001) and leg amputation (P = 0.016). The accuracy of four models was almost similar with AUC between 0.680 and 0.711. The predictive models from logistic regression model and risk scoring model were selected as the preferred models based on both accuracy and simplicity. Besides the mode of dialysis, diabetes mellitus and its complications are the important predictors for early mortality among prevalent ESRD patients.
Conclusions: The models either based on logistic regression or risk scoring model can be used to screen high risk prevalent ESRD patients.
Methods: Retrospective cross-sectional study conducted in Hospital Serdang, Malaysia. We included end-stage renal disease (ESRD) patients who opted for PD and examined catheter-related infections (peritonitis, exit site infection, and tunnel tract infection) and organisms causing these infections.
Results: We included 126 patients in this study; 75 patients received the coiled PD catheter (59.5%) and 51 patients received the straight PD catheter (40.5%). The majority of patients were young, under the age of 65 years old (77.3% and 72.5%) in the coiled and straight PD catheter group, respectively, and the main cause of ESRD was diabetes mellitus in both groups (78.7% vs. 92.2%). The demographic and anthropometric data were similar between both groups. Peritonitis rate (0.29 episodes/patient-years vs. 0.31 episodes/patient-years, P value = 0.909), exit site infection rate (0.31 episodes/patient-year vs. 0.37 episodes/patient-year, P value = 0.730), and tunnel tract infection rate (0.02 episodes/patient-year, P value = 0.430) were similar in the coiled versus straight PD catheter groups. The predominant organism causing peritonitis was the gram-negative organism; Escherichia coli and Klebsiella pneumoniae. In exit site and tunnel tract infections, there is a predominance of gram-negative organisms; Pseudomonas aeruginosa and K. pneumoniae.
Conclusions: There was no difference in infectious outcomes between the two different types of catheters. Type of organism in both groups was gram-negative.
METHODS: This is a prospective observational study of critically ill patients. Inclusion criteria were patients >18 years old with sepsis, defined as clinical infection with an increase in SOFA score >2, and plasma procalcitonin >0.5 ng/mL. Plasma creatinine and Cystatin C were measured on ICU admission and 4 h later, and their keGFR was calculated. Urine creatinine and urine output were measured over 4 h to calculate the E/G ratio.
RESULTS: A total of 70 patients were recruited, of which 49 (70%) had AKI. Of these, 33 recovered within 3 days, and 15 had a composite outcome of death or dialysis. Day 1 keGFRCr and keGFRCysC discriminated AKI from non-AKI with AUCs of 0.85 (95% Confidence interval: 0.74-0.96), and 0.86 (0.76-0.97), respectively. The E/G ratio predicted AKI recovery (AUC: 0.81 (0.69-0.97)). The keGFRs were not predictive of death or dialysis, whereas E/G was predictive (AUC: 0.76 (0.63-0.89).
CONCLUSION: keGFR was strongly diagnostic of AKI. The E/G ratio predicted AKI recovery and a composite outcome of death and dialysis.