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- Title
Prevalence of chronic kidney disease-mineral and bone disorder in incident peritoneal dialysis patients and its association with short-term outcomes.
- Authors
Shen Hui Chuang; Hung Chew Wong; Vathsala, Anantharaman; Lee, Evan; Priscilla Pei Ching How; Chuang, Shen Hui; Wong, Hung Chew; How, Priscilla Pei Ching
- Abstract
<bold>Introduction: </bold>A complex relationship exists between chronic kidney disease-mineral and bone disorder (CKD-MBD) and adverse outcomes among dialysis patients. This study aimed to report the prevalence of CKD-MBD and examine the impact of achieving target CKD-MBD parameters on morbidity and mortality one year after peritoneal dialysis (PD) initiation.<bold>Methods: </bold>In this retrospective cohort study, patients electively initiated on PD were followed up for one year. Laboratory parameters were collected and the prevalence of CKD-MBD 4-6 months after PD initiation was determined based on the Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Linear regression and Cox proportional hazards model were used to evaluate the effects of achieving CKD-MBD targets 4-6 months after PD initiation on hospitalisation, the incidence of peritonitis or exit-site infections (ESIs), and mortality at one year.<bold>Results: </bold>The prevalence of CKD-MBD among the 86 patients in this study was 86.0% (KDOQI) and 54.7% (KDIGO). There was no significant difference in hospitalisation duration between patients who achieved targets and those who did not. Patients who failed to meet all the KDIGO CKD-MBD or calcium serum targets had a higher incidence of peritonitis or ESI. A trend toward shorter time to death was observed among patients who failed to meet the KDIGO phosphorus serum targets.<bold>Conclusion: </bold>There was moderate (KDIGO) to high prevalence (KDOQI) of CKD-MBD among the patients. Achievement of all the KDIGO CKD-MBD or calcium serum targets was associated with reduced peritonitis or ESI, while achievement of the KDIGO phosphorus serum targets was associated with improved survival.
- Subjects
PERITONEAL dialysis; KIDNEY diseases; METABOLIC bone disorders; HEMODIALYSIS patients; CALCIUM; PATIENTS; TREATMENT of chronic kidney failure; CHRONIC kidney failure complications; QUALITY control; REGRESSION analysis; TREATMENT effectiveness; DISEASE prevalence; PROPORTIONAL hazards models; RETROSPECTIVE studies
- Publication
Singapore Medical Journal, 2016, Vol 57, Issue 11, p603
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2015195