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Tytuł:
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Early-start and conventional-start peritoneal dialysis: a Chinese cohort study on outcome.
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Autorzy:
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Wang Y; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Li Y; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Wang H; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Ma Y; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Ma D; Nephrology Division, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
Tian D; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Liu B; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Zhou Z; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Yang W; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Li X; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Cui J; Nephrology Division, Massachusetts General Hospital, Boston, MA, USA.
Chen L; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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Źródło:
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Renal failure [Ren Fail] 2020 Nov; Vol. 42 (1), pp. 305-313.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: London : Informa Healthcare
Original Publication: New York, N.Y. : M. Dekker, c1987-
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MeSH Terms:
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Peritoneal Dialysis/*methods
Peritoneal Dialysis/*mortality
Adult ; Aged ; Cause of Death ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Peritoneal Dialysis/adverse effects ; Retrospective Studies ; Survival Analysis ; Time Factors ; Treatment Outcome
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References:
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Contributed Indexing:
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Keywords: Early-start dialysis; peritoneal dialysis; prognosis
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Entry Date(s):
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Date Created: 20200327 Date Completed: 20201127 Latest Revision: 20201127
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Update Code:
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20240105
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PubMed Central ID:
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PMC7144326
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DOI:
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10.1080/0886022X.2020.1743310
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PMID:
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32208797
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Background: Early-start peritoneal dialysis (PD) is an effective option for patients need unplanned dialysis. However, there are few studies on the long-term prognosis of early-start PD patients. Methods: In this retrospective study, 635 eligible patients from 1 March 1996 to 30 September 2016 were included, and divided into three groups according to the duration of break-in period: 3 days or less, 4-13 days and more than 14 days. Patients started PD within 2 weeks and after 2 weeks were defined as early-start and conventional-start, respectively. The primary outcome was all-cause mortality, and the secondary outcome measures were peritonitis free survival and technical survival. Mechanical and infectious complications in the first 180 days were also analyzed. Results: Early-start PD patients were more likely to have higher serum total carbon dioxide and creatinine levels and lower serum albumin, Kt/v, creatinine clearance (Ccr) and residual glomerular filtration rate (rGFR) levels at the start of PD. The median follow-up period was 30 months (interquartile range, 13-53 months). A worse survival was observed in the early-start group than that in the conventional-start group ( p < 0.001), even adjustment for the covariates (HR 1.549, 95%CI 1.104-2.173, p = 0.011). In the subgroup analysis, in patients commencing PD after 2006 early-start and conventional-start PD patients had comparable survival. No differences were observed in the rate of infectious and mechanical complications, peritonitis-free survival and technique survival between early-start and conventional-start PD patients. Conclusions: Early-start PD could be a safe and effective strategy for patients needing unplanned dialysis initiation with the progress of technology on PD.
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