Epidemiology and outcome of acute pancreatitis in end-stage renal disease dialysis patients: a 10-year national cohort study
| Autor: | Chih-Chiang Chien, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Jhi-Joung Wang, Hung-Jui Chen |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Population 030232 urology & nephrology Taiwan Gastroenterology Peritoneal dialysis End stage renal disease 03 medical and health sciences Young Adult 0302 clinical medicine Renal Dialysis Risk Factors Internal medicine medicine Humans Cumulative incidence Hospital Mortality Longitudinal Studies Intensive care medicine education Dialysis Aged Transplantation education.field_of_study business.industry Incidence (epidemiology) Incidence Middle Aged medicine.disease Survival Rate Pancreatitis Nephrology Acute Disease Acute pancreatitis Kidney Failure Chronic 030211 gastroenterology & hepatology Female Hemodialysis business |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 32(10) |
| ISSN: | 1460-2385 |
| Popis: | Background The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. Methods We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan. All patients were followed up from the start of their dialysis to first AP diagnosis, death, end of dialysis or 31 December 2008. Cox proportional hazards models were used to identify risk factors. Results The cumulative incidence rates of AP were 0.6, 1.7, 2.6, 3.4 and 4% at 1, 3, 5, 7 and 9 years, respectively. ESRD patients on HD and PD had an AP incidence of 5.11 and 5.86 per 1000 person-years, respectively. Independent risk factors for AP in this population were being elderly, being female, having biliary stones or liver disease, and being on PD. Severe AP occurred in 44.9% of the HD patients and in 36% of the PD patients. Patients with AP on HD had a higher incidence of upper gastrointestinal (UGI) bleeding than those on PD (P = 0.002). In contrast, those with AP on PD had a higher incidence of need for total parenteral nutrition (TPN) support than those on HD (P = 0.072). Overall in-hospital mortality was 8.1%. The risk factors for mortality after an AP attack were male gender, increased age, AP severity, and the presence of diabetes mellitus or liver disease. Conclusions ESRD patients on PD were at higher risk for AP than those on HD. HD patients with AP attacks had a greater incidence of UGI bleeding and PD patients with AP attacks a more frequent need for TPN support. |
| Databáze: | OpenAIRE |
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