The Comparison Of The Comorbidities Of Patients With Peritoneal Dialysis And Hemodialysis With The Charlson Comorbidity Index
Year 2023,
, 258 - 262, 22.03.2023
Alper Sarı
,
Sinan Kazan
,
Elif Dizen Kazan
,
Onur Tunca
,
Murat Ay
,
Sevnur Aysal Sarı
Abstract
Aim: Hemodialysis and peritoneal dialysis are renal replacement treatment options in patients with chronic renal failure. Mortality and morbidity rates are higher in hemodialysis and peritoneal dialysis patients when compared to the healthy population. Comorbidities of the patients play roles in the high mortality and morbidity rates. In the present study, the comorbidities of hemodialysis and peritoneal dialysis patients were evaluated; and the Charlson Comorbidity Index, whose reliability was proven in many studies before, was compared and discussed.
Materials and Method: A total of 154 patients (78 hemodialysis and 76 peritoneal dialysis patients), who were followed up for end-stage renal disease, were included in the study. The Charlson Comorbidity Index scores of the patients were calculated. The Charlson Comorbidity Index score and parameters were compared between patient groups on hemodialysis and peritoneal dialysis.
Results: The Charlson Comorbidity Index was found to be significantly higher in peritoneal dialysis patients than in hemodialysis patients (p=0.001). It was also found that the frequency of congestive heart failure, cerebrovascular accident, and connective tissue, which are the parameters of the Charlson Comorbidity Index, were significantly different between the groups (p<0.05).
Conclusion: Comorbidities that may cause mortality and morbidity were found to occur more frequently in peritoneal dialysis patients when compared to hemodialysis patients.
References
- 1. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Clasification and Stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1-266.
- 2. Mauri JM, Clèries M, Vela E, Registry CR. Design and validation of a model to predict early mortality in haemodialysis patients. Nephrol Dial Transplant. 2008;23(5):1690–6.
- 3. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40(5):373–83.
- 4. Tikici D, Er S, Tez M. Acil Kolorektal Cerrahi Yapılan Hastalarda Mortaliteyi Öngörmede Amerikan Anesteziyoloji Derneği Sınıflaması (ASA) ve Charlson Komorbidite İndeksi (CCI)’nin Karşılaştırılması. TURKISH J Clin Lab. 2018;9(Cci):162–5.
- 5. Daş M, Bardakcı O, Akdur G, Kankaya İ, Bakar C, Akdur O, et al. Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital. Cukurova Med J. 2022;47(1):199–207.
- 6. Süleymanlar G, Ateş K, Seyahi N, Koçyiğit İ. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon Registry 2020. 2020. 1–166 p.
- 7. Sabaz MS, Aşar S. Association of Charlson Comorbidity and Pneumonia Severity Indices with Mortality in Patients with Coronavirus Disease-2019 in the Intensive Care Unit. Turkish J Intensive Care. 2021;19(1):33–41.
- 8. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676–82.
- 9. Garabed Eknoyan, M.D. Gerald J. Beck, Ph.D., Alfred K. Cheung, M.D., John T. Daugirdas Md, Tom Greene, Ph.D., John W. Kusek, Ph.D.at all. Effect Of Dialysis Dose And Membrane Flux In Maintenance Hemodialysis. N Engl J Med. 2010;347(25):2010–9.
- 10. Sun CY, Sung JM, Wang J Der, Li CY, Kuo YT, Lee CC, et al. A comparison of the risk of congestive heart failure-related hospitalizations in patients receiving hemodialysis and peritoneal dialysis - A retrospective propensity score-matched study. PLoS One. 2019;14(10):1–14.
- 11. Takeda K, Nakamoto M, Baba M, Tanaka T, Yasunaga C, Nishihara G, et al. Echocardiographic evaluation in long-term continuous ambulatory peritoneal dialysis compared with the hemodialysis patients. Clin Nephrol. 1998;49(5):308–12.
- 12. Klinger M, Madziarska K. Mortality predictor pattern in hemodialysis and peritoneal dialysis in diabetic patients. Adv Clin Exp Med. 2019;28(1):133–5.
- 13. Menon MK, Naimark DM, Bargman JM, Vas SI, Oreopoulos DG. Long-term blood pressure control in a cohort of peritoneal dialysis patients and its association with residual renal function. Nephrol Dial Transplant. 2001;16(11):2207–13.
- 14. Kebapcioglu AS, Bakoglu E, Kafali ME, Girisgin S, Koyuncu F, Bircan M, et al. Silent Cerebral Ischemia and Infarct Prevelance in Chronic Renal Failure Patients. J Acad Emerg Med. 2012;208–11.
- 15. Ovbiagele B, Bath PM, Cotton D, Sha N, Diener HC. Low glomerular filtration rate, recurrent stroke risk, and effect of renin-angiotensin system modulation. Stroke. 2013;44(11):3223–5.
- 16. Wang H-H, Hung S-Y, Sung J-M, Hung K-Y, Wang J-D. Risk of Stroke in Long-term Dialysis Patients Compared With the General Population. Am J Kidney Dis. 2014;63(4):604–11.
- 17. Martins LS, Malheiro J, Pedroso S, Almeida M, Dias L, Henriques AC, et al. Pancreas-Kidney transplantation: Impact of dialysis modality on the outcome. Transpl Int. 2015;28(8):972–9.
Periton Diyalizi Ve Hemodiyaliz Hastalarının Komorbiditelerinin Charlson Komorbidite İndeksi İle Karşılaştırılması
Year 2023,
, 258 - 262, 22.03.2023
Alper Sarı
,
Sinan Kazan
,
Elif Dizen Kazan
,
Onur Tunca
,
Murat Ay
,
Sevnur Aysal Sarı
Abstract
Amaç: Hemodiyaliz ve periton diyalizi kronik böbrek yetmezlikli hastalarda renal replasman tedavisi seçeneklerindendir. Hemodiyaliz ve periton diyalizi hastalarında sağlıklı popülasyona göre mortalite ve morbidite oranları yüksektir. Mortalite ve morbidite oranlarının yüksek olmasında hastaların sahip olduğu komorbiditelerde rol oynamaktadır. Biz bu çalışmada hemodiyaliz ve periton diyalizi hastalarının komorbiditelerini; daha önce güvenilirliği pek çok çalışma ile ispatlanmış olan Charlson Komorbidite İndeksi ile karşılaştırmayı ve tartışmayı amaçladık.
Gereç ve yöntem: Çalışmamıza son dönem böbrek yetmezliği nedeni ile takip edilen 78 hemodiyaliz, 76 periton diyalizi hastası olmak üzere toplamda 154 hasta dahil edildi. Bu hastaların Charlson komorbidete indeksi puanları hesaplandı. Hemodiyaliz ve periton diyalizindeki hasta grupları arasında Charlson komorbidite indeksi skoru ve parametreleri karşılaştırıldı.
Bulgular: Charlson komorbidite indeksi periton diyalizi hastalarında hemodiyaliz hastalarına göre anlamlı şekilde yüksek bulundu(p=0.001). Gruplar arasında Charlson Komorbidite İndeksi parametrelerinden olan konjestif kalp yetmezliği, serebrovasküler olay ve konnektif bağ dokusu sıklığının anlamlı şekilde farklı olduğu görüldü(p<0.05).
Sonuç: Periton diyalizi yapan hastalarda hemodiyaliz hastalarına göre mortalite ve morbiditeye neden olabilecek komorbiditeler daha sık bulunmuştur.
References
- 1. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Clasification and Stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1-266.
- 2. Mauri JM, Clèries M, Vela E, Registry CR. Design and validation of a model to predict early mortality in haemodialysis patients. Nephrol Dial Transplant. 2008;23(5):1690–6.
- 3. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40(5):373–83.
- 4. Tikici D, Er S, Tez M. Acil Kolorektal Cerrahi Yapılan Hastalarda Mortaliteyi Öngörmede Amerikan Anesteziyoloji Derneği Sınıflaması (ASA) ve Charlson Komorbidite İndeksi (CCI)’nin Karşılaştırılması. TURKISH J Clin Lab. 2018;9(Cci):162–5.
- 5. Daş M, Bardakcı O, Akdur G, Kankaya İ, Bakar C, Akdur O, et al. Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital. Cukurova Med J. 2022;47(1):199–207.
- 6. Süleymanlar G, Ateş K, Seyahi N, Koçyiğit İ. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon Registry 2020. 2020. 1–166 p.
- 7. Sabaz MS, Aşar S. Association of Charlson Comorbidity and Pneumonia Severity Indices with Mortality in Patients with Coronavirus Disease-2019 in the Intensive Care Unit. Turkish J Intensive Care. 2021;19(1):33–41.
- 8. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676–82.
- 9. Garabed Eknoyan, M.D. Gerald J. Beck, Ph.D., Alfred K. Cheung, M.D., John T. Daugirdas Md, Tom Greene, Ph.D., John W. Kusek, Ph.D.at all. Effect Of Dialysis Dose And Membrane Flux In Maintenance Hemodialysis. N Engl J Med. 2010;347(25):2010–9.
- 10. Sun CY, Sung JM, Wang J Der, Li CY, Kuo YT, Lee CC, et al. A comparison of the risk of congestive heart failure-related hospitalizations in patients receiving hemodialysis and peritoneal dialysis - A retrospective propensity score-matched study. PLoS One. 2019;14(10):1–14.
- 11. Takeda K, Nakamoto M, Baba M, Tanaka T, Yasunaga C, Nishihara G, et al. Echocardiographic evaluation in long-term continuous ambulatory peritoneal dialysis compared with the hemodialysis patients. Clin Nephrol. 1998;49(5):308–12.
- 12. Klinger M, Madziarska K. Mortality predictor pattern in hemodialysis and peritoneal dialysis in diabetic patients. Adv Clin Exp Med. 2019;28(1):133–5.
- 13. Menon MK, Naimark DM, Bargman JM, Vas SI, Oreopoulos DG. Long-term blood pressure control in a cohort of peritoneal dialysis patients and its association with residual renal function. Nephrol Dial Transplant. 2001;16(11):2207–13.
- 14. Kebapcioglu AS, Bakoglu E, Kafali ME, Girisgin S, Koyuncu F, Bircan M, et al. Silent Cerebral Ischemia and Infarct Prevelance in Chronic Renal Failure Patients. J Acad Emerg Med. 2012;208–11.
- 15. Ovbiagele B, Bath PM, Cotton D, Sha N, Diener HC. Low glomerular filtration rate, recurrent stroke risk, and effect of renin-angiotensin system modulation. Stroke. 2013;44(11):3223–5.
- 16. Wang H-H, Hung S-Y, Sung J-M, Hung K-Y, Wang J-D. Risk of Stroke in Long-term Dialysis Patients Compared With the General Population. Am J Kidney Dis. 2014;63(4):604–11.
- 17. Martins LS, Malheiro J, Pedroso S, Almeida M, Dias L, Henriques AC, et al. Pancreas-Kidney transplantation: Impact of dialysis modality on the outcome. Transpl Int. 2015;28(8):972–9.