Influencing factors for residual kidney function in incident peritoneal dialysis patients: a systematic review and meta-analysis.

BACKGROUND: Residual kidney function (RKF) impacts patients' survival rate and quality of life when undergoing peritoneal dialysis (PD). This meta-analysis was conducted to systematically identify risk and protective factors associated with RKF decline and loss. METHODS: We searched three English and one Chinese databases from inception to January 31, 2023, for cohort and cross-sectional studies exploring factors associated with RKF decline or loss. The random effects model was employed to aggregate risk estimates and 95% confidence intervals (CIs) from multivariate analysis. Sensitivity and subgroup analyses were performed to explore the heterogeneity among the studies. RESULTS: Twenty-seven studies comprising 13549 individuals and 14 factors were included in the meta-analysis. Based on the meta-analysis results, risk factors involving male gender (hazard ratio (HR) 1.689, 95%CI 1.385-2.061), greater body mass index (BMI) (odds ratio (OR) 1.081, 95% confidence interval (CI) 1.029-1.135), higher systolic blood pressure (SBP) (HR 1.014, 95%CI 1.005-1.024), diabetes mellitus (DM) (HRRKF loss 1.873, 95%CI 1.475-2.378), DM (ORRKF decline 1.906, 95%CI 1.262-2.879), peritonitis (relative ratio (RR) 2.291, 95%CI 1.633-3.213), proteinuria (OR 1.223, 95%CI 1.117-1.338), and elevated serum phosphorus (RR 2.655, 95%CI 1.679-4.201) significantly contributed to the risk of RKF decline and loss in PD patients. Conversely, older age (HR 0.968, 95%CI 0.956-0.981), higher serum albumin (OR 0.834, 95%CI 0.720-0.966), weekly Kt/V urea (HR 0.414, 95%CI 0.248-0.690), baseline urine volume (UV) (HR 0.791, 95%CI 0.639-0.979), baseline RKF (HR 0.795, 95%CI 0.739-0.857) exhibited protective effects. However, diuretics use, automatic peritoneal dialysis (APD) modality and baseline RKF did not significantly impact RKF decline. CONCLUSIONS: Patients with male gender, greater BMI, higher SBP, DM, peritonitis, proteinuria, and elevated serum phosphorus might have a higher risk of RKF decline and loss. In contrast, older age, higher serum albumin, weekly Kt/V urea, baseline UV, and baseline RKF might protect against RKF deterioration.

Calculated inflammatory markers derived from complete blood count results, along with routine laboratory and clinical data, predict treatment failure of acute peritonitis in chronic peritoneal dialysis patients.

BACKGROUND & AIMS: Complete blood count (CBC)-derived inflammatory markers are predictive biomarkers for the prognosis of many diseases. However, there was no study on patients with peritoneal dialysis-associated peritonitis (PDAP). We aimed to investigate the value of these markers in predicting treatment failure of acute peritonitis in chronic PD patients. METHODS: The records of 138 peritonitis episodes were reviewed and divided into treatment success or failure groups in a single center for 10 years. CBC-derived markers and other routine data were recorded before peritonitis treatment was initiated. Univariate and multivariate regression analyses and the receiver operating characteristic (ROC) curve about the predictors of treatment outcomes were performed. RESULTS: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and derived NLR were significantly higher in the failure group. Univariate logistic regression results showed that NLR and PLR were risk factors of treatment outcomes. The backward stepwise multivariate logistic regression results demonstrated that NLR [adjusted odds ratio (aOR), 1.376; 95% confidence intervals (CI), 1.105-1.713; p = .004], PLR (aOR, 1.010; 95%CI, 1.004-1.017; p = .002) were risk factors, but hemoglobin-to-lymphocyte ratio (HLR) (aOR, 0.977; 95%CI, 0.963-0.991; p = .001), and SII (aOR, 0.999; 95%CI, 0.998-1.000; p = .040) were protective factors. A combination of age, PD vintage, Gram-positive peritonitis, staphylococcus aureus, culture-negative, NLR, PLR, HLR, and SII would improve prognostic performance. The area under this ROC curve was 0.85, higher than other factors. CONCLUSIONS: NLR, PLR, HLR, and SII were associated with PDAP outcomes. Age, PD vintage, NLR, and PLR were significant risk factors in PDAP patients.

The impact of psychosocial adaptation status on quality of life for Chinese patients with visual impairments.

AIMS AND OBJCTIVES: To analyse the association of psychosocial adaptation with quality of life and to examine the influential factors for Chinese people with visual impairments. BACKGROUND: The status of psychosocial adaptation is the main influential factor for quality of life. The correlation between psychosocial adaptation and quality of life for various diseases has been studied previously. However, there have been few reports on the impact of psychosocial adaptation on quality of life in people with visual impairments. DESIGN: Survey. METHODS: In this study, subjects with visual impairment (n = 213) were interviewed to assess their demographics, disease-related information, psychosocial adaptation status and quality of life. The psychosocial adaptation questionnaire and quality of life scale for visually impaired patients were used to survey psychosocial adaptation and quality of life. Correlation and multiple stepwise regression analyses were used to study the association of psychosocial adaptation with quality of life in visually impaired patients. RESULTS: Psychosocial adaptation was significantly associated with quality of life, including the sense of belonging and psychological dimensions. The results also showed that there was statistical significance for the impact of occupational status, payment, monthly income (family), vision classification and psychosocial adaptation on quality of life, and the status of psychosocial adaptation was the main factor affecting the quality of life in people with visual impairments. CONCLUSION: It was found that the status of psychosocial adaptation was conspicuously associated with multiple dimensions of quality of life. Therefore, psychosocial adaptation status should be given close attention in clinical care. RELEVANCE TO CLINICAL PRACTICE: Our results could be used to guide nurses in making a plan for health education and nursing that improves the quality of life for the visually impaired.

Development, reliability and validity of the psychosocial adaptation scale for Parkinson's disease in Chinese population.

OBJECTIVE: To develop psychosocial adaptation scale for Parkinson's disease (PD) in Chinese population and evaluate its reliability and validity. METHODS: The items were designed by literature review, expert consultation and semi-structured interview. The methods of corrected item-total correlation, discrimination analysis and exploratory factor analysis were used for items selection. 427 valid scales from PD patients were collected in the study to test the reliability and validity. RESULTS: The scale incorporated six dimensions: anxiety, self-esteem, attitude, self-acceptance, self-efficacy and social support, a total of 32 items. The scale possessed good internal consistency. The test-retest correlation coefficient was 0.99 and average content validation rate was 0.97. The Hoehn and Yahr stage were correlated with total score of the scale. CONCLUSIONS: The psychosocial adaptation scale in this study showed good reliability and validity, it can be used as a reliable and valid instrument to evaluate the psychosocial adaptation of PD objectively and effectively.