Abstract | BACKGROUND: METHODS: This was a prospective observational cohort study in CAPD patients in which prognostic risks of pneumonia were evaluated in DN and non-DN patients by Cox regression analysis. Hazard ratios of pneumonia events, all-cause and pneumonia-related mortality were calculated by Kaplan-Meier curves and the Cox proportional hazards model for DN versus non-DN patients. RESULTS: A total of 1148 patients (58.6% male, 48.34±15.78 years) had a median follow-up of 23.8 months and a maximum follow-up of 72.0 months. The pneumonia incidence rate of 62.3/1,000 patient-years in CAPD patients with DN was significantly higher than that of 28.5/1,000 patient-years in non-DN patients. On multivariate analysis, independent predictors of pneumonia occurrence in CAPD patients with DN were high body mass index (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01-1.31; Pā=ā0.037) and low serum albumin level (HR, 0.87; 95% CI, 0.78-0.98; Pā=ā0.014). Older age (HR, 1.63; 95% CI, 1.35-1.96; P<0.001) was an independent risk factor for the presence of pneumonia in non-DN patients. CAPD patients with DN had higher pneumonia-related mortality (HR, 4.424; 95% CI, 1.871-10.461; P<0.001) and all-cause mortality (HR, 2.608; 95% CI, 1.890-3.599; P<0.001) hazards than their non-DN counterparts, even when extensive demographics, comorbidities, and lab adjustments were made. CONCLUSIONS: The pneumonia and all-cause mortality risks were strikingly higher in CAPD patients with DN than in non-DN counterparts, which may warrant further investigation and therapeutic care intensification.
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Authors | Feng He, Xianfeng Wu, Xi Xia, Fenfen Peng, Fengxian Huang, Xueqing Yu |
Journal | PloS one
(PLoS One)
Vol. 8
Issue 4
Pg. e61497
( 2013)
ISSN: 1932-6203 [Electronic] United States |
PMID | 23585903
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Age Factors
- Aged
- Diabetic Nephropathies
(complications, mortality, physiopathology)
- Female
- Humans
- Male
- Middle Aged
- Peritoneal Dialysis, Continuous Ambulatory
- Pneumonia
(complications, mortality, physiopathology)
- Proportional Hazards Models
- Prospective Studies
- Risk
- Survival Analysis
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