Pub Date : 2023-12-21DOI: 10.1186/s41100-023-00515-x
M. Aydın, Mehmet Sezen, A. Oruc, A. Yildiz, Kübra Özerik, Hatice Aslan, Can Özgü, Elif Özge Kuş, Ferda Kahveci, A. Ersoy
{"title":"Three cases of mushroom poisoning with an unexpected initial presentation: acute kidney injury with Amanita proxima poisoning","authors":"M. Aydın, Mehmet Sezen, A. Oruc, A. Yildiz, Kübra Özerik, Hatice Aslan, Can Özgü, Elif Özge Kuş, Ferda Kahveci, A. Ersoy","doi":"10.1186/s41100-023-00515-x","DOIUrl":"https://doi.org/10.1186/s41100-023-00515-x","url":null,"abstract":"","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"1 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-18DOI: 10.1186/s41100-023-00516-w
Laila Abdel Naby Ahmed, Heba H. Eltrawy, Amira Mohamed Elsadek, Wagenat E. Ali, Hanaa Elsayed Abozeid, Sanaa Fathy Qutb, Fatma Gamal Elsayed, A. E. A. Enayet, Ahmed A Elshehawy
{"title":"Diaphragmatic dysfunction in hemodialysis patients: risk factors and effect of incentive spirometry training","authors":"Laila Abdel Naby Ahmed, Heba H. Eltrawy, Amira Mohamed Elsadek, Wagenat E. Ali, Hanaa Elsayed Abozeid, Sanaa Fathy Qutb, Fatma Gamal Elsayed, A. E. A. Enayet, Ahmed A Elshehawy","doi":"10.1186/s41100-023-00516-w","DOIUrl":"https://doi.org/10.1186/s41100-023-00516-w","url":null,"abstract":"","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"40 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-18DOI: 10.1186/s41100-023-00514-y
Sachi Yamabe, Shohei Yamamoto, M. Harada, Yuta Suzuki, K. Imamura, S. Yoshikoshi, S. Osada, A. Matsunaga
{"title":"Utility of the low physical activity questionnaire for hemodialysis patients with frailty: a cross-sectional study","authors":"Sachi Yamabe, Shohei Yamamoto, M. Harada, Yuta Suzuki, K. Imamura, S. Yoshikoshi, S. Osada, A. Matsunaga","doi":"10.1186/s41100-023-00514-y","DOIUrl":"https://doi.org/10.1186/s41100-023-00514-y","url":null,"abstract":"","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"96 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.1186/s41100-023-00512-0
Hayato Fujioka, T. Imamura, T. Koike, Shingo Yokoyama, Kota Kakeshita, Hidenori Yamazaki, K. Kinugawa
{"title":"Sodium zirconium cyclosilicate hydrate reduces medical expenses compared with hemodialysis in patients with acute hyperkalemia","authors":"Hayato Fujioka, T. Imamura, T. Koike, Shingo Yokoyama, Kota Kakeshita, Hidenori Yamazaki, K. Kinugawa","doi":"10.1186/s41100-023-00512-0","DOIUrl":"https://doi.org/10.1186/s41100-023-00512-0","url":null,"abstract":"","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"31 8","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Malnutrition is associated with discontinuing peritoneal dialysis (PD). The prognostic nutritional index (PNI), composed of serum albumin level and total lymphocyte count, has been suggested as a prognostic marker for mortality in patients undergoing PD. However, the relationship between PNI and PD discontinuation has not yet been well addressed. We evaluated the relationship between PNI and PD discontinuation in patients with end-stage kidney disease who initiated PD treatment. Methods This retrospective cohort study included patients who underwent PD at a single academic hospital between 2007 and 2022. We examined the association between PNI (< 40 vs. ≥ 40) and PD discontinuation using Cox proportional hazards regression models. We used restricted cubic spline analysis to examine the continuous associations between the PNI and outcomes. Results The mean age (and standard deviation) of the 91 patients was 57.1 ± 13.4 years; 72 (79.1%) discontinued PD during the median follow-up period of 25.0 months. Lower PNI was associated with an increased risk of PD discontinuation. The hazard ratios (95% confidence intervals) with three levels of adjustments were 1.74 (1.08, 2.79), 2.21 (1.32, 3.66), and 1.81 (1.01, 3.24) (reference: PNI ≥ 40). Restricted cubic spline analysis showed that a PNI < 40 was continuously associated with a higher risk of PD discontinuation. Conclusion A lower PNI (< 40) was associated with a higher risk of PD discontinuation. Our findings suggest that evaluating the PNI may help identify patients at high risk of PD discontinuation and lead to appropriate nutritional management for dialysis maintenance.
{"title":"Association between prognostic nutritional index and peritoneal dialysis discontinuation: a retrospective cohort study","authors":"Yoshikazu Miyasato, Jun Morinaga, Hideki Inoue, Yushi Nakayama, Masataka Adachi, Yuichiro Izumi, Yutaka Kakizoe, Teruhiko Mizumoto, Terumasa Nakagawa, Daisuke Fujimoto, Makoto Ono, Akira Oda, Takashige Kuwabara, Masashi Mukoyama","doi":"10.1186/s41100-023-00511-1","DOIUrl":"https://doi.org/10.1186/s41100-023-00511-1","url":null,"abstract":"Abstract Background Malnutrition is associated with discontinuing peritoneal dialysis (PD). The prognostic nutritional index (PNI), composed of serum albumin level and total lymphocyte count, has been suggested as a prognostic marker for mortality in patients undergoing PD. However, the relationship between PNI and PD discontinuation has not yet been well addressed. We evaluated the relationship between PNI and PD discontinuation in patients with end-stage kidney disease who initiated PD treatment. Methods This retrospective cohort study included patients who underwent PD at a single academic hospital between 2007 and 2022. We examined the association between PNI (< 40 vs. ≥ 40) and PD discontinuation using Cox proportional hazards regression models. We used restricted cubic spline analysis to examine the continuous associations between the PNI and outcomes. Results The mean age (and standard deviation) of the 91 patients was 57.1 ± 13.4 years; 72 (79.1%) discontinued PD during the median follow-up period of 25.0 months. Lower PNI was associated with an increased risk of PD discontinuation. The hazard ratios (95% confidence intervals) with three levels of adjustments were 1.74 (1.08, 2.79), 2.21 (1.32, 3.66), and 1.81 (1.01, 3.24) (reference: PNI ≥ 40). Restricted cubic spline analysis showed that a PNI < 40 was continuously associated with a higher risk of PD discontinuation. Conclusion A lower PNI (< 40) was associated with a higher risk of PD discontinuation. Our findings suggest that evaluating the PNI may help identify patients at high risk of PD discontinuation and lead to appropriate nutritional management for dialysis maintenance.","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"88 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-06DOI: 10.1186/s41100-023-00508-w
Giacomo Cusumano, Edoardo Cola, Gionata Spagnoletti, Anna Severino, Simona Giubilato, Egidio Stigliano, Maria Emiliana Caristo, Gisella Vischini, Giovanna Liuzzo, Maria Paola Salerno, Filippo Crea, Jacopo Romagnoli
Abstract Background Renal ischemia/reperfusion injury is an unavoidable event in transplantation in which free radical-mediated injury determines release of pro-inflammatory cytokines and activation of innate immunity. In addition to their cholesterol-lowering action, statins have shown dose-dependent pleiotropic effects on inflammatory pathways and oxidative stress. We investigated the effects of high-dose atorvastatin (atorvastatin 40 mg/kg) in preventing ischemia/reperfusion injury in an animal model of kidney transplant. Methods Forty female rats underwent left nephrectomy and orthotopic autotransplantation. Animals were divided in four groups: A = Transplant only; B = high-dose atorvastatin + Transplant; C = right nephrectomy + Transplant; D = high-dose atorvastatin + right nephrectomy + Transplant. Bilateral nephrectomy was performed 24 h post-transplant. Oxidative stress was assessed measuring malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx) and myeloperoxidase (MPO) activity on renal tissue; ischemia/reperfusion injury was also evaluated by histology. Donor pre-treatment with high-dose atorvastatin improved oxidative stress. Results MDA levels were lower in group B versus A ( p = 0.002) and D ( p = 0.004). High-dose atorvastatin pre-treated rats displayed higher GPx activity in group B versus A ( p = 0.009) and D ( p = 0.005). SOD scavenger activity was also higher in group B versus A ( p < 0.001) D ( p < 0.001) and C ( p = 0.003). MPO activity was lower in group B versus A ( p = 0.02), C ( p = 0.007) and D ( p = 0.03). Histology revealed significantly lower rate of intratubular casts and luminal congestion in Group D versus C ( p = 0.02 and p = 0.008, respectively). Conclusions High-dose atorvastatin pre-treatment reduces oxidative stress and inflammation in a model of kidney transplant in the rat.
{"title":"High-dose atorvastatin reduces oxidative stress of ischemia/reperfusion injury after isogeneic kidney transplantation in rats: in vivo, preclinical, case–control, open-label study","authors":"Giacomo Cusumano, Edoardo Cola, Gionata Spagnoletti, Anna Severino, Simona Giubilato, Egidio Stigliano, Maria Emiliana Caristo, Gisella Vischini, Giovanna Liuzzo, Maria Paola Salerno, Filippo Crea, Jacopo Romagnoli","doi":"10.1186/s41100-023-00508-w","DOIUrl":"https://doi.org/10.1186/s41100-023-00508-w","url":null,"abstract":"Abstract Background Renal ischemia/reperfusion injury is an unavoidable event in transplantation in which free radical-mediated injury determines release of pro-inflammatory cytokines and activation of innate immunity. In addition to their cholesterol-lowering action, statins have shown dose-dependent pleiotropic effects on inflammatory pathways and oxidative stress. We investigated the effects of high-dose atorvastatin (atorvastatin 40 mg/kg) in preventing ischemia/reperfusion injury in an animal model of kidney transplant. Methods Forty female rats underwent left nephrectomy and orthotopic autotransplantation. Animals were divided in four groups: A = Transplant only; B = high-dose atorvastatin + Transplant; C = right nephrectomy + Transplant; D = high-dose atorvastatin + right nephrectomy + Transplant. Bilateral nephrectomy was performed 24 h post-transplant. Oxidative stress was assessed measuring malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx) and myeloperoxidase (MPO) activity on renal tissue; ischemia/reperfusion injury was also evaluated by histology. Donor pre-treatment with high-dose atorvastatin improved oxidative stress. Results MDA levels were lower in group B versus A ( p = 0.002) and D ( p = 0.004). High-dose atorvastatin pre-treated rats displayed higher GPx activity in group B versus A ( p = 0.009) and D ( p = 0.005). SOD scavenger activity was also higher in group B versus A ( p < 0.001) D ( p < 0.001) and C ( p = 0.003). MPO activity was lower in group B versus A ( p = 0.02), C ( p = 0.007) and D ( p = 0.03). Histology revealed significantly lower rate of intratubular casts and luminal congestion in Group D versus C ( p = 0.02 and p = 0.008, respectively). Conclusions High-dose atorvastatin pre-treatment reduces oxidative stress and inflammation in a model of kidney transplant in the rat.","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"8 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135590253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Latent tuberculosis infection (LTBI) affects 11.9% of outpatients under maintenance hemodialysis in Japan. In addition, the risk of reactivation of LTBI in hemodialysis patients is up to 10–25 times higher than that in the general population. Therefore, the accurate diagnosis and treatment for LTBI are extremely important. The interferon-γ release assays are widely used for screening LTBI; however, the impact of hemodialysis on the assay results has been uncertain. Case presentation Twenty-seven hemodialysis patients (17 males, 69.9 ± 10.1 year old) were performed T-SPOT ® .TB test (T-SPOT) both before and after hemodialysis. In cases where T-SPOT results were different before and after hemodialysis, T-SPOT was re-evaluated in a same manner. As a result, two cases showed consistent T-SPOT diagnostic discrepancy before and after hemodialysis in two measurements. In the first case, T-SPOT was indeterminate/positive before hemodialysis, but changed to negative after hemodialysis. In the second case, T-SPOT was positive before hemodialysis, but changed to indeterminate after hemodialysis. Conclusions We experienced the negative conversion of T-SPOT after hemodialysis in cases of LTBI. T-SPOT may show false-negative when measured after hemodialysis due to immunomodulation caused by hemodialysis.
{"title":"Negative conversion of T-SPOT results after hemodialysis: case series and literature review","authors":"Masataro Toda, Ayumi Yoshifuji, Koji Hosoya, Motoaki Komatsu, Naoki Hasegawa, Munekazu Ryuzaki","doi":"10.1186/s41100-023-00510-2","DOIUrl":"https://doi.org/10.1186/s41100-023-00510-2","url":null,"abstract":"Abstract Background Latent tuberculosis infection (LTBI) affects 11.9% of outpatients under maintenance hemodialysis in Japan. In addition, the risk of reactivation of LTBI in hemodialysis patients is up to 10–25 times higher than that in the general population. Therefore, the accurate diagnosis and treatment for LTBI are extremely important. The interferon-γ release assays are widely used for screening LTBI; however, the impact of hemodialysis on the assay results has been uncertain. Case presentation Twenty-seven hemodialysis patients (17 males, 69.9 ± 10.1 year old) were performed T-SPOT ® .TB test (T-SPOT) both before and after hemodialysis. In cases where T-SPOT results were different before and after hemodialysis, T-SPOT was re-evaluated in a same manner. As a result, two cases showed consistent T-SPOT diagnostic discrepancy before and after hemodialysis in two measurements. In the first case, T-SPOT was indeterminate/positive before hemodialysis, but changed to negative after hemodialysis. In the second case, T-SPOT was positive before hemodialysis, but changed to indeterminate after hemodialysis. Conclusions We experienced the negative conversion of T-SPOT after hemodialysis in cases of LTBI. T-SPOT may show false-negative when measured after hemodialysis due to immunomodulation caused by hemodialysis.","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"48 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136102807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Empirical antibiotic treatment against peritoneal dialysis (PD)-related peritonitis should be immediately initiated before PD effluent culture results are obtained. As culture results guide the choice of antibiotics, culture-negative peritonitis (CNP) is a serious issue. In addition, the identification of the causative organism often indicates a possible source of infection. This study aimed to clarify the predictors of CNP. Methods This single-center, retrospective study was conducted from November 2007–December 2018 in patients undergoing PD with peritonitis at our institution, where 204 peritonitis episodes (57 culture-negative, 147 culture-positive) were investigated based on demographics, and clinical parameters. CNP predictors were investigated using logistic regression. Results CNP rate was significantly higher in female and in patients with higher platelet counts, lower dialysate cell counts at peritonitis diagnosis, and higher serum β 2 -microglobulin levels. In multivariate logistic regression, female sex (odds ratio [OR] 2.69, 95% confidence interval [CI] 1.31–5.54), dialysate cell count at diagnosis (OR0.99, 95% CI 0.99–0.99), and serum β 2 -microglobulin level (OR 1.04, 95% CI 1.00–1.07) were significantly associated with CNP. The areas under the receiver operating characteristic curve for female patients, dialysate cell counts at diagnosis of peritonitis, serum β 2 -microglobulin level, and female patients + dialysate cell counts at diagnosis of peritonitis + serum β 2 -microglobulin level were 0.604, 0.694, 0.603, and 0.751, respectively. Conclusions Female sex, dialysate cell counts at peritonitis diagnosis, and serum β 2 -microglobulin levels may be predictors of CNP.
{"title":"Predictors of culture-negative peritoneal dialysis-associated peritonitis: a single center, retrospective study","authors":"Hisato Shima, Takuya Okamoto, Manabu Tashiro, Tomoko Inoue, Seiichiro Wariishi, Hiroyasu Bando, Hiroyuki Azuma, Naohito Iwasaka, Takuji Ohara, Toshio Doi, Kazuyoshi Okada, Jun Minakuchi","doi":"10.1186/s41100-023-00498-9","DOIUrl":"https://doi.org/10.1186/s41100-023-00498-9","url":null,"abstract":"Abstract Background Empirical antibiotic treatment against peritoneal dialysis (PD)-related peritonitis should be immediately initiated before PD effluent culture results are obtained. As culture results guide the choice of antibiotics, culture-negative peritonitis (CNP) is a serious issue. In addition, the identification of the causative organism often indicates a possible source of infection. This study aimed to clarify the predictors of CNP. Methods This single-center, retrospective study was conducted from November 2007–December 2018 in patients undergoing PD with peritonitis at our institution, where 204 peritonitis episodes (57 culture-negative, 147 culture-positive) were investigated based on demographics, and clinical parameters. CNP predictors were investigated using logistic regression. Results CNP rate was significantly higher in female and in patients with higher platelet counts, lower dialysate cell counts at peritonitis diagnosis, and higher serum β 2 -microglobulin levels. In multivariate logistic regression, female sex (odds ratio [OR] 2.69, 95% confidence interval [CI] 1.31–5.54), dialysate cell count at diagnosis (OR0.99, 95% CI 0.99–0.99), and serum β 2 -microglobulin level (OR 1.04, 95% CI 1.00–1.07) were significantly associated with CNP. The areas under the receiver operating characteristic curve for female patients, dialysate cell counts at diagnosis of peritonitis, serum β 2 -microglobulin level, and female patients + dialysate cell counts at diagnosis of peritonitis + serum β 2 -microglobulin level were 0.604, 0.694, 0.603, and 0.751, respectively. Conclusions Female sex, dialysate cell counts at peritonitis diagnosis, and serum β 2 -microglobulin levels may be predictors of CNP.","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135315996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Coronavirus disease (COVID-19) continues to be prevalent in 2023, and infection control measures against it remain important in medical practice. In 2020, we conducted a questionnaire survey mainly on the implementation of infection prevention measures for patients on hemodialysis under COVID-19 pandemic in Japan. Since then, vaccination for COVID-19 has been initiated and the outbreak of new variants had occurred. Infection prevention measures at dialysis facilities have possibly changed; therefore, we conducted a follow-up survey. Methods Between October 11 and November 14, 2022, we distributed a questionnaire survey to 4,198 dialysis facilities in Japan. The survey investigated (i) the characteristics of the facilities, (ii) infection prevention measures in routine dialysis practice, (iii) experience in treating COVID-19-positive/suspected dialysis patients, (iv) feasibility of various isolation measures, (v) nosocomial transmission, (vi) COVID-19 vaccination status, and (vii) impact on medical practice and economic aspects. We then compared the answers from the previous survey conducted in 2020 with those of the current survey. Results Responses were obtained from 1956 facilities (response rate: 46.6%). Overall, 83.5% of the facilities have examined and treated patients with COVID-19. While the compliance rate improved since the previous survey, it remained low for some factors such as linen exchange. More than 60% of the facilities reported that they were coping with a lack of manpower and space for isolation. Most patients at the surveyed facilities were vaccinated for COVID-19; only 2.8% were unvaccinated. Compared with unvaccinated patients, vaccinated patients had a lower infection rate (vaccinated 9.2% vs. unvaccinated 41.2%; crude risk ratio [RR] 0.22; 95% confidence interval [CI] 0.22–0.23; p < 0.001) and mortality rates (vaccinated 0.3% vs. unvaccinated 6.6%; crude RR 0.05; 95% CI 0.04–0.06; p < 0.001). Conclusion The implementation rates of most of the infection prevention measures improved compared to those in the previous survey. However, labor shortages, lack of space, and problems coordinating with other medical facilities remain a challenge. COVID-19 vaccination was significantly associated with reduced infection and mortality in Japanese patients on hemodialysis, which should be confirmed by further studies with confounding adjustment.
{"title":"Infection prevention measures for patients on hemodialysis during COVID-19 pandemic in Japan: a nationwide questionnaire follow-up survey in 2022","authors":"Toyohiro Hashiba, Yuka Suagawara, Masao Iwagami, Tomoyuki Yamakawa, Munekazu Ryuzaki, Kan Kikuchi, Takashi Kadowaki, Masaomi Nangaku","doi":"10.1186/s41100-023-00509-9","DOIUrl":"https://doi.org/10.1186/s41100-023-00509-9","url":null,"abstract":"Abstract Background Coronavirus disease (COVID-19) continues to be prevalent in 2023, and infection control measures against it remain important in medical practice. In 2020, we conducted a questionnaire survey mainly on the implementation of infection prevention measures for patients on hemodialysis under COVID-19 pandemic in Japan. Since then, vaccination for COVID-19 has been initiated and the outbreak of new variants had occurred. Infection prevention measures at dialysis facilities have possibly changed; therefore, we conducted a follow-up survey. Methods Between October 11 and November 14, 2022, we distributed a questionnaire survey to 4,198 dialysis facilities in Japan. The survey investigated (i) the characteristics of the facilities, (ii) infection prevention measures in routine dialysis practice, (iii) experience in treating COVID-19-positive/suspected dialysis patients, (iv) feasibility of various isolation measures, (v) nosocomial transmission, (vi) COVID-19 vaccination status, and (vii) impact on medical practice and economic aspects. We then compared the answers from the previous survey conducted in 2020 with those of the current survey. Results Responses were obtained from 1956 facilities (response rate: 46.6%). Overall, 83.5% of the facilities have examined and treated patients with COVID-19. While the compliance rate improved since the previous survey, it remained low for some factors such as linen exchange. More than 60% of the facilities reported that they were coping with a lack of manpower and space for isolation. Most patients at the surveyed facilities were vaccinated for COVID-19; only 2.8% were unvaccinated. Compared with unvaccinated patients, vaccinated patients had a lower infection rate (vaccinated 9.2% vs. unvaccinated 41.2%; crude risk ratio [RR] 0.22; 95% confidence interval [CI] 0.22–0.23; p < 0.001) and mortality rates (vaccinated 0.3% vs. unvaccinated 6.6%; crude RR 0.05; 95% CI 0.04–0.06; p < 0.001). Conclusion The implementation rates of most of the infection prevention measures improved compared to those in the previous survey. However, labor shortages, lack of space, and problems coordinating with other medical facilities remain a challenge. COVID-19 vaccination was significantly associated with reduced infection and mortality in Japanese patients on hemodialysis, which should be confirmed by further studies with confounding adjustment.","PeriodicalId":21028,"journal":{"name":"Renal Replacement Therapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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