Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1371/journal.pone.0270214 http://hdl.handle.net/11449/240343 |
Resumo: | Background We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country’s cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality. Results We used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates. Conclusions Among patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality. |
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Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United StatesBackground We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country’s cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality. Results We used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates. Conclusions Among patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality.Fresenius Medical Care North AmericaPontifícia Universidade Católica do Paraná, PRJohns Hopkins Bloomberg School of Public HealthFresenius Medical Care Global Medical OfficeFresenius Medical Care North AmericaUniversidade do Estado de São Paulo, SPRenal Research InstituteIcahn School of Medicine at Mount SinaiFresenius Medical Care AG & Co. KGaA Global Medical OfficeArbor Research Collaborative for HealthPontifícia Universidade Católica do ParanáJohns Hopkins Bloomberg School of Public HealthFresenius Medical Care Global Medical OfficeFresenius Medical Care North AmericaUniversidade do Estado de São PauloRenal Research InstituteIcahn School of Medicine at Mount SinaiGlobal Medical OfficeArbor Research Collaborative for HealthGuedes, MuriloWallim, LizGuetter, Camila R.Jiao, YueRigodon, VladimirMysayphonh, ChanceUsvyat, Len A.Barretti, PasqualKotanko, PeterLarkin, John W.Maddux, Franklin W.Pecoits-Filho, Robertode Moraes, Thyago Proenca2023-03-01T20:12:58Z2023-03-01T20:12:58Z2022-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1371/journal.pone.0270214PLoS ONE, v. 17, n. 6 June, 2022.1932-6203http://hdl.handle.net/11449/24034310.1371/journal.pone.02702142-s2.0-85132819588Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPLoS ONEinfo:eu-repo/semantics/openAccess2023-03-01T20:12:59Zoai:repositorio.unesp.br:11449/240343Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T20:27:36.210855Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
title |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
spellingShingle |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States Guedes, Murilo |
title_short |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
title_full |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
title_fullStr |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
title_full_unstemmed |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
title_sort |
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States |
author |
Guedes, Murilo |
author_facet |
Guedes, Murilo Wallim, Liz Guetter, Camila R. Jiao, Yue Rigodon, Vladimir Mysayphonh, Chance Usvyat, Len A. Barretti, Pasqual Kotanko, Peter Larkin, John W. Maddux, Franklin W. Pecoits-Filho, Roberto de Moraes, Thyago Proenca |
author_role |
author |
author2 |
Wallim, Liz Guetter, Camila R. Jiao, Yue Rigodon, Vladimir Mysayphonh, Chance Usvyat, Len A. Barretti, Pasqual Kotanko, Peter Larkin, John W. Maddux, Franklin W. Pecoits-Filho, Roberto de Moraes, Thyago Proenca |
author2_role |
author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Pontifícia Universidade Católica do Paraná Johns Hopkins Bloomberg School of Public Health Fresenius Medical Care Global Medical Office Fresenius Medical Care North America Universidade do Estado de São Paulo Renal Research Institute Icahn School of Medicine at Mount Sinai Global Medical Office Arbor Research Collaborative for Health |
dc.contributor.author.fl_str_mv |
Guedes, Murilo Wallim, Liz Guetter, Camila R. Jiao, Yue Rigodon, Vladimir Mysayphonh, Chance Usvyat, Len A. Barretti, Pasqual Kotanko, Peter Larkin, John W. Maddux, Franklin W. Pecoits-Filho, Roberto de Moraes, Thyago Proenca |
description |
Background We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country’s cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality. Results We used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates. Conclusions Among patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-06-01 2023-03-01T20:12:58Z 2023-03-01T20:12:58Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1371/journal.pone.0270214 PLoS ONE, v. 17, n. 6 June, 2022. 1932-6203 http://hdl.handle.net/11449/240343 10.1371/journal.pone.0270214 2-s2.0-85132819588 |
url |
http://dx.doi.org/10.1371/journal.pone.0270214 http://hdl.handle.net/11449/240343 |
identifier_str_mv |
PLoS ONE, v. 17, n. 6 June, 2022. 1932-6203 10.1371/journal.pone.0270214 2-s2.0-85132819588 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
PLoS ONE |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1808129204728889344 |