Background: We aimed to evaluate sex differences in peritoneal dialysis (PD) outcomes and to explore direct and indirect effects of nurse-assisted PD on outcomes.
Methods: This was a retrospective study using data from the Registre de Dialyse Péritonéale de Langue Française of incident PD patients between 2005 and 2016. Cox proportional hazards modelling was used to analyse transfer to haemodialysis (HD), death, PD failure, peritonitis and renal transplantation. Mediation analyses with a counterfactual approach were carried out to evaluate natural direct and indirect effects of sex on transfer to HD and peritonitis, with nurse-assisted PD as a mediator a priori.
Results: Of the 14 659 patients included, there were 5970 females (41%) and 8689 males (59%). Women were more frequently treated by nurse-assisted PD than men [2926/5970 (49.1%) versus 3357/8689 (38.7%)]. In the multivariable analysis, women had a lower risk of transfer to HD [cause-specific hazard ratio {cs-HR} 0.82 {95% confidence interval (CI) 0.77-0.88}], death [cs-HR 0.90 (95% CI 0.85-0.95)], peritonitis [cs-HR 0.82 (95% CI 0.78-0.87)], PD failure [cs-HR 0.86 (95% CI 0.83-0.90)] and a lower chance of undergoing transplant [cs-HR 0.83 (95% CI 0.77-0.90)] than men. There was a direct effect of sex on the risk of transfer to HD [cs-HR 0.82 (95% CI 0.82-0.83)], with an indirect effect of nurse-assisted PD [cs-HR 0.97 (95% CI 0.96-0.99)]. Nurse-assisted PD had no indirect effect on the risk of peritonitis.
Conclusions: Our results suggest that compared with men, women have a lower risk of both transfer to HD and peritonitis. Mediation analysis showed that nurse assistance was a potential mediator in the causal pathway between sex and transfer to HD.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ndt/gfab354 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Absolute uterine factor infertility is conditioned by the congenital or acquired absence of the uterus or the presence of a nonfunctioning uterus in women who wish to become biological mothers. Uterine transplantation along with assisted reproductive techniques can provide this option for women without a uterus. In the early research period, to minimize the risk of preterm birth and other pregnancy-related complications, the uterus of a donor with a history of one to three successfully completed pregnancies was recommended for transplantation.
View Article and Find Full Text PDFAssessing chemical exposure risk in breastfeeding infants: An explainable machine learning model for human milk transfer prediction.
Ecotoxicol Environ Saf
January 2025
Department of Pharmacy, Jieyang People's Hospital, Jieyang, China.
Breast milk is essential for infant health, but the transfer of xenobiotic chemicals poses significant risks. Ethical challenges in clinical trials necessitate the use of in vitro predictive models to assess chemical exposure risks in breastfeeding infants. This study introduces an explainable machine learning model to predict the risk of chemical transfer through human milk.
View Article and Find Full Text PDFIntelligent skin disease prediction system using transfer learning and explainable artificial intelligence.
Sci Rep
January 2025
Research Innovation and Entrepreneurship Unit, University of Buraimi, 512, Buraimi, Oman.
Skin diseases impact millions of people around the world and pose a severe risk to public health. These diseases have a wide range of effects on the skin's structure, functionality, and appearance. Identifying and predicting skin diseases are laborious processes that require a complete physical examination, a review of the patient's medical history, and proper laboratory diagnostic testing.
View Article and Find Full Text PDFCritical Review: Considerations in Applying Avian Egg Injection Studies to Characterize Effects of Hydrophobic Organic Compounds on Wild Birds.
Chemosphere
January 2025
Ramboll, 3401 Enterprise Place, Suite 340, Beachwood, Ohio 44122, USA. Electronic address:
Egg injection has been used for decades to determine embryonic mortality and developmental effects of chemical exposures in birds. Specific egg injection methods affect how well these studies replicate the process of chemical delivery to the embryo via maternal deposition, yet few data are available to compare exposure-response relationships between egg injection and maternal transfer studies. This information gap creates uncertainty when considering egg injection studies for assessment of potential adverse effects in wild birds.
View Article and Find Full Text PDFRefluxing Mature Compost to Replace Bulking Agents: A Low-Cost Solution for Suppressing Antibiotic Resistance Genes Rebound in Sewage Sludge Composting.
Environ Res
January 2025
State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090, China. Electronic address:
Antibiotic resistance genes (ARGs) rebounding during composting cooling phase is a critical bottleneck in composting technology that increased ARGs dissemination and application risk of compost products. In this study, mature compost (MR) was used as a substitute for rice husk (RH) to mitigate the rebound of ARGs and mobile genetic elements (MGEs) during the cooling phase of sewage sludge composting, and the relationship among ARGs, MGEs, bacterial community and environmental factors was investigated to explore the key factor influencing ARGs rebound. The results showed that aadD, blaCTX-M02, ermF, ermB, tetX and vanHB significantly increased 4.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!