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The effects of hospital and dialysis unit characteristics on hospitalizations for access-related complications among children on maintenance dialysis: a European, multicenter, observational, cross-sectional study
YÖ. Atikel, CP. Schmitt, E. Lévai, S. Adalat, R. Shroff, N. Goodman, İ. Dursun, AS. Pınarbaşı, B. Yazıcıoğlu, F. Paglialonga, K. Vondrak, I. Guzzo, N. Printza, A. Zurowska, I. Zagożdżon, AK. Bayazıt, B. Atmış, M. Tkaczyk, M. do Sameiro Faria, A....
Language English Country Germany
Document type Multicenter Study, Journal Article
NLK
ProQuest Central
from 1996-08-01 to 1 year ago
Medline Complete (EBSCOhost)
from 1996-08-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1996-08-01 to 1 year ago
Health & Medicine (ProQuest)
from 1996-08-01 to 1 year ago
Family Health Database (ProQuest)
from 1996-08-01 to 1 year ago
- MeSH
- Kidney Failure, Chronic * epidemiology therapy MeSH
- Renal Dialysis adverse effects MeSH
- Child MeSH
- Hospitalization MeSH
- Humans MeSH
- Hospitals MeSH
- Peritoneal Dialysis * MeSH
- Cross-Sectional Studies MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND: Previous studies investigating hospitalizations in dialysis patients have focused primarily on patient-centered factors. We analyzed the impact of hospital and dialysis unit characteristics on pediatric dialysis patients' hospitalizations for access-related complications (ARCs). METHODS: This cross-sectional study involved 102 hemodialysis (HD) and 163 peritoneal dialysis (PD) patients. Data between July 2017 and July 2018 were analyzed. RESULTS: Children's hospitals (CHs) had more pediatric nephrologists and longer PD experience (years) than general hospitals (GHs) (p = 0.026 and p = 0.023, respectively). A total of 53% of automated PD (APD) and 6% of continuous ambulatory PD (CAPD) patients were in CHs (p < 0.001). Ninety-three percent of APD and 69% of CAPD patients were treated in pediatric-specific PD units (p = 0.001). CHs had a higher prevalence in providing hemodiafiltration (HDF) than GHs (83% vs. 30%). Ninety-seven percent of HDF vs. 66% for conventional HD (cHD) patients, and 94% of patients with arteriovenous fistula (AVF) vs. 70% of those with central venous catheters (CVC), were dialyzed in pediatric-specific HD units (p = 0.001 and p = 0.016, respectively). Eighty patients (51 PD and 29 HD) had 135 (84 PD, 51 HD) hospitalizations. CAPD was an independent risk factor for hospitalizations for infectious ARCs (I-ARCs) (p = 0.009), and a health center's PD experience negatively correlated with CAPD patient hospitalizations for I-ARCs (p = 0.041). cHD and dialyzing in combined HD units significantly increased hospitalization risk for non-infectious (NI-)ARCs (p = 0.044 and p = 0.017, respectively). CONCLUSIONS: CHs and pediatric-specific dialysis units have higher prevalence of APD and HDF use. Hospitalizations for I-ARCs in CAPD are lower in centers with longer PD experience, and pediatric HD units are associated with fewer hospitalizations due to NI-ARCs. A higher resolution version of the Graphical abstract is available as Supplementary information.
Department of Pediatric Nephrology Center for Pediatric and Adolescent Medicine Heidelberg Germany
Department of Pediatric Nephrology Centro Materno Infantil Do Norte CHP Porto Portugal
Department of Pediatric Nephrology Country Hautepierre CHU Strasbourg France
Department of Pediatric Nephrology Eskişehir City Training and Research Hospital Eskişehir Turkey
Department of Pediatric Nephrology Evelina London Children's Hospital London UK
Department of Pediatric Nephrology Faculty of Medicine Ankara University Ankara Turkey
Department of Pediatric Nephrology Faculty of Medicine Çukurova University Adana Turkey
Department of Pediatric Nephrology Faculty of Medicine Erciyes University Kayseri Turkey
Department of Pediatric Nephrology Gazi University Faculty of Medicine Beşevler Ankara Turkey 06500
Department of Pediatric Nephrology Great Ormond Street Hospital for Children London UK
Department of Pediatric Nephrology Instytut Centrum Zdrowia Matki Poland
Department of Pediatric Nephrology Medical School of Aristotle University Thessaloniki Greece
Department of Pediatric Nephrology University Hospital Motol Prague Czech Republic
Department of Pediatric Nephrology Vilnius University Hospital Vilnius Lithuania
Department of Pediatrics Nephrology and Hypertension Medical University of Gdansk Gdansk Poland
References provided by Crossref.org
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- $a Atikel, Yeşim Özdemir $u Department of Pediatric Nephrology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey, 06500. yesozdemir@gmail.com $u Department of Pediatric Nephrology, Eskişehir City Training and Research Hospital, Eskişehir, Turkey. yesozdemir@gmail.com $1 https://orcid.org/0000000153043125
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- $a The effects of hospital and dialysis unit characteristics on hospitalizations for access-related complications among children on maintenance dialysis: a European, multicenter, observational, cross-sectional study / $c YÖ. Atikel, CP. Schmitt, E. Lévai, S. Adalat, R. Shroff, N. Goodman, İ. Dursun, AS. Pınarbaşı, B. Yazıcıoğlu, F. Paglialonga, K. Vondrak, I. Guzzo, N. Printza, A. Zurowska, I. Zagożdżon, AK. Bayazıt, B. Atmış, M. Tkaczyk, M. do Sameiro Faria, A. Zaloszyc, A. Jankauskiene, M. Ekim, A. Edefonti, SA. Bakkaloğlu
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- $a BACKGROUND: Previous studies investigating hospitalizations in dialysis patients have focused primarily on patient-centered factors. We analyzed the impact of hospital and dialysis unit characteristics on pediatric dialysis patients' hospitalizations for access-related complications (ARCs). METHODS: This cross-sectional study involved 102 hemodialysis (HD) and 163 peritoneal dialysis (PD) patients. Data between July 2017 and July 2018 were analyzed. RESULTS: Children's hospitals (CHs) had more pediatric nephrologists and longer PD experience (years) than general hospitals (GHs) (p = 0.026 and p = 0.023, respectively). A total of 53% of automated PD (APD) and 6% of continuous ambulatory PD (CAPD) patients were in CHs (p < 0.001). Ninety-three percent of APD and 69% of CAPD patients were treated in pediatric-specific PD units (p = 0.001). CHs had a higher prevalence in providing hemodiafiltration (HDF) than GHs (83% vs. 30%). Ninety-seven percent of HDF vs. 66% for conventional HD (cHD) patients, and 94% of patients with arteriovenous fistula (AVF) vs. 70% of those with central venous catheters (CVC), were dialyzed in pediatric-specific HD units (p = 0.001 and p = 0.016, respectively). Eighty patients (51 PD and 29 HD) had 135 (84 PD, 51 HD) hospitalizations. CAPD was an independent risk factor for hospitalizations for infectious ARCs (I-ARCs) (p = 0.009), and a health center's PD experience negatively correlated with CAPD patient hospitalizations for I-ARCs (p = 0.041). cHD and dialyzing in combined HD units significantly increased hospitalization risk for non-infectious (NI-)ARCs (p = 0.044 and p = 0.017, respectively). CONCLUSIONS: CHs and pediatric-specific dialysis units have higher prevalence of APD and HDF use. Hospitalizations for I-ARCs in CAPD are lower in centers with longer PD experience, and pediatric HD units are associated with fewer hospitalizations due to NI-ARCs. A higher resolution version of the Graphical abstract is available as Supplementary information.
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