Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa

 

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dc.contributor.author Isla, Ramon A Tamayo en_ZA
dc.contributor.author Ameh, Oluwatoyin I en_ZA
dc.contributor.author Mapiye, Darlington en_ZA
dc.contributor.author Swanepoel, Charles R en_ZA
dc.contributor.author Bello, Aminu K en_ZA
dc.contributor.author Ratsela, Andrew R en_ZA
dc.contributor.author Okpechi, Ikechi G en_ZA
dc.date.accessioned 2016-10-31T07:35:39Z
dc.date.available 2016-10-31T07:35:39Z
dc.date.issued 2016 en_ZA
dc.identifier.citation Isla, R. A. T., Ameh, O. I., Mapiye, D., Swanepoel, C. R., Bello, A. K., Ratsela, A. R., & Okpechi, I. G. (2016). Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa. PloS one, 11(6), e0156642. doi:10.1371/journal.pone.0156642 en_ZA
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0156642 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/22344
dc.description.abstract BACKGROUND: Dialysis therapy for end-stage renal disease (ESRD) continues to be the readily available renal replacement option in developing countries. While the impact of rural/remote dwelling on mortality among dialysis patients in developed countries is known, it remains to be defined in sub-Saharan Africa. METHODS: A single-center database of end-stage renal disease patients on chronic dialysis therapies treated between 2007 and 2014 at the Polokwane Kidney and Dialysis Centre (PKDC) of the Pietersburg Provincial Hospital, Limpopo South Africa, was retrospectively reviewed. All-cause, cardiovascular, and infection-related mortalities were assessed and associated baseline predictors determined. RESULTS: Of the 340 patients reviewed, 52.1% were male, 92.9% were black Africans, 1.8% were positive for the human immunodeficiency virus (HIV), and 87.5% were rural dwellers. The average distance travelled to the dialysis centre was 112.3 ± 73.4 Km while 67.6% of patients lived in formal housing. Estimated glomerular filtration rate (eGFR) at dialysis initiation was 7.1 ± 3.7 mls/min while hemodialysis (HD) was the predominant modality offered (57.1%). Ninety-two (92) deaths were recorded over the duration of follow-up with the majority (34.8%) of deaths arising from infection-related causes. Continuous ambulatory peritoneal dialysis (CAPD) was a significant predictor of all-cause mortality (HR: 1.62, CI: 1.07-2.46) and infection-related mortality (HR: 2.27, CI: 1.13-4.60). On multivariable cox regression, CAPD remained a significant predictor of all-cause mortality (HR: 2.00, CI: 1.29-3.10) while the risk of death among CAPD patients was also significantly modified by diabetes mellitus (DM) status (HR: 4.99, CI: 2.13-11.71). CONCLUSION: CAPD among predominantly rural dwelling patients in the Limpopo province of South Africa is associated with an increased risk of death from all-causes and infection-related causes. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Medical dialysis en_ZA
dc.subject.other Death rates en_ZA
dc.subject.other Chronic kidney disease en_ZA
dc.subject.other Diabetes mellitus en_ZA
dc.subject.other Peritonitis en_ZA
dc.subject.other South Africa en_ZA
dc.subject.other Hypertension en_ZA
dc.subject.other Serum albumin en_ZA
dc.title Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2016 Tamayo Isla et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Nephrology and Hypertension en_ZA
uct.type.filetype Text
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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.