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.authorIsla, Ramon A Tamayoen_ZA
dc.contributor.authorAmeh, Oluwatoyin Ien_ZA
dc.contributor.authorMapiye, Darlingtonen_ZA
dc.contributor.authorSwanepoel, Charles Ren_ZA
dc.contributor.authorBello, Aminu Ken_ZA
dc.contributor.authorRatsela, Andrew Ren_ZA
dc.contributor.authorOkpechi, Ikechi Gen_ZA
dc.date.accessioned2016-10-31T07:35:39Z
dc.date.available2016-10-31T07:35:39Z
dc.date.issued2016en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationIsla, 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. <i>PLoS One</i>, http://hdl.handle.net/11427/22344en_ZA
dc.identifier.chicagocitationIsla, Ramon A Tamayo, Oluwatoyin I Ameh, Darlington Mapiye, Charles R Swanepoel, Aminu K Bello, Andrew R Ratsela, and Ikechi G Okpechi "Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa." <i>PLoS One</i> (2016) http://hdl.handle.net/11427/22344en_ZA
dc.identifier.citationIsla, 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.0156642en_ZA
dc.identifier.ris TY - Journal Article AU - Isla, Ramon A Tamayo AU - Ameh, Oluwatoyin I AU - Mapiye, Darlington AU - Swanepoel, Charles R AU - Bello, Aminu K AU - Ratsela, Andrew R AU - Okpechi, Ikechi G AB - 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. DA - 2016 DB - OpenUCT DO - 10.1371/journal.pone.0156642 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa TI - Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa UR - http://hdl.handle.net/11427/22344 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0156642en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/22344
dc.identifier.vancouvercitationIsla RAT, Ameh OI, Mapiye D, Swanepoel CR, Bello AK, Ratsela AR, et al. Baseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africa. PLoS One. 2016; http://hdl.handle.net/11427/22344.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Nephrology and Hypertensionen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2016 Tamayo Isla et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherMedical dialysisen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherChronic kidney diseaseen_ZA
dc.subject.otherDiabetes mellitusen_ZA
dc.subject.otherPeritonitisen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherHypertensionen_ZA
dc.subject.otherSerum albuminen_ZA
dc.titleBaseline predictors of mortality among predominantly rural-dwelling end-stage renal disease patients on chronic dialysis therapies in Limpopo, South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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