Browsing by Author "Boonphiphop Boonpheng"

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    Acute kidney injury among salicylate intoxication hospitalisations in the United States
    (2021-03-01) Charat Thongprayoon; Tananchai Petnak; Wisit Kaewput; Fawad Qureshi; Michael A. Mao; Aleksandra I. Pivovarova; Boonphiphop Boonpheng; Tarun Bathini; Saraschandra Vallabhajosyula; Juan Medaura; Wisit Cheungpasitporn; Faculty of Medicine Ramathibodi Hospital, Mahidol University; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; David Geffen School of Medicine at UCLA; University of Mississippi Medical Center; Emory University School of Medicine; Mayo Clinic in Jacksonville, Florida
    Background: This study aimed to evaluate the risk factors and the association of acute kidney injury (AKI) with outcomes, and resource utilisation in patients hospitalised because of salicylate intoxication in the United States. Methods: Hospitalised patients with a primary diagnosis of salicylate intoxication from 2003 to 2014 were identified in the National Inpatient Sample (NIS) database. End-stage kidney disease patients were excluded. The occurrence of AKI was identified using hospital diagnosis code. Clinical characteristics, in-hospital treatment, outcomes and resource utilisation were compared between patients with and without AKI. Results: A total of 13 787 eligible hospital admissions were included in the analysis. AKI occurred in 1279 (9.3%) admissions. Older age, male sex, more recent year of hospitalisation, anaemia, hypertension, congestive heart failure, chronic kidney disease, volume depletion, sepsis and ventricular arrhythmia/cardiac arrest were significantly associated with increased risk of AKI, whereas Hispanic race was associated with decreased risk. AKI was significantly associated with increased risk of organ failure, and in-hospital mortality. In addition, the need for ventilation support, blood component transfusion, renal replacement therapy, length of hospital stay and hospitalisation cost were higher in AKI patients. Conclusion: Approximately one tenth of salicylate intoxication patients developed AKI during hospitalisation. AKI was associated with higher morbidity, mortality and resource utilisations.
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    Acute kidney injury in hospitalized patients with methanol intoxication: National Inpatient Sample 2003-2014
    (2021-08-01) Charat Thongprayoon; Tananchai Petnak; Wisit Kaewput; Michael A. Mao; Boonphiphop Boonpheng; Tarun Bathini; Saraschandra Vallabhajosyula; Ploypin Lertjitbanjong; Fawad Qureshi; Wisit Cheungpasitporn; Ramathibodi Hospital; The University of Arizona; Phramongkutklao College of Medicine; David Geffen School of Medicine at UCLA; Emory University School of Medicine; University of Tennessee Health Science Center; MN; FL
    BACKGROUND: This study aimed to 1) determine the incidence of acute kidney injury (AKI), 2) identify risk factors for AKI, and 3) evaluate the impact of AKI on in-hospital outcomes in hospitalized patients for methanol intoxication. METHODS: We searched the National Inpatient Sample Database for hospitalized patients from 2003 to 2014 with a primary diagnosis of methanol intoxication. We excluded patients with end-stage kidney disease. We identified the AKI using a discharge diagnosis code. We compared clinical characteristics, in-hospital treatment, outcomes, and resource use between AKI and non-AKI patients. RESULTS: A total of 603 hospital admissions for methanol intoxication were analyzed. AKI developed in 135 (22.4%) admissions. Anemia (OR 3.43 p < 0.001), hypertension (OR 1.86; p = 0.02), volume depletion (OR 3.46; p = 0.001), sepsis (OR 6.91; p < 0.001), rhabdomyolysis (OR 6.25; p = 0.003), and acute pancreatitis (OR 5.30; p = 0.004) were independent risk factors for AKI development. AKI was significantly associated with increased risk of in-hospital mortality and organ failure. AKI patients needed more mechanical ventilation, and extracorporeal therapy, had longer length of hospital stay, and higher hospitalization costs. CONCLUSION: Over one-fifth of methanol intoxication patients developed AKI during hospitalization. AKI was associated with higher morbidity, mortality, and resource utilization.
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    BK polyomavirus genotypes in renal transplant recipients in the United States: A meta-analysis
    (2019-11-01) Charat Thongprayoon; Nadeen J. Khoury; Tarun Bathini; Narothama Reddy Aeddula; Boonphiphop Boonpheng; Napat Leeaphorn; Patompong Ungprasert; Jackrapong Bruminhent; Ploypin Lertjitbanjong; Kanramon Watthanasuntorn; Supavit Chesdachai; Michael A. Mao; Wisit Cheungpasitporn; Henry Ford Health System; University of Minnesota Twin Cities; UMKC School of Medicine; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University; University of Arizona; Indiana University School of Medicine Evansville; Mayo Clinic; University of Mississippi Medical Center; Mayo Clinic in Jacksonville, Florida; East Tennessee State University; Bassett Medical Center
    © 2019 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd Background: In the United States, increasing ethnic diversity has been apparent. However, the epidemiology and trends of BKV genotypes remain unclear. This meta-analysis was conducted with the aim to assess the prevalence of BKV genotypes among kidney transplant (KTx) recipients in the United States. Methods: A comprehensive literature review was conducted through October 2018 utilizing MEDLINE, Embase, and Cochrane Database to identify studies that reported the prevalence of BKV subtypes and/or subgroups in KTx recipients in the United States. Pooled prevalence rates were combined using random effects, generic inverse variance method. The protocol for this study is registered with PROSPERO (no. CRD42019134582). Results: A total of eight observational studies with a total of 193 samples (urine, blood, and kidney tissues) from 188 BKV-infected KTX recipients were enrolled. Overall, the pooled estimated prevalence rates of BKV subtypes were 72.2% (95% confidence of interval [CI]: 62.7-80.0%) for subtype I, 6.8% (95% CI: 2.5-16.9%) for subtype II, 8.3% (95% CI: 4.4-15.1%) for subtype III, and 16.1% (95% CI: 10.4-24.2%) for subtype IV, respectively. While metaregression analysis demonstrated a significant positive correlation between year of study and the prevalence of BKV subtype I (slopes = +0.1023, P =.01), there were no significant correlations between year of study and percentages of BKV subtype II-IV (P >.05). Among KTx recipients with BKV subtype I, the pooled estimated percentages of BKV subgroups were 22.4% (95% CI: 13.7-34.5%) for subgroup Ia, 30.6% (95% CI: 17.7-47.5%) for subgroup Ib1, 47.7% (95% CI: 35.8-59.9%) for subgroup Ib2, and 4.1% (95% CI:1.2-13.3%) for subgroup Ic, respectively. Conclusion: BKV subtype I is the most prevalent subtype among KTx recipients in the United States and its prevalence seems to increasing overtime. Subgroup Ib2 is the most common subgroup among BKV subtype I.
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    Epidemiology of parvovirus B19 and anemia among kidney transplant recipients: A meta-analysis
    (2020-07-01) Charat Thongprayoon; Nadeen J. Khoury; Tarun Bathini; Narothama Reddy Aeddula; Boonphiphop Boonpheng; Ploypin Lertjitbanjong; Kanramon Watthanasuntorn; Napat Leeaphorn; Supavit Chesdachai; Aldo Torres-Ortiz; Wisit Kaewput; Jackrapong Bruminhent; Michael A. Mao; Wisit Cheungpasitporn; University of Minnesota Twin Cities; UMKC School of Medicine; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University; The University of Arizona; Indiana University School of Medicine-Evansville; Henry Ford Hospital; Mayo Clinic; University of Mississippi Medical Center; The Mary Imogene Bassett Hospital; Mayo Clinic in Jacksonville, Florida; East Tennessee State University
    © 2020 Urology Annals | Published by Wolters Kluwer-Medknow. Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia. Materials and Methods: A systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716). Results: Nineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%-76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1st year after KTx was 10.3% (95% CI: 5.5%-18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%-15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%-41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA (P = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses. Conclusion: The overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime.
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    Impact of anca-associated vasculitis on outcomes of hospitalizations for goodpasture’s syndrome in the united states: Nationwide inpatient sample 2003–2014
    (2020-03-01) Charat Thongprayoon; Wisit Kaewput; Boonphiphop Boonpheng; Patompong Ungprasert; Tarun Bathini; Narat Srivali; Saraschandra Vallabhajosyula; Jorge L. Castaneda; Divya Monga; Swetha R. Kanduri; Juan Medaura; Wisit Cheungpasitporn; St. Agnes Hospital; Faculty of Medicine, Siriraj Hospital, Mahidol University; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; David Geffen School of Medicine at UCLA; University of Mississippi Medical Center
    © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Background and objectives: Goodpasture’s syndrome (GS) is a rare, life-threatening autoimmune disease. Although the coexistence of anti-neutrophil cytoplasmic antibody (ANCA) with Goodpasture’s syndrome has been recognized, the impacts of ANCA vasculitis on mortality and resource utilization among patients with GS are unclear. Materials and Methods: We used the National Inpatient Sample to identify hospitalized patients with a principal diagnosis of GS from 2003 to 2014 in the database. The predictor of interest was the presence of ANCA-associated vasculitis. We tested the differences concerning in-hospital treatment and outcomes between GS patients with and without ANCA-associated vasculitis using logistic regression analysis with adjustment for other clinical characteristics. Results: A total of 964 patients were primarily admitted to hospital for GS. Of these, 84 (8.7%) had a concurrent diagnosis of ANCA-associated vasculitis. Hemoptysis was more prevalent in GS patients with ANCA-associated vasculitis. During hospitalization, GS patients with ANCA-associated required non-significantly more mechanical ventilation and non-invasive ventilation support, but non-significantly less renal replacement therapy and plasmapheresis than those with GS alone. There was no significant difference in in-hospital outcomes, including organ failure and mortality, between GS patients with and without ANCA-associated vasculitis. Conclusions: Our study demonstrated no significant differences between resource utilization and in-hospital mortality among hospitalized patients with coexistence of ANCA vasculitis and GS, compared to those with GS alone.
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    Impact of rhabdomyolysis on outcomes of hospitalizations for heat stroke in the United States
    (2020-12-01) Charat Thongprayoon; Tananchai Petnak; Swetha R. Kanduri; Karthik Kovvuru; Wisit Cheungpasitporn; Boonphiphop Boonpheng; Api Chewcharat; Tarun Bathini; Juan Medaura; Saraschandra Vallabhajosyula; Wisit Kaewput; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; David Geffen School of Medicine at UCLA; University of Mississippi Medical Center
    BACKGROUND: The objective of this study was to evaluate the predictors and associated outcomes of rhabdomyolysis in admitted patients for heat stroke in the United States. METHODS: The National Inpatient Sample was utilized to identify hospitalized patients with a primary diagnosis of heat stroke from the years 2003-2014. Rhabdomyolysis was identified using hospital diagnosis code. We compared the clinical characteristics, in-hospital treatment, complications, outcomes, and resource utilization between patients with and without rhabdomyolysis. RESULTS: A total of 3,372 hospital admissions for heat stroke were studied. Of these, rhabdomyolysis occurred in 1049 (31%) admissions. The risk factors for rhabdomyolysis were age 20-39 years, male sex, African American race, history of alcohol drinking, whereas age ≥60 years, smoking, history of diabetes mellitus, and hypertension were associated with lower risk of rhabdomyolysis. Patients with rhabdomyolysis had greater requirements for mechanical ventilation, blood component transfusion, and renal replacement therapy. Rhabdomyolysis was significantly associated with increased risk of hyponatremia, hypernatremia, hyperkalemia, hypocalcemia, serum phosphorus and magnesium derangement, metabolic acidosis, sepsis, ventricular arrhythmia or cardiac arrest, renal failure, respiratory failure, liver failure, neurological failure, hematologic failure, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher when rhabdomyolysis occurred during hospital stay. CONCLUSION: Rhabdomyolysis occurred in about one-third of hospitalized patients for heat stroke and was associated with increased morbidity, mortality, and resource utilization.
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    In-hospital mortality of hepatorenal syndrome in the United States: Nationwide inpatient sample
    (2021-12-07) Wisit Kaewput; Charat Thongprayoon; Carissa Y. Dumancas; Swetha R. Kanduri; Karthik Kovvuru; Chalermrat Kaewput; Pattharawin Pattharanitima; Tananchai Petnak; Ploypin Lertjitbanjong; Boonphiphop Boonpheng; Karn Wijarnpreecha; Jose L. Zabala Genovez; Saraschandra Vallabhajosyula; Caroline C. Jadlowiec; Fawad Qureshi; Wisit Cheungpasitporn; Ramathibodi Hospital; Siriraj Hospital; Wake Forest University School of Medicine; Mayo Clinic Scottsdale-Phoenix, Arizona; University of Michigan, Ann Arbor; Ochsner Health System; University of Washington; Faculty of Medicine, Thammasat University; Phramongkutklao College of Medicine; Mayo Clinic; University of Tennessee Health Science Center
    BACKGROUND Hepatorenal syndrome (HRS) is a life-threatening condition among patients with advanced liver disease. Data trends specific to hospital mortality and hospital admission resource utilization for HRS remain limited. AIM To assess the temporal trend in mortality and identify the predictors for mortality among hospital admissions for HRS in the United States. METHODS We used the National Inpatient Sample database to identify an unweighted sample of 4938 hospital admissions for HRS from 2005 to 2014 (weighted sample of 23973 admissions). The primary outcomes were temporal trends in mortality as well as predictors for hospital mortality. We estimated odds ratios from multilevel mixed effect logistic regression to identify patient characteristics and treatments associated with hospital mortality. RESULTS Overall hospital mortality was 32%. Hospital mortality decreased from 44% in 2005 to 24% in 2014 (P < 0.001), while there was an increase in the rate of liver transplantation (P = 0.02), renal replacement therapy (P < 0.001), length of hospital stay (P < 0.001), and hospitalization cost (P < 0.001). On multivariable analysis, older age, alcohol use, coagulopathy, neurological disorder, and need for mechanical ventilation predicted higher hospital mortality, whereas liver transplantation, transjugular intrahepatic portosystemic shunt, and abdominal paracentesis were associated with lower hospital mortality. CONCLUSION Although there was an increase in resource utilizations, hospital mortality among patients admitted for HRS significantly improved. Several predictors for hospital mortality were identified.
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    Inpatient burden and mortality of heatstroke in the United States
    (2021-04-01) Wisit Kaewput; Charat Thongprayoon; Tananchai Petnak; Liam D. Cato; Api Chewcharat; Boonphiphop Boonpheng; Tarun Bathini; Saraschandra Vallabhajosyula; Wisit Cheungpasitporn; University of California, Los Angeles; University Hospitals Birmingham NHS Foundation Trust; Faculty of Medicine Ramathibodi Hospital, Mahidol University; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic
    Background: This study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilisation of hospitalisation for heatstroke in the United States. Additionally, this study aimed to explore factors associated with in-hospital mortalities of heatstroke. Methods: The 2003-2014 National Inpatient Sample database was used to identify hospitalised patients with a principal diagnosis of heatstroke. The inpatient prevalence, clinical characteristics, in-hospital treatments, outcomes, length of hospital stay, and hospitalisation cost were studied. Multivariable logistic regression was performed to identify independent factors associated with in-hospital mortality. Results: A total of 3372 patients were primarily admitted for heatstroke, accounting for an overall inpatient prevalence of heatstroke amongst hospitalised patients of 36.3 cases per 1 000 000 admissions in the United States with an increasing trend during the study period (P <.001). Age 40-59 was the most prevalent age group. During the hospital stay, 20% required mechanical ventilation, and 2% received renal replacement therapy. Rhabdomyolysis was the most common complication. Renal failure was the most common end-organ failure, followed by neurological, respiratory, metabolic, hematologic, circulatory, and liver systems. The in-hospital mortality rate of heatstroke hospitalisation was 5% with a decreasing trend during the study period (P <.001). The presence of end-organ failure was associated with increased in-hospital mortality, whereas more recent years of hospitalisation was associated with decreased in-hospital mortality. The median length of hospital stay was 2 days. The median hospitalisation cost was $17 372. Conclusion: The inpatient prevalence of heatstroke in the United States increased, while the in-hospital mortality of heatstroke decreased.
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    Inpatient Burden and Mortality of Methanol Intoxication in the United States
    (2021-01-01) Wisit Kaewput; Charat Thongprayoon; Tananchai Petnak; Api Chewcharat; Boonphiphop Boonpheng; Tarun Bathini; Saraschandra Vallabhajosyula; Wisit Cheungpasitporn; University of California, Los Angeles; Faculty of Medicine Ramathibodi Hospital, Mahidol University; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; University of Mississippi Medical Center
    Background: This study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilization of hospitalization for methanol intoxication in the United States. Materials and Methods: A total of 603 hospitalized patients with a primary diagnosis of methanol intoxication from 2003 to 2014 were identified in the National Inpatient Sample database. The inpatient prevalence, clinical characteristics, treatments, outcomes, resource utilization, were investigated. Multivariable logistic regression was performed to identify factors independently associated with in-hospital mortality. Results: The overall inpatient prevalence of methanol intoxication among hospitalized patients was 6.4 cases per 1,000,000 admissions in the United States. The mean age was 38±18 (range 0–86) years. 44% used methanol for suicidal attempts. 20% of admissions required mechanical ventilation, and 40% required renal replacement therapy. The three most common complications were metabolic acidosis (44%), hypokalemia (18%), and visual impairment or optic neuritis (8%). The three most common end-organ failures were renal failure (22%), respiratory failure (21%), and neurological failure (17%). 6.5% died in the hospital. Factors associated with increased in-hospital mortality included alcohol drinking, hypernatremia, renal failure, respiratory failure, circulatory failure, and neurological failure. The mean length of hospital stay was 4.0 days. The mean hospitalization cost per patient was $43,222 Conclusion: The inpatient prevalence of methanol intoxication in the United States was 6.4 cases per 1,000,000 admissions. The risk of in-hospital mortality mainly depended on the number of end-organ failures.
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    Nonalcoholic fatty liver disease and albuminuria: A systematic review and meta-analysis
    (2018-09-01) Karn Wijarnpreecha; Charat Thongprayoon; Boonphiphop Boonpheng; Panadeekarn Panjawatanan; Konika Sharma; Patompong Ungprasert; Surakit Pungpapong; Wisit Cheungpasitporn; Faculty of Medicine, Siriraj Hospital, Mahidol University; University of Mississippi; Mayo Clinic in Jacksonville, Florida; East Tennessee State University; Chiang Mai University; Bassett Medical Center
    © 2018 Wolters Kluwer Health, Inc. All rights reserved. Background/objectives The relationship between nonalcoholic fatty liver disease (NAFLD) and albuminuria has been shown in many epidemiologic studies, although the results were inconsistent. This meta-analysis was conducted to summarize all available data and to estimate the risk of albuminuria among patients with NAFLD. Methods Comprehensive literature review was conducted utilizing Medline and Embase database through January 2018 to identify studies that compared the risk of albuminuria among patients with NAFLD versus those without NAFLD. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results Nineteen studies (17 cross-sectional studies and two cohort studies) with 24 804 participants fulfilled the eligibility criteria and were included in this meta-analysis. The risk of albuminuria among patients with NAFLD was significantly higher than those without NAFLD with the pooled odds ratio (OR) of 1.67 [95% confidence interval (CI): 1.32-2.11]. Subgroup analysis demonstrated the significantly increased risk of albuminuria among patients with NAFLD without diabetes with pooled OR of 2.25 (95% CI: 1.65-3.06). However, we found no significant association between albuminuria and NAFLD among diabetic patients [pooled OR 1.28 (95% CI: 0.94-1.75)]. Conclusion A significantly increased risk of albuminuria among patients with NAFLD was observed in this meta-analysis. Physicians should pay more attention to the early detection and subsequent treatment of individuals with microalbuminuria especially in patients with NAFLD.
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    Rhabdomyolysis among hospitalized patients for salicylate intoxication in the United States: Nationwide inpatient sample 2003–2014
    (2021-03-01) Wisit Kaewput; Charat Thongprayoon; Tananchai Petnak; Wisit Cheungpasitporn; Fawad Qureshi; Boonphiphop Boonpheng; Saraschandra Vallabhajosyula; Tarun Bathini; Sohail Abdul Salim; Tibor Fülöp; Ramathibodi Hospital; Medical University of South Carolina; The University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; David Geffen School of Medicine at UCLA; University of Mississippi Medical Center; Emory University School of Medicine; Ralph H. Johnson VA Medical Center
    Introduction This study aimed to assess the risk factors and impact of rhabdomyolysis on treatments, outcomes, and resource utilization in hospitalized patients for salicylate intoxication in the United States. Materials and methods The National Inpatient Sample was utilized to identify hospitalized patients with a primary diagnosis of salicylate intoxication from 2003–2014. Rhabdomyolysis was identified using hospital diagnosis code. We compared the clinical characteristics, in-hospital treatment, outcomes, and resource utilization between patients with and without rhabdomyolysis. Results A total of 13,805 hospital admissions for salicylate intoxication were studied. Of these, rhabdomyolysis developed in 258 (1.9%) admissions. The risk factors for rhabdomyolysis were age>20 years, male sex, volume depletion, hypokalemia, sepsis, and seizure. After adjustment for baseline clinical characteristics, salicylate intoxication patients with rhabdomyolysis required more invasive mechanical ventilation, and renal replacement therapy. Rhabdomyolysis was significantly associated with higher risk of failure of any organ systems, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher when rhabdomyolysis occurred during hospital stay. Conclusions Rhabdomyolysis was not common in hospitalized patients for salicylate intoxication but it was associated with increased morbidity, mortality, and resource utilization.
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    Risk of hip fracture in patients on hemodialysis versus peritoneal dialysis: A meta-analysis of observational studies
    (2019-05-01) Boonphiphop Boonpheng; Charat Thongprayoon; Michael A. Mao; Karn Wijarnpreecha; Tarun Bathini; Wisit Kaewput; Patompong Ungprasert; Wisit Cheungpasitporn; Faculty of Medicine, Siriraj Hospital, Mahidol University; University of Arizona; Phramongkutklao College of Medicine; Mayo Clinic; University of Mississippi Medical Center; Mayo Clinic in Jacksonville, Florida; East Tennessee State University
    © 2019 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd Background: Bone and mineral metabolism disorders are common among end-stage renal disease (ESRD) patients, which could lead to hip fracture. It is unclear whether the hip fracture risk is different among patients on hemodialysis (HD) versus peritoneal dialysis (PD). This meta-analysis was conducted to evaluate the hip fracture risk in ESRD patients on HD, when compared to PD. Methods: A literature review was conducted in EMBASE, MEDLINE, and Cochrane databases through January 31, 2018 to identify studies that appraised the rate or risk of hip fracture among patients on HD, when compared to PD. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, generic inverse variance approach of DerSimonian and Laird. Results: Five cohort studies with 1 276 677 ESRD patients were enrolled. HD status was associated with a significantly higher risk of hip fracture with the pooled odds ratio (OR) of 1.61 (95% confidence interval [CI] 1.50-1.73, I2 = 10.0%), compared with PD. When the analysis was limited to studies with confounder-adjusted analysis, the pooled OR of hip fracture among HD patients was 1.57 (95% CI 1.43-1.72, I2 = 13.6%). Funnel plots and Egger's regression test demonstrated no significant publication bias in our meta-analysis. Conclusions: Among ESRD patients, HD status is associated with a 61% higher risk of hip fracture compared to PD.
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    Risk of venous thromboembolism in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis
    (2018-08-09) Boonphiphop Boonpheng; Patompong Ungprasert; Faculty of Medicine, Siriraj Hospital, Mahidol University; Mayo Clinic; East Tennessee State University
    © Mattioli 1885. Background: Recent studies have suggested that patients with idiopathic pulmonary fibrosis (IPF) may have a higher risk of venous thromboembolism (VTE) compared to general population even though the results were inconsistent. Objective: To investigate the risk of VTE among patients with IPF. Methods: Comprehensive literature review using MEDLINE and EMBASE database were performed to identify studies that compared the risk of VTE among patients with IPF to general population. Effect estimates from each study were combined together using random effect model, generic inverse variance method of DerSimonian and Laird. Results: Out of 510 retrieved articles, 5 studies met the inclusion criteria and were included in the meta-analysis. A significant risk of VTE in patients with IPF was observed with the pooled risk ratio of 2.11 (95% confidence interval, 1.28-3.48). The heterogeneity was moderate with I 2 of 64%. Conclusion: An approximately 2-fold increased risk of VTE among patients with IPF was observed in this meta-analysis.