D Dialysis Centre (PKDC) of the Pietersburg Provincial Hospital, Limpopo South Africa. The study received approval from the Pietersburg Provincial Hospital Ethics Committee. The period under review was from 2007 (when PKDC was commissioned) to July 2014. All incident dialysis patients treated at the unit during the period under review were included. Patients were included if they had been on stable dialysis for at least 3 months. Twenty (20) patients who had started dialysis before 2007 at other centres and who continued dialysis with the unit due to proximity considerations were also included in our review. The outcomes of 340 patients were thus determined. Dialysis modality at day 91 after dialysis initiation (60 days of which the patient would have continuously been on the modality) was taken as the predominant modality. Duration of follow up for each modality was calculated from the date of starting dialysis to date of last date of follow up (31st July 2014), or date of transplantation, or date of death.CovariatesWe collected relevant socio-demographic data such as age at initiation of dialysis, gender, marital status, race, socio-economic status, predominant area of dwelling (urban versus rural), and housing characteristics (formal or informal). Baseline (at dialysis initiation) clinical and biochemical parameters collected included weight, body mass index (BMI), systolic and diastolic blood pressures, estimated glomerular filtration rate (eGFR), serum albumin, serum cholesterol, serum ferritin, transferrin saturation, calcium, inorganic phosphate, and parathyroid hormone. The cause of ESRD was also ascertained. The cause was reported as unknown in those patients who were late presenters; however if the cause despite late presentation was apparent (e.g. polycystic kidney disease) a definite cause was allotted.Outcomes and DefinitionsDeath within each modality was the outcome of interest of this study. Causes of death were divided into CV, infection-related or other causes. We defined CV death as death resulting from stroke, heart failure, RG7666 site myocardial infarction, pulmonary embolism or any death reported to have occurred suddenly with no other known cause. Infection-related deaths were deaths related to any ongoing infection at the time of death and these included peritonitis (for patients on PD), pneumonia, tuberculosis, catheter-related blood stream infection(CRBSI), infective endocarditis (one case) and empyema thoracis (one case). Deaths recorded as others were deaths at home that were not medically certified, and malignancy-related deaths.Statistical analysisPatients’ data were anonymized and de-identified prior to statistical analysis. The data was analyzed using the Stata1 13 software (Stata Corp, Texas). Continuous variables are presented as means and standard deviation (SD), and median with interquartile ranges where applicable.PLOS ONE | DOI:10.1371/journal.pone.0156642 June 14,3 /Baseline Predictors of Mortality in Chronic Dialysis Patients in Limpopo, South AfricaCategorical variables were presented as frequencies and percentages. Univariate analysis was performed using the independent student’s t-test, or Wilcoxon rank sum test where appropriate. Chi-squared test was used to compare categorical variables as appropriate. Kaplan-Meier PD98059 custom synthesis survival analysis was used to determine the median time-to-survival of patients with the log rank test applied to explore significant difference in survival between dialysis modalities. Censor.D Dialysis Centre (PKDC) of the Pietersburg Provincial Hospital, Limpopo South Africa. The study received approval from the Pietersburg Provincial Hospital Ethics Committee. The period under review was from 2007 (when PKDC was commissioned) to July 2014. All incident dialysis patients treated at the unit during the period under review were included. Patients were included if they had been on stable dialysis for at least 3 months. Twenty (20) patients who had started dialysis before 2007 at other centres and who continued dialysis with the unit due to proximity considerations were also included in our review. The outcomes of 340 patients were thus determined. Dialysis modality at day 91 after dialysis initiation (60 days of which the patient would have continuously been on the modality) was taken as the predominant modality. Duration of follow up for each modality was calculated from the date of starting dialysis to date of last date of follow up (31st July 2014), or date of transplantation, or date of death.CovariatesWe collected relevant socio-demographic data such as age at initiation of dialysis, gender, marital status, race, socio-economic status, predominant area of dwelling (urban versus rural), and housing characteristics (formal or informal). Baseline (at dialysis initiation) clinical and biochemical parameters collected included weight, body mass index (BMI), systolic and diastolic blood pressures, estimated glomerular filtration rate (eGFR), serum albumin, serum cholesterol, serum ferritin, transferrin saturation, calcium, inorganic phosphate, and parathyroid hormone. The cause of ESRD was also ascertained. The cause was reported as unknown in those patients who were late presenters; however if the cause despite late presentation was apparent (e.g. polycystic kidney disease) a definite cause was allotted.Outcomes and DefinitionsDeath within each modality was the outcome of interest of this study. Causes of death were divided into CV, infection-related or other causes. We defined CV death as death resulting from stroke, heart failure, myocardial infarction, pulmonary embolism or any death reported to have occurred suddenly with no other known cause. Infection-related deaths were deaths related to any ongoing infection at the time of death and these included peritonitis (for patients on PD), pneumonia, tuberculosis, catheter-related blood stream infection(CRBSI), infective endocarditis (one case) and empyema thoracis (one case). Deaths recorded as others were deaths at home that were not medically certified, and malignancy-related deaths.Statistical analysisPatients’ data were anonymized and de-identified prior to statistical analysis. The data was analyzed using the Stata1 13 software (Stata Corp, Texas). Continuous variables are presented as means and standard deviation (SD), and median with interquartile ranges where applicable.PLOS ONE | DOI:10.1371/journal.pone.0156642 June 14,3 /Baseline Predictors of Mortality in Chronic Dialysis Patients in Limpopo, South AfricaCategorical variables were presented as frequencies and percentages. Univariate analysis was performed using the independent student’s t-test, or Wilcoxon rank sum test where appropriate. Chi-squared test was used to compare categorical variables as appropriate. Kaplan-Meier survival analysis was used to determine the median time-to-survival of patients with the log rank test applied to explore significant difference in survival between dialysis modalities. Censor.
