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Effect of altitude on mortality of end-stage renal disease patients on hemodialysis in Peru

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dc.contributor.author Bravo-Jaimes, Katia
dc.contributor.author Loescher, Viky Y.
dc.contributor.author Canelo-Aybar, Carlos
dc.contributor.author Rojas-Camayo, Jose
dc.contributor.author Mejia, Christian R.
dc.contributor.author Schult, Sandra
dc.contributor.author Nieto, Ruben
dc.contributor.author Singh, Kyra
dc.contributor.author Messing, Susan
dc.contributor.author Hinostroza, Juana
dc.date.accessioned 2021-04-13T20:51:04Z
dc.date.available 2021-04-13T20:51:04Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/9228
dc.description.abstract Background: In Latin America, the prevalence of end-stage kidney disease (ESKD) has risen tremendously during the last decade. Previous studies have suggested that receiving dialysis at high altitude confers mortality benefits; however, this effect has not been demonstrated at >2000 m above sea level (masl) or in developing countries. Methods: This historical cohort study analyzed medical records from six Peruvian hemodialysis (HD) centers located at altitudes ranging from 44 to 3827 masl. Adult ESKD patients who started maintenance HD between 2000 and 2010 were included. Patients were classified into two strata based on the elevation above sea level of their city of residence: low altitude (<2000 masl) and high altitude (≥2000 masl). Death from any cause was collected from national registries and Cox proportional hazards models were built. Results: A total of 720 patients were enrolled and 163 (22.6%) resided at high altitude. The low-altitude group was significantly younger, more likely to have diabetes or glomerulonephritis as the cause of ESKD and higher hemoglobin. The all-cause mortality rate was 84.3 per 1000 person-years. In the unadjusted Cox model, no mortality difference was found between the high- and low-altitude groups {hazard ratio [HR] 1.20 [95% confidence interval (CI) 0.89-1.62]}. After multivariable adjustment, receiving HD at high altitude was not significantly associated with higher mortality, but those with diabetes as the cause of ESKD had significantly higher mortality [HR 2.50 (95% CI 1.36-4.59)]. Conclusions: In Peru, patients receiving HD at high altitudes do not have mortality benefits. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Clinical Kidney Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject altitude en_US
dc.subject anemia en_US
dc.subject chronic hemodialysis en_US
dc.subject chronic hypoxia en_US
dc.subject mortality en_US
dc.title Effect of altitude on mortality of end-stage renal disease patients on hemodialysis in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/ckj/sfaa056
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.20
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.13
dc.relation.issn 2048-8513


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