The association between embedded catheter implantation and hospitalization costs for peritoneal dialysis initiation: a retrospective cohort study

Background: Compared with the conventional peritoneal dialysis (PD) catheter insertion, embedding PD catheter implantation is one of the procedures for planned PD initiation. However, facilities where embedded PD catheter implantation is available are limited, and the impact of embedded PD catheter implantation on hospitalization cost and length of hospitalization is unknown. Methods: This retrospective single-center cohort study included 132 patients with PD initiation between 2005 and 2020. The patients were divided into two groups: 64 patients in the embedding group and 68 patients in the conventional insertion group. We created a multivariable generalized linear model (GLM) with the gamma family and log-link function to evaluate the association among catheter embedding, the duration and medical costs of hospitalization for PD initiation. We also evaluated the effect modification between age and catheter embedding. Results: Catheter embedding (β coefficient − 0.13 [95% confidence interval − 0.21, − 0.05]) and age (per 10 years 0.08 [0.03, 0.14]) were significantly associated with hospitalization costs. Catheter embedding (− 0.21 [− 0.32, − 0.10]) and age (0.11 [0.03, 0.19]) were also identified as factors significantly associated with length of hospitalization. The difference between the embedding group and the conventional insertion group in hospitalization costs for PD initiation (P for interaction = 0.060) and the length of hospitalization (P for interaction = 0.027) was larger in young-to-middle-aged patients than in elderly patients. Conclusions: Catheter embedding was associated with lower hospitalization cost and shorter length of hospitalization for PD initiation than conventional PD catheter insertion, especially in young-to-middle-aged patients.The version of record of this article, first published in Clinical and Experimental Nephrology, is available online at Publisher’s website: https://doi.org/10.1007/s10157-023-02416-

Interrelation between ice nucleation and condensation

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Sublimation et congélation de l'eau par des noyaux d'iodure d'argent

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Relation between ice-forming ability and conditions of formation of silver iodide nuclei

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The effect of small topographic variations on reflectance

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Molecular dissipation of turbulent fluctuations in the convective mixed layer Part II : height variations of characteristic time scales and experimental test of molecular dissipation models

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Sulfur emission, CNN, clouds and climate : a review

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Molecular dissipation of turbulent fluctuations in the convective mixed layer Part I : height variations of dissipation rates

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Radiative transfer in multifractal clouds

International audienceWe studied effects of the cloud inhomogeneity in subcloud scale on the reflectance, transmittance, and absorptance of two-dimensional, inhomogeneous clouds. We generated the inhomogeneous clouds as multifractal clouds with a lognormal multiplicative process. For such clouds, the information codimension C• is a measure of the cloud inhomogeneity. Radiative transfer through the multifractal clouds was computed with a discrete angle radiative transfer model. The average reflectance, transmittance, and absorptance of multifractal clouds with a given codimension were estimated as averages of 200 realizations. They were computed for different sets of the C• parameter, cloud total optical thickness, and asymmetry factor of cloud scatterers. An effective optical thickness of inhomogeneous clouds was defined empirically in the framework of a homogeneous, plane parallel cloud model. Consequently, computation of radiative flux in an inhomogeneous cloud could be transformed into that of an equivalent homogeneous, plane parallel cloud. For a two-dimensional, inhomogeneous, absorbing cloud we found that an inhomogeneous cloud absorbs generally less energy than its homogeneous counterpart. An exception was found for inhomogeneous clouds characterized by a small information codimension, a large cloud optical thickness, and a large single-scattering albedo and for which absorptance is much larger than for their homogeneous counterpart. However, this increase was less than 5% of the homogeneous cloud absorptance. The use of the effective optical thickness also enabled us to treat an inhomogeneous absorbing cloud as an equivalent homogeneous absorbing cloud and to estimate the radiative flux of the equivalent homogeneous cloud as an approximation to the one in the inhomogeneous cloud. We found no immediate need to conceive of a direct effect of the cloud inhomogeneity on the single-scattering albedo, as far as we considered this treatment as a first-order approximation. We discussed the use of the effective optical thickness in twostream radiative approximations. We also compared our results with those based on the independent pixel approximation