Journal of School of Public Health and

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Background and Aim: In many medical studies along with longitudinal data, which are repeatedly measured during a certain time period, survival data are also recorded. In these situations, using models such as, mixed effects models or GEE method for longitudinal data and Cox model for survival data, are not appropriate because some necessary assumptions are not met. Instead, the joint models have been introduced, to consider: 1- measurement error in time-dependent covariates 2-monotone and non-ignorable missing data which occurs after an event and 3- relation between longitudinal and survival outcomes, simultaneously. At this paper, joint model Puts longitudinal response (i.e. creatinine) as a time dependent variable, along with other covariates in survival sub model, to investigate dialysis patients survival. Materials and Methods: This research contained information about 417 patients affected to chronic renal failure, under treatment of continuous ambulatory peritoneal dialysis (CAPD) method. Patients were referred to three medical centers in Tehran (Shariati, Modares and Shafa) between 1997 to 2009.In this study longitudinal data and time dependent covariate were used Therefore, different variables for each person at certain time have been measured. In first some information was gathered from patient’s file, and then effective factors on survival of patients have been determined by using joint model. Results were compared with naive analysis (extended Cox model). For data analyzing, R software and significant level of 0.05 have been used. Results: with using joint model sex, age, diabetes, diastolic blood pressure, haemoglobin, urea, LdL, and creatinine covariates were significant. In extended Cox model, only age and Diastolic blood pressure covariates were considered as effective factors on hazard of death in patients. Conclusion: Joint model assess the effective factors on both endpoints simultaneously. Also it considers missing data that appeared due to an event, and covariates which were measured with error. Therefore in these cases, using joint models that led to better results and more knowledge about dieses, are necessary.

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Background and Aim: Assessing dietary intake and nutritional status of dialysis patients can be challenging. Accurate and regular assessment of patients ensures adequate macronutrient and micronutrient intake, thereby reducing morbidity and mortality and improving patients' quality of life.
Materials and Methods: A scientific search was conducted in scientific databases and search engines such as PubMed, Google scholar, Science Direct, and Scopus with the keywords dialysis, peritoneal dialysis, end-stage renal disease, renal failure, chronic kidney disease, nutritional needs, and nutritional assessment in English to find studies published between 2014 and 2024. A total of 18 articles were found and reviewed based on the inclusion criteria.
Results: The goals of medical nutrition therapy for the management of end-stage renal disease (ESRD) include the following: preventing nutritional deficiency and maintaining appropriate nutritional status (in children, growth support) through adequate intake of protein, energy, vitamins, and minerals; controlling edema and electrolyte imbalance by controlling sodium, potassium, and fluid intake; preventing or delaying the progression of renal osteodystrophy by controlling calcium, phosphorus, vitamin D, and parathyroid hormone; enabling the patient to consume a balanced diet that is appropriate to the patient's lifestyle to the extent possible; coordinating patient care with family, dietitians, nurses, and physicians; providing initial nutrition education, periodic counseling, and long-term monitoring of patients with the aim of receiving adequate education to be able to control their diet.
Conclusion: Dialysis is a treatment for the survival of patients with end-stage renal disease (ESRD), and nutritional care is an integral part of the patient's treatment process.