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https://www.readbyqxmd.com/read/29740879/return-on-investment-for-financial-assistance-for-living-kidney-donors-in-the-u-s
#1
Amit K Mathur, Jiawei Xing, David M Dickinson, Patricia H Warren, Kimberly A Gifford, Barry A Hong, Akinlolu Ojo, Robert M Merion
BACKGROUND: The National Living Donor Assistance Center (NLDAC) enables living donor kidney transplants through financial assistance of living donors, but its return on investment (ROI) through savings on dialysis costs remains unknown. METHODS: We retrospectively reviewed 2012-2015 data from NLDAC, the United States Renal Data System, and the Scientific Registry of Transplant Recipients to construct 1-year, 3-year, and 5-year ROI models based on NLDAC applications and national dialysis and transplant cost data...
May 8, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29737013/incremental-dialysis-for-preserving-residual-kidney-function-does-one-size-fit-all-when-initiating-dialysis
#2
Anna T Mathew, Yoshitsugu Obi, Connie M Rhee, Jason A Chou, Kamyar Kalantar-Zadeh
While many patients have substantial residual kidney function (RKF) when initiating hemodialysis (HD), most patients with end stage renal disease in the United States are initiated on 3-times per week conventional HD regimen, with little regard to RKF or patient preference. RKF is associated with many benefits including survival, volume control, solute clearance, and reduced inflammation. Several strategies have been recommended to preserve RKF after HD initiation, including an incremental approach to HD initiation...
May 7, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29730345/hemiarch-reconstruction-vs-clamped-aortic-anastomosis-for-concomitant-ascending-aortic-aneurysm
#3
Ibrahim Sultan, Valentino Bianco, Ibrahim Yajzi, Arman Kilic, Keith Dufendach, Arturo Cardounel, Andrew D Althouse, Ahmad Masri, Forozan Navid, Thomas G Gleason
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is often avoided in patients with concomitant ascending aortic pathology when treating other cardiac disease to avoid increased risk of morbidity and mortality. We hypothesized that the use of DHCA with retrograde cerebral perfusion (RCP) does not add incremental risk to ascending aortic replacement alone in the setting of concomitant cardiac surgery. METHODS: 408 ascending aortic ± hemiarch replacements and aortic (root)/mitral/tricuspid valve(s), CABG, or MAZE procedures were performed for concomitant cardiac disease...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29728200/thyroid-status-and-death-risk-in-us-veterans-with-chronic-kidney-disease
#4
Connie M Rhee, Kamyar Kalantar-Zadeh, Vanessa Ravel, Elani Streja, Amy S You, Steven M Brunelli, Danh V Nguyen, Gregory A Brent, Csaba P Kovesdy
OBJECTIVE: Given that patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) have a disproportionately higher prevalence of hypothyroidism compared with their non-CKD counterparts, we sought to determine the association between thyroid status, defined by serum thyrotropin (TSH) levels, and mortality among a national cohort of patients with NDD-CKD. PATIENTS AND METHODS: Among 227,422 US veterans with stage 3 NDD-CKD with 1 or more TSH measurements during the period October 1, 2004, to September 30, 2012, we first examined the association of thyroid status, defined by TSH categories of less than 0...
May 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29688512/greater-fluid-overload-and-lower-interdialytic-weight-gain-are-independently-associated-with-mortality-in-a-large-international-hemodialysis-population
#5
Manfred Hecking, Ulrich Moissl, Bernd Genser, Hugh Rayner, Indranil Dasgupta, Stefano Stuard, Andrea Stopper, Charles Chazot, Franklin W Maddux, Bernard Canaud, Friedrich K Port, Carmine Zoccali, Peter Wabel
Background: Fluid overload and interdialytic weight gain (IDWG) are discrete components of the dynamic fluid balance in haemodialysis patients. We aimed to disentangle their relationship, and the prognostic importance of two clinically distinct, bioimpedance spectroscopy (BIS)-derived measures, pre-dialysis and post-dialysis fluid overload (FOpre and FOpost) versus IDWG. Methods: We conducted a retrospective cohort study on 38 614 incident patients with one or more BIS measurement within 90 days of haemodialysis initiation (1 October 2010 through 28 February 2015)...
April 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29677068/health-care-costs-for-the-evaluation-surgery-and-follow-up-care-of-living-kidney-donors
#6
Steven Habbous, Sisira Sarma, Lianne Barnieh, Eric McArthur, Scott Klarenbach, Braden Manns, Mehmet A Begen, Krista L Lentine, Amit X Garg
BACKGROUND: The health care costs to evaluate, perform surgery, and follow a living kidney donor for the year after donation are poorly described. METHODS: We obtained information on the health care costs of 1099 living kidney donors between April 1, 2004 and March 31, 2014 from Ontario, Canada using comprehensive health care administrative databases. We estimated the cost of 3 periods of the living donation process: the predonation evaluation period (start of evaluation until the day before donation), perioperative period (day of donation until 30-days postdonation), and 1 year of follow-up period (after perioperative period until 1-year postdonation)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29606268/-incremental-haemodialysis
#7
Cécile Courivaud
The majority of incidental haemodialysis patients are systematically treated at the rate of three sessions per week, regardless of their level of residual kidney function. Incremental haemodialysis is a therapeutic strategy adapted to the residual kidney function level of each patient, to offer patients only the "dialysis dose" needed to supplement their residual kidney function, while ensuring that they achieve the objective of total clearance (renal+per-HD) recommended (weekly Standard Kt/V urea>2...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29601230/test-retest-reliability-validation-and-minimal-detectable-change-scores-for-frequently-reported-tests-of-objective-physical-function-in-patients-with-non-dialysis-chronic-kidney-disease
#8
Thomas J Wilkinson, Soteris Xenophontos, Douglas W Gould, Barbara P Vogt, João L Viana, Alice C Smith, Emma L Watson
Physical function is an important outcome in chronic kidney disease (CKD). We aimed to establish the reliability, validity, and the "minimal detectable change" (MDC) of several common tests used in renal rehabilitation and research. In a repeated measures design, 41 patients with CKD not requiring dialysis (stage 3b to 5) were assessed at an interval of 6 weeks. The tests were the incremental shuttle walk test (ISWT), "sit-to-stand" (STS) test, estimated 1 repetition maximum for quadriceps strength (e1RM), and VO2peak by cardiopulmonary exercise testing (CPET)...
March 30, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29584720/cost-effectiveness-of-multidisciplinary-care-in-mild-to-moderate-chronic-kidney-disease-in-the-united-states-a-modeling-study
#9
Eugene Lin, Glenn M Chertow, Brandon Yan, Elizabeth Malcolm, Jeremy D Goldhaber-Fiebert
BACKGROUND: Multidisciplinary care (MDC) programs have been proposed as a way to alleviate the cost and morbidity associated with chronic kidney disease (CKD) in the US. METHODS AND FINDINGS: We assessed the cost-effectiveness of a theoretical Medicare-based MDC program for CKD compared to usual CKD care in Medicare beneficiaries with stage 3 and 4 CKD between 45 and 84 years old in the US. The program used nephrologists, advanced practitioners, educators, dieticians, and social workers...
March 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29566839/cost-effectiveness-of-first-line-sevelamer-and-lanthanum-versus-calcium-based-binders-for-hyperphosphatemia-of-chronic-kidney-disease
#10
COMPARATIVE STUDY
Steven Habbous, Sebastian Przech, Janet Martin, Amit X Garg, Sisira Sarma
BACKGROUND: Phosphate binders are used to treat hyperphosphatemia among patients with chronic kidney disease (CKD). OBJECTIVES: To conduct an economic evaluation comparing calcium-free binders sevelamer and lanthanum with calcium-based binders for patients with CKD. METHODS: Effectiveness data were obtained from a recent meta-analysis of randomized trials. Effectiveness was measured as life-years gained and translated to quality-adjusted life-years (QALYs) using utility weights from the literature...
March 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29543897/cost-effectiveness-analysis-of-elbasvir-grazoprevir-regimen-for-treating-hepatitis-c-virus-genotype-1-infection-in-stage-4-5-chronic-kidney-disease-patients-in-france
#11
Franck Maunoury, Aurore Clément, Chizoba Nwankwo, Laurie Levy-Bachelot, Armand Abergel, Vincent Di Martino, Eric Thervet, Isabelle Durand-Zaleski
OBJECTIVE: To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. DESIGN: This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context...
2018: PloS One
https://www.readbyqxmd.com/read/29532495/clinical-predictors-and-outcomes-of-patients-with-pericardial-effusion-in-chronic-kidney-disease
#12
Venkatesh Ravi, Fady Iskander, Abhimanyu Saini, Carolyn Brecklin, Rami Doukky
BACKGROUND: Pericardial effusion is common in hospitalized patients with chronic kidney disease (CKD). We sought to identify predictors and prognostic impact of pericardial effusion in CKD patients. HYPOTHESIS: Clinical and biochemical parameters can predict pericardial effusion in CKD patients. METHODS: In a retrospective nested case-control design, we analyzed hospitalized adult patients with CKD stage 4, 5, or end-stage renal disease diagnosed with pericardial effusion...
March 13, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29530443/post-depositional-behaviour-of-mercury-and-arsenic-in-submarine-mine-tailings-deposited-in-buyat-bay-north-sulawesi-indonesia
#13
Thomas Shepherd, Inneke Rumengan, Ali Sahami
The post-depositional geochemical behaviour of mercury and arsenic in submarine mine tailings from the Mesel Gold Mine in Buyat Bay, North Sulawesi, Indonesia was assessed by in situ sampling of tailings porewaters using dialysis arrays and seawater and fish monitoring. Under steady-state conditions one year after cessation of tailings discharge, the calculated arsenic efflux incrementally added 0.8 μg/L of arsenic to the overlying seawater. The mercury efflux across the tailings-seawater interface was negligible...
June 2018: Marine Environmental Research
https://www.readbyqxmd.com/read/29525394/a-population-based-cohort-study-defines-prognoses-in-severe-chronic-kidney-disease
#14
Marcello Tonelli, Natasha Wiebe, Matthew T James, Scott W Klarenbach, Braden J Manns, Pietro Ravani, Giovanni F M Strippoli, Brenda R Hemmelgarn
In older people with chronic kidney disease (CKD) and comorbidities, the risk of death or disability may overshadow the risk of kidney failure. To help refine this we did a retrospective population-based cohort study to evaluate the relative likelihood of adverse outcomes as functions of age and comorbidity burden among 47,228 adults with severe non-dialysis dependent CKD. We identified comorbidities using 29 validated algorithms applied to administrative data and assessed death, end-stage renal disease (ESRD), cardiovascular disease (CVD) events, and long-term care...
May 2018: Kidney International
https://www.readbyqxmd.com/read/29519952/association-of-fgf-2-concentrations-with-atheroma-progression-in-chronic-kidney-disease-patients
#15
Milica Bozic, Angels Betriu, Marcelino Bermudez-Lopez, Alberto Ortiz, Elvira Fernandez, Jose M Valdivielso
BACKGROUND AND OBJECTIVES: Atherosclerosis is highly prevalent in CKD. The rate of progression of atherosclerosis is associated with cardiovascular events. Fibroblast growth factor 2 (FGF-2) is a member of the FGF family with potentially both protective and deleterious effects in the development of atherosclerosis. The role of circulating FGF-2 levels in the progression of atherosclerosis in CKD is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used a multicenter, prospective, observational cohorts study of 481 patients with CKD...
April 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29513372/the-opportunity-costs-of-kidney-transplantation
#16
EDITORIAL
C L Jay, M M Abecassis
No abstract text is available yet for this article.
May 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29494637/individualized-prediction-of-mortality-using-multiple-inflammatory-markers-in-patients-on-dialysis
#17
Hee-Yeon Jung, Su Hee Kim, Hye Min Jang, Sukyung Lee, Yon Su Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Ji-Young Choi, Jang-Hee Cho, Chan-Duck Kim, Sun-Hee Park, Yong-Lim Kim
This study aimed to evaluate whether the combination of inflammatory markers could provide predictive powers for mortality in individual patients on dialysis and develop a predictive model for mortality according to dialysis modality. Data for inflammatory markers were obtained at the time of enrollment from 3,309 patients on dialysis from a prospective multicenter cohort. Net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated. Cox proportional hazards regression analysis was used to derive a prediction model of mortality and the integrated area under the curve (iAUC) was calculated to compare the predictive accuracy of the models...
2018: PloS One
https://www.readbyqxmd.com/read/29478058/visions-in-a-crystal-ball-the-future-of-peritoneal-dialysis
#18
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
2018: Blood Purification
https://www.readbyqxmd.com/read/29471458/pro-the-rationale-for-dietary-therapy-for-patients-with-advanced-chronic-kidney-disease
#19
Joel D Kopple, Denis Fouque
Dietary treatment offers many benefits to patients with advanced chronic kidney disease (CKD) who are approaching the need for renal replacement therapy. A large number of these benefits are independent of whether diets slow the rate of progression of CKD. These diets are low in protein and many minerals, and provide adequate energy for the CKD patient. The diets can reduce accumulation of potentially toxic metabolic products derived from protein and amino acid degradation, maintain a healthier balance of body water, sodium, potassium, phosphorus, calcium and other minerals, and prevent or improve protein-energy wasting...
March 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29466361/is-there-relationship-between-epicardial-fat-and-cardiovascular-parameters-in-incident-kidney-transplant-patients-a-post-hoc-analysis
#20
RANDOMIZED CONTROLLED TRIAL
Daniel Constantino Yazbek, Aluizio Barbosa Carvalho, Cinara Sa Barros, Jose Osmar Medina Pestana, Carlos Eduardo Rochitte, Raul Dias Dos Santos Filho, Maria Eugênia F Canziani
BACKGROUND: Epicardial fat (EF) has been related to increased cardiovascular risk in chronic kidney disease patients. Kidney transplantation is associated with weight gain, especially within the first 12 months. Recently an association between EF and left ventricular mass (LVM) has been suggested in kidney transplant (KTX) recipients. OBJECTIVE: Evaluate the EF in KTX recipients and its association with cardiovascular parameters in a 12-month follow-up study. METHODS: EF volume was determined using thoracic computed tomography...
2018: PloS One
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