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Maddux Franklin

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https://www.readbyqxmd.com/read/29149476/clinical-parameters-before-and-after-the-transition-to-dialysis
#1
Dugan W Maddux, Len A Usvyat, Terry Ketchersid, Yue Jiao, Tommy C Blanchard, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
INTRODUCTION: The transition from pre-dialysis chronic kidney disease (CKD) to post-dialysis start is a critical period associated with high patient mortality and increased hospital admissions. Little is known about the trends of key clinical and laboratory parameters through this time of transition to start dialysis. METHODS: De-identified data including demographics, vital signs, lab results, and eGFR from the Fresenius Medical Care-CKD Registry were analyzed to determine trends in clinical and laboratory parameters through the time of transition from 12 months pre-dialysis start to 12 months post-dialysis start...
November 17, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28943158/dynamics-of-nutritional-competence-in-the-last-year-before-death-in-a-large-cohort-of-us-hemodialysis-patients
#2
Xiaoling Ye, Marijke J E Dekker, Franklin W Maddux, Peter Kotanko, Constantijn J A M Konings, Jochen G Raimann, Frank M van der Sande, Len A Usvyat, Jeroen P Kooman, Stephan Thijssen
OBJECTIVES: Recently, a new Nutritional Competence Score (NCS) has been shown to associate with hospitalization and outcome in hemodialysis patients. The aim of this study was to investigate the dynamics, the individual components, and the impact of hospitalizations of this score's trajectory in the year before death. In addition, we investigated whether dynamics in the NCS add additional independent prognostic value over a single cross-sectional assessment. DESIGN: We included all Fresenius Medical Care North America patients who initiated hemodialysis between January 1, 2006, and December 31, 2011 with data on all 5 NCS components (serum albumin, creatinine, phosphate, equilibrated normalized protein catabolic rate, and interdialytic weight gain) in at least 1 month...
November 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28898574/integrating-kidney-transplantation-into-value-based-care-for-people-with-renal-failure
#3
Benjamin E Hippen, Franklin W Maddux
Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28851317/the-dynamics-of-the-metabolism-of-acetate-and-bicarbonate-associated-with-use-of-hemodialysates-in-the-abchd-trial-a-phase-iv-prospective-single-center-single-blind-randomized-cross-over-two-week-investigation
#4
William B Smith, Sandy Gibson, George E Newman, Kendra S Hendon, Margarita Askelson, James Zhao, Jamil Hantash, Brigid Flanagan, John W Larkin, Len A Usvyat, Ravi I Thadhani, Franklin W Maddux
BACKGROUND: In the United States, hemodialysis (HD) is generally performed via a bicarbonate dialysate. It is not known if small amounts of acid used in dialysate to buffer the bicarbonate can meaningfully contribute to overall buffering administered during HD. We aimed to investigate the metabolism of acetate with use of two different acid buffer concentrates and determine if it effects blood bicarbonate concentrations in HD patients. METHODS: The Acid-Base Composition with use of hemoDialysates (ABChD) trial was a Phase IV, prospective, single blind, randomized, cross-over, 2 week investigation of peridialytic dynamics of acetate and bicarbonate associated with use of acid buffer concentrates...
August 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28666073/to-cool-or-too-cool-is-reducing-dialysate-temperature-the-optimal-approach-to-preventing-intradialytic-hypotension
#5
John W Larkin, Marta M Reviriego-Mendoza, Len A Usvyat, Peter Kotanko, Franklin W Maddux
Abnormal decreases in blood pressure during hemodialysis are frequent in end stage renal disease (ESRD) patients treated with hemodialysis, and thought to be largely due to an inadequate cardiovascular response to the rapid blood volume decline. Intradialytic hypotension (IDH) and cardiac instability during dialysis can increase risks for negative health consequences and is possibly preventable though several types of interventions. One intervention that holds promise for prevention of IDH in hemodialysis patients is to reduce the temperature of the dialysate to or below the patient's core temperature...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28587714/real-world-effectiveness-of-sucroferric-oxyhydroxide-in-patients-on-chronic-hemodialysis-a-retrospective-analysis-of-pharmacy-data%C3%A2
#6
Daniel W Coyne, Linda H Ficociello, Vidhya Parameswaran, Ludmila Anderson, Sharanya Vemula, Norma J Ofsthun, Claudy Mullon, Franklin W Maddux, Robert J Kossmann, Stuart M Sprague
AIMS: Hyperphosphatemia has been associated with an increased risk of mortality in patients with end-stage renal disease. We sought to assess the real-world effectiveness of sucroferric oxyhydroxide (SO), an iron-based phosphate binder (PB), in control of serum phosphorus levels, and to determine the associated pill burden in hemodialysis patients. MATERIALS AND METHODS: Adult, in-center hemodialysis patients first prescribed SO through a renal pharmacy service as part of routine clinical care between April 1, 2014 and March 31, 2015 were included in the analysis...
August 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28531888/right-trac%C3%A2-post-hospitalization-care-transitions-program-to-reduce-readmissions-for-hemodialysis-patients
#7
Rebecca L Wingard, Kathryn McDougall, Billie Axley, Andrew Howard, Cathleen O''Keefe, Nancy Armistead, Janet R Lynch, Sophia Rosen, Len Usvyat, Franklin W Maddux
BACKGROUND: Hemodialysis (HD) patients have high hospitalization rates. This nonrandomized trial tested the effect of a bundle of renal-specific "Right TraC™" strategies on 30-day all-cause readmission rates and, secondarily, 90-day readmissions and overall admissions among HD patients. METHODS: Twenty-six Fresenius clinics in West Virginia, Ohio, and Kentucky participated in the interventions. Eighteen matched clinics served as controls; intervention clinics also served as their own controls...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28416322/nephrologists-and-integrated-kidney-disease-care-roles-and-skills-essential-for-nephrologists-for-future-success
#8
Allen R Nissenson, Franklin W Maddux
As the costs of caring for patients with end-stage renal disease have grown, so has the pressure to provide high-quality care at a lower cost. Prompted in large part by regulatory and legislative changes, reimbursement is shifting from a fee-for-service environment to one of value-based payment models. Nephrologists in this new environment are increasingly responsible not only for direct patient care, but also for population management and the associated clinical outcomes for this vulnerable population. This Perspective article aims to recognize the key role and skills needed in order to successfully practice within these new value-based care models...
July 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27866964/dialysate-potassium-serum-potassium-mortality-and-arrhythmia-events-in-hemodialysis-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#9
MULTICENTER STUDY
Angelo Karaboyas, Jarcy Zee, Steven M Brunelli, Len A Usvyat, Daniel E Weiner, Franklin W Maddux, Allen R Nissenson, Michel Jadoul, Francesco Locatelli, Wolfgang C Winkelmayer, Friedrich K Port, Bruce M Robinson, Francesca Tentori
BACKGROUND: Sudden death is a leading cause of death in patients on maintenance hemodialysis therapy. During hemodialysis sessions, the gradient between serum and dialysate levels results in rapid electrolyte shifts, which may contribute to arrhythmias and sudden death. Controversies exist about the optimal electrolyte concentration in the dialysate; specifically, it is unclear whether patient outcomes differ among those treated with a dialysate potassium concentration of 3 mEq/L compared to 2 mEq/L...
February 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27789006/improving-outcomes-of-dialysis-patients-by-population-health-management-the-global-chief-medical-officer-initiative
#10
Bernard Canaud, Jörgen Hegbrant, Allen R Nissenson, Claudia Barth, Franklin Maddux, Michael Etter, Mahesh Krishnan
No abstract text is available yet for this article.
October 22, 2016: Lancet
https://www.readbyqxmd.com/read/27311528/nonvitamin-k-anticoagulant-agents-in%C3%A2-patients-with-advanced-chronic-kidney%C3%A2-disease-or-on-dialysis-with-af
#11
REVIEW
Kevin E Chan, Robert P Giugliano, Manesh R Patel, Stuart Abramson, Meg Jardine, Sophia Zhao, Vlado Perkovic, Franklin W Maddux, Jonathan P Piccini
Nonvitamin K-dependent oral anticoagulant agents (NOACs) are currently recommended for patients with atrial fibrillation at risk for stroke. As a group, NOACs significantly reduce stroke, intracranial hemorrhage, and mortality, with lower to similar major bleeding rates compared with warfarin. All NOACs are dependent on the kidney for elimination, such that patients with creatinine clearance <25 ml/min were excluded from all the pivotal phase 3 NOAC trials. It therefore remains unclear how or if NOACs should be prescribed to patients with advanced chronic kidney disease and those on dialysis...
June 21, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27080977/a-nationally-representative-study-of-calcific-uremic-arteriolopathy-risk-factors
#12
Sagar U Nigwekar, Sophia Zhao, Julia Wenger, Jeffrey L Hymes, Franklin W Maddux, Ravi I Thadhani, Kevin E Chan
Accurate identification of risk factors for calcific uremic arteriolopathy (CUA) is necessary to develop preventive strategies for this morbid disease. We investigated whether baseline factors recorded at hemodialysis initiation would identify patients at risk for future CUA in a matched case-control study using data from a large dialysis organization. Hemodialysis patients with newly diagnosed CUA (n=1030) between January 1, 2010, and December 31, 2014, were matched by age, sex, and race in a 1:2 ratio to hemodialysis patients without CUA (n=2060)...
November 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26958348/implementation-of-routine-foot-check-in-patients-with-diabetes-on-hemodialysis-associations-with-outcomes
#13
Andreja Marn Pernat, Vanja Peršič, Len Usvyat, Lynn Saunders, John Rogus, Franklin W Maddux, Eduardo Lacson, Peter Kotanko
OBJECTIVE: Patients with diabetes are at increased risk of foot ulcers, which may result in limb amputations. While regular foot care prevents ulcerations and amputation in those patients with diabetes not on dialysis, evidence is limited in diabetic hemodialysis patients. We investigated the association between the implementation of a routine foot check program in diabetic incident hemodialysis patients, and major lower limb amputations. METHODS: In 1/2008, monthly intradialytic foot checks were implemented as part of standard clinic care in all Fresenius Medical Care North America hemodialysis facilities...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/26858140/doing-more-than-caring-about-quality
#14
Franklin W Maddux
The treatment of chronically ill patients with end stage renal disease (ESRD) receiving dialysis therapies has advanced greatly over the years and accomplished many successes in prolonging the life of patients with ESRD, yet has had considerable failures due to the inability to compensate for all functions of the kidneys. In addition, the focus to achieve quality goals for laboratories and vascular access measures may indicate a good quality of care from providers, but meeting these clinical and physiological goals may not fully maximize individual benefit to a patient, may not be aligned with the patient's care goals, and could conceivably impact negatively the patient's experience of care and quality of life...
March 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/26833299/effects-of-renal-care-coordinator-case-management-on-outcomes-in-incident-dialysis-patients
#15
COMPARATIVE STUDY
Dugan W Maddux, Len A Usvyat, Daniel DeFalco, Peter Kotanko, Jeroen P Kooman, Frank M van der Sande, Franklin W Maddux
BACKGROUND: Pre-dialysis chronic kidney disease (CKD) care impacts dialysis start and incident dialysis outcomes. We describe the use of late stage CKD population data coupled with CKD case management to improve dialysis start. METHODS: The Renal Care Coordinator (RCC) program is a nephrology practice and Fresenius Medical Care North America (FMCNA) partnership involving a case manager resource and data analytics. We studied patients starting dialysis between August 1, 2009 and February 28, 2013 in 9 nephrology practices partnering in the RCC program...
March 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/26185260/nutritional-competence-and-resilience-among-hemodialysis-patients-in-the-setting-of-dialysis-initiation-and-hospitalization
#16
Stephan Thijssen, Michelle M Y Wong, Len A Usvyat, Qingqing Xiao, Peter Kotanko, Franklin W Maddux
BACKGROUND AND OBJECTIVES: Dialysis patients have a high risk for inadequate nutrition. Their nutritional status is particularly susceptible to deterioration when faced with intercurrent events such as hospitalization. This study was conducted to improve the understanding of the temporal evolution of nutritional parameters as a foundation for rational and proactive nutritional intervention. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective cohort study was performed to investigate the temporal evolution of nutritional parameters (serum albumin, serum phosphate, serum creatinine, equilibrated normalized protein catabolic rate, and interdialytic weight gain) and a composite nutritional score derived from these parameters, in two populations: (1) incident hemodialysis (HD) patients who started HD between January 2006 and December 2011 and were followed for up to 54 months (median 16...
September 4, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26044799/quality-of-life-in-dialysis-patients-a-retrospective-cohort-study
#17
Natascha J H Broers, Len A Usvyat, Jeroen P Kooman, Frank M van der Sande, Eduardo Lacson, Peter Kotanko, Franklin W Maddux
BACKGROUND/AIM: Physical component summary (PCS) and mental component summary (MCS) scores are associated with hospitalization and mortality in patients with end-stage renal disease. Most studies in these patients are cross-sectional in nature. This study aimed to assess the dynamics of health-related quality of life (HRQOL) over time, as well as determinants of changes in HRQOL. Also, the relation between changes in HRQOL with respect to both hospitalization and mortality was assessed...
2015: Nephron
https://www.readbyqxmd.com/read/26003780/peer-kidney-care-initiative-2014-report-dialysis-care-and-outcomes-in-the-united-states
#18
Eric Weinhandl, Edward Constantini, Susan Everson, David Gilbertson, Suying Li, Craig Solid, Michael Anger, J Ganesh Bhat, Peter DeOreo, Mahesh Krishnan, Allen Nissenson, Doug Johnson, T Alp Ikizler, Franklin Maddux, John Sadler, Leanna Tyshler, Tom Parker, Brigitte Schiller, Barry Smith, Stan Lindenfeld, Allan J Collins
No abstract text is available yet for this article.
June 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/25965145/the-glycemic-indices-in-dialysis-evaluation-gide-study-comparative-measures-of-glycemic-control-in-diabetic-dialysis-patients
#19
Mark E Williams, Neal Mittman, Lin Ma, Julia I Brennan, Ann Mooney, Curtis D Johnson, Chinu M Jani, Franklin W Maddux, Eduardo Lacson
The validity of hemoglobin A1c (HgbA1c) is undergoing increasing scrutiny in the advanced CKD/ESRD (chronic kidney disease/end-stage renal disease) population, where it appears to be discordant from other glycemic indices. In the Glycemic Indices in Dialysis Evaluation (GIDE) Study, we sought to assess correlation of HgbA1c with casual glucose, glycated albumin, and serum fructosamine in a large group of diabetic patients on dialysis. From 26 dialysis facilities in the United States, 1758 diabetic patients (hemodialysis = 1476, peritoneal dialysis = 282) were enrolled in the first quarter of 2013...
October 2015: Hemodialysis International
https://www.readbyqxmd.com/read/25882830/heritability-of-risk-for-sudden-cardiac-arrest-in-esrd
#20
Kevin E Chan, Christopher Newton-Cheh, James F Gusella, Franklin W Maddux
Patients on dialysis are 20 times more likely to have a cardiac arrest compared with the general population. We considered whether inherited factors associate with cardiac arrest among patients on dialysis. From a sample of 647,457 patients on chronic dialysis, we identified 5117 pairs of patients who came from the same family. These patients were each matched to a control subject from the same population. McNemar's tests were used to compare the risk of cardiac arrest between the familial related and unrelated pairs...
November 2015: Journal of the American Society of Nephrology: JASN
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