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https://www.readbyqxmd.com/read/27796622/racial-ethnic-disparities-in-mortality-and-kidney-transplant-outcomes-among-pediatric-dialysis-patients
#1
Marciana Laster, Melissa Soohoo, Clinton Hall, Elani Streja, Connie M Rhee, Vanessa A Ravel, Uttam Reddy, Keith C Norris, Isidro B Salusky, Kamyar Kalantar-Zadeh
BACKGROUND: Previous studies in adult hemodialysis patients have shown that African-American and Hispanic patients have a lower risk of mortality in addition to a lower likelihood of kidney transplantation. However, studies of the association between race and outcomes in pediatric dialysis are sparse and often do not examine outcomes in Hispanic children. The objective was to determine if racial-ethnic disparities in mortality and kidney transplantation outcomes exist in pediatric dialysis patients...
October 29, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27753815/ssa-05-2-hypertension-and-kidney-complication-in-africa
#2
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643378/ssa-05-2-hypertension-and-kidney-complication-in-africa
#3
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27605683/early-peritonitis-in-a-large-peritoneal-dialysis-provider-system-in-colombia
#4
Edgar Vargas, Peter G Blake, Mauricio Sanabria, Alfonso Bunch, Patricia López, Jasmin Vesga, Alberto Buitrago, Kindar Astudillo, Martha Devia, Ricardo Sánchez
♦ Background: Peritonitis is the most important complication of peritoneal dialysis (PD), and early peritonitis rate is predictive of the subsequent course on PD. Our aim was to calculate the early peritonitis rate and to identify characteristics and predisposing factors in a large nationwide PD provider network in Colombia. ♦ Methods: This was a historical observational cohort study of all adult patients starting PD between January 1, 2012, and December 31, 2013, in 49 renal facilities in the Renal Therapy Services in Colombia...
September 7, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27602224/cancer-risk-in-patients-receiving-renal-replacement-therapy-a-meta-analysis-of-cohort-studies
#5
Weifeng Shang, Liu Huang, Li Li, Xiaojuan Li, Rui Zeng, Shuwang Ge, Gang Xu
It has been reported that patients receiving renal replacement therapy (RRT), including dialysis and kidney transplantation, tend to have an increased risk of cancer; however, studies on the degree of this risk have remained inconclusive. The present meta-analysis was therefore performed to quantify the cancer risk in patients with RRT. Cohort studies assessing overall cancer risk in RRT patients published before May 29, 2015 were included following systematic searches with of PubMed, EMBASE and the reference lists of the studies retrieved...
September 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27591296/delays-in-prior-living-kidney-donors-receiving-priority-on-the-transplant-waiting-list
#6
Jennifer L Wainright, David K Klassen, Anna Y Kucheryavaya, Darren E Stewart
BACKGROUND AND OBJECTIVES: Prior living donors (PLDs) receive very high priority on the Organ Procurement and Transplantation Network (OPTN) kidney waiting list. Program delays in adding PLDs to the waiting list, setting their status to active, and submitting requests for PLD priority can affect timely access to transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used the OPTN and the Centers for Medicare and Medicaid Services data to examine timing of (1) listing relative to start of dialysis, (2) activation on the waiting list, and (3) requests for PLD priority relative to listing date...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27575009/ultrafiltration-rate-and-mortality-in-maintenance-hemodialysis%C3%A2-patients
#7
Magdalene M Assimon, Julia B Wenger, Lily Wang, Jennifer E Flythe
BACKGROUND: Observational data have demonstrated an association between higher ultrafiltration rates and greater mortality among hemodialysis patients. Prior studies were small and did not consider potential differences in the association across body sizes and other related subgroups. No study has investigated ultrafiltration rates normalized to anthropometric measures beyond body weight. Also, potential methodological shortcomings in prior studies have led to questions about the veracity of the ultrafiltration rate-mortality association...
December 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27556272/an-update-on-intradialytic-cardiac-dysfunction
#8
Aghogho Odudu, Christopher W McIntyre
Cardiac dysfunction is a key factor in the high morbidity and mortality rates seen in hemodialysis (HD) patients. Much of the dysfunction is manifest as adverse changes in cardiac and vascular structure prior to commencing dialysis. This adverse vascular remodeling arises as a dysregulation between pro- and antiproliferative signaling pathways in response to hemodynamic and nonhemodynamic factors. The HD procedure itself further promotes cardiomyopathy by inducing hypotension and episodic regional cardiac ischemia that precedes global dysfunction, fibrosis, worsening symptoms, and increased mortality...
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27528373/spectrum-and-burden-of-erythropoiesis-stimulating-agent%C3%A2-hyporesponsiveness-among-contemporary-hemodialysis%C3%A2-patients
#9
Jiacong Luo, Donna E Jensen, Bradley J Maroni, Steven M Brunelli
BACKGROUND: Hemodialysis patients with erythropoiesis-stimulating agent (ESA) hyporesponsiveness have been a topic of active research. However, there have been no studies of ESA hyporesponsiveness among US patients following the dramatic change in anemia management that resulted from the 2011 changes in ESA product labeling and bundling of dialysis remuneration. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: We studied prevalent hemodialysis patients treated at a large dialysis organization in calendar years 2012 to 2013 (N=98,972)...
August 12, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27525529/thyroid-functional-disease-and-mortality-in-a-national-peritoneal-dialysis-cohort
#10
Connie M Rhee, Vanessa A Ravel, Elani Streja, Rajnish Mehrotra, Steven Kim, Jiaxi Wang, Danh V Nguyen, Csaba P Kovesdy, Gregory A Brent, Kamyar Kalantar-Zadeh
CONTEXT AND OBJECTIVE: End-stage renal disease patients have a higher risk of thyroid disease compared with those without kidney disease. Although thyroid dysfunction is associated with higher death risk in the general population and those undergoing hemodialysis, little is known about the effect of thyroid disease upon mortality in patients treated with peritoneal dialysis (PD). Design, Setting, Participants, and Main Outcome: We examined the association of thyroid status, assessed by serum TSH, with all-cause mortality among PD patients from a large national dialysis organization who underwent one or more TSH measurements over 5 years (January 2007 to December 2011)...
November 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27495761/delayed-graft-function-phenotypes-and-12-month-kidney-transplant-outcomes
#11
Isaac E Hall, Peter P Reese, Mona D Doshi, Francis L Weng, Bernd Schröppel, William S Asch, Joseph Ficek, Heather Thiessen-Philbrook, Chirag R Parikh
BACKGROUND: Ischemia-reperfusion injury (IRI) leading to delayed graft function, defined by the United Network for Organ Sharing as dialysis in the first week (UNOS-DGF), associates with poor kidney transplant outcomes. Controversies remain, however, about dialysis initiation thresholds and the utility for other criteria to denote less severe IRI, or slow graft function (SGF). METHODS: Multicenter, prospective study of deceased-donor kidney recipients to compare UNOS-DGF to a definition that combines impaired creatinine reduction in the first 48 hours or >1 dialysis session for predicting 12-month estimated glomerular filtration rate (eGFR)...
August 4, 2016: Transplantation
https://www.readbyqxmd.com/read/27469161/success-stories-showing-the-diversity-of-kidney-foundations-turkish-kidney-foundation
#12
Timur Erk
Founded in 1985, the Turkish Kidney Foundation serves the society with 3 dialysis centers and a 113-bed general hospital. Interacting with public authorities and advocating end-stage renal disease (ESRD) patients' rights are essential services of this non-governmental organization (NGO). Over the last 30 years, keeping with the trend of chronic kidney disease (CKD) in the country, the foundation raised awareness in the population for this condition and prepared an activity road map by using statistical facts and data...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27469145/burden-of-end-stage-kidney-disease-north-africa
#13
Rashad S Barsoum
Geographical, ecological, and genetic factors result in many similarities among the six main countries of the African Sahara, including the epidemiology of kidney disease. With an average incidence of 182 and prevalence of 522 patients with end-stage kidney disease (ESKD) per million population, North Africa (NA) spends $650 million on dialysis and transplantation despite an estimated annual loss of 600,000 life years. The health burden of ESKD is not limited to its directly-related morbidity and mortality but affects even more significantly other body systems, particularly the cardiovascular system...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27401689/pragmatic-trials-in-maintenance-dialysis-perspectives-from-the-kidney-health-initiative
#14
Laura M Dember, Patrick Archdeacon, Mahesh Krishnan, Eduardo Lacson, Shari M Ling, Prabir Roy-Chaudhury, Kimberly A Smith, Michael F Flessner
Pragmatic clinical trials are conducted under the real-world conditions of clinical care delivery. As a result, these trials yield findings that are highly generalizable to the nonresearch setting, identify interventions that are readily translatable into clinical practice, and cost less than trials that require extensive research infrastructures. Maintenance dialysis is a setting especially well suited for pragmatic trials because of inherently frequent and predictable patient encounters, highly granular and uniform data collection, use of electronic data systems, and delivery of care by a small number of provider organizations to approximately 90% of patients nationally...
October 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27400185/mean-platelet-volume-and-mortality-risk-in-a-national-incident-hemodialysis-cohort
#15
Steven Kim, Miklos Z Molnar, Gregg C Fonarow, Elani Streja, Jiaxi Wang, Daniel L Gillen, Rajnish Mehrotra, Steven M Brunelli, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Connie M Rhee
BACKGROUND: Higher mean platelet volume (MPV) is an indicator of larger, reactive platelets, and has been associated with a higher risk of thrombosis and cardiovascular events in the general population. Hemodialysis patients have a higher risk for cardiovascular death and predisposition to platelet dysfunction (thrombosis and bleeding diathesis), but the relationship between MPV and mortality in this population is unknown. METHODS: Among a 5-year cohort (1/2007-12/2011) of 149,118 incident hemodialysis patients from a large national dialysis organization, we examined the association between MPV and all-cause mortality...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27391198/predictive-score-for-posttransplantation-outcomes
#16
Miklos Z Molnar, Danh V Nguyen, Yanjun Chen, Vanessa Ravel, Elani Streja, Mahesh Krishnan, Csaba P Kovesdy, Rajnish Mehrotra, Kamyar Kalantar-Zadeh
BACKGROUND: Most current scoring tools to predict allograft and patient survival upon kidney transplantion are based on variables collected posttransplantation. We developed a novel score to predict posttransplant outcomes using pretransplant information including routine laboratory data available before or at the time of transplantation. METHODS: Linking the 5-year patient data of a large dialysis organization to the Scientific Registry of Transplant Recipients, we identified 15 125 hemodialysis patients who underwent first deceased transplantion...
July 7, 2016: Transplantation
https://www.readbyqxmd.com/read/27358272/serum-sodium-and-mortality-in-a-national-peritoneal-dialysis-cohort
#17
Vanessa A Ravel, Elani Streja, Rajnish Mehrotra, John J Sim, Kevin Harley, Juan Carlos Ayus, Alpesh N Amin, Steven M Brunelli, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Connie M Rhee
BACKGROUND: Sodium disarrays are common in peritoneal dialysis (PD) patients, and may be associated with adverse outcomes in this population. However, few studies of limited sample size have examined the association of serum sodium with mortality in PD patients, with inconsistent results. We hypothesized that both hypo- and hypernatremia are associated with higher death risk in a nationally representative cohort of US PD patients. METHODS: We sought to examine the association of serum sodium over time and mortality among 4687 adult incident PD patients from a large US dialysis organization who underwent one or more serum sodium measurements within the first 3 months of dialysis over January 2007 to December 2011...
June 29, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27346298/the-association-between-cinacalcet-use-and-missed-in-center-hemodialysis-treatment-rate
#18
Steven M Brunelli, Scott Sibbel, Paul J Dluzniewski, Kerry Cooper, Mark E Bensink, Brian D Bradbury
PURPOSE: Missed in-center hemodialysis treatments (MHT) are a general indicator of health status in hemodialysis patients. This analysis was conducted to estimate the association between cinacalcet use and MHT rate. METHODS: We studied patients receiving hemodialysis and prescription benefits services from a large dialysis organization. Incident cinacalcet users were propensity score matched to controls on 31 demographic, clinical, and laboratory variables. We applied inverse probability (IP) of censoring and crossover weights to account for informative censoring...
June 27, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27335126/ultrafiltration-rates-and-the-quality-incentive-program-proposed-measure-definitions-and-their-potential-dialysis-facility-implications
#19
Jennifer E Flythe, Magdalene M Assimon, Julia B Wenger, Lily Wang
BACKGROUND AND OBJECTIVES: Rapid ultrafiltration rates are associated with adverse outcomes among patients on hemodialysis. The Centers for Medicare and Medicaid Services is considering an ultrafiltration rate quality measure for the ESRD Quality Incentive Program. Two measure developers proposed ultrafiltration rate measures with different selection criteria and specifications. We aimed to compare the proposed ultrafiltration rate measures and quantify dialysis facility operational burden if treatment times were extended to lower ultrafiltration rates...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27269611/geovariation-in-fracture-risk-among-patients-receiving-hemodialysis
#20
James B Wetmore, Jiannong Liu, Heidi S Wirtz, David T Gilbertson, Kerry Cooper, Kimberly M Nieman, Allan J Collins, Brian D Bradbury
BACKGROUND AND OBJECTIVES: Fractures are a major source of morbidity and mortality in patients receiving dialysis. We sought to determine whether rates of fractures and tendon ruptures vary geographically. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data from the US Renal Data System were used to create four yearly cohorts, 2007-2010, including all eligible prevalent patients on hemodialysis in the United States on January 1 of each year. A secondary analysis comprising patients in a large dialysis organization conducted over the same period permitted inclusion of patient-level markers of mineral metabolism...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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