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DOPPS vascular

Leoné Malan, Mark Hamer, Roland von Känel, Markus P Schlaich, Manja Reimann, Nancy Frasure-Smith, Gavin W Lambert, Walthard Vilser, Brian H Harvey, Faans Steyn, Nico T Malan
BACKGROUND: Depression has been associated with impaired nitric oxide (NO)-mediated vasodilation and vascular dysregulation (VD). Whether depression and NO levels will disturb retinal haemodynamics is not clear. OBJECTIVES AND METHODS: Associations between the retinal vasculature, diastolic ocular perfusion pressure (DOPP) as measure of hypoperfusion, NO metabolites (NOx) and depression symptoms were assessed. Chronic VD risk markers [depression symptoms (Patient Health Questionnaire/PHQ-9 ≥ 10) and 24 h pulse pressure] were determined in a bi-ethnic cohort (n = 313; 48...
May 1, 2016: Nitric Oxide: Biology and Chemistry
Ronald L Pisoni, Lindsay Zepel, Friedrich K Port, Bruce M Robinson
BACKGROUND: Since the bundled end-stage renal disease prospective payment system began in 2011 in the United States, some hemodialysis practices have changed substantially, raising the question of whether vascular access practice also has changed. We describe monthly US vascular access use from August 2010 to August 2013 with international comparisons, and other aspects of US vascular access practice. STUDY DESIGN: Prospective observational cohort study of vascular access...
June 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jürgen Floege, Iain A Gillespie, Florian Kronenberg, Stefan D Anker, Ioanna Gioni, Sharon Richards, Ronald L Pisoni, Bruce M Robinson, Daniele Marcelli, Marc Froissart, Kai-Uwe Eckardt
Although mortality risk scores for chronic hemodialysis (HD) patients should have an important role in clinical decision-making, those currently available have limited applicability, robustness, and generalizability. Here we applied a modified Framingham Heart Study approach to derive 1- and 2-year all-cause mortality risk scores using a 11,508 European incident HD patient database (AROii) recruited between 2007 and 2009. This scoring model was validated externally using similar-sized Dialysis Outcomes and Practice Patterns Survey (DOPPS) data...
May 2015: Kidney International
Manabu Asano, Jyothi Thumma, Kenichi Oguchi, Ronald L Pisoni, Tadao Akizawa, Takashi Akiba, Shunichi Fukuhara, Kiyoshi Kurokawa, Jean Ethier, Rajiv Saran, Akira Saito
BACKGROUND: Vascular access (VA) guidelines recommend the native arteriovenous fistula (AVF) as VA of first choice for chronic hemodialysis patients. AVF management is important in hemodialysis patient care. AVF survival is associated with various physical factors, but the effects of dialysis treatment factors upon AVF survival are still not clear. METHODS: Study patients were treated at 498 dialysis facilities participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) 2 or 3 (2002-2007)...
2013: Nephron. Clinical Practice
Pietro Ravani, Brenda W Gillespie, Robert Ross Quinn, Jennifer MacRae, Braden Manns, David Mendelssohn, Marcello Tonelli, Brenda Hemmelgarn, Matthew James, Neesh Pannu, Bruce M Robinson, Xin Zhang, Ronald Pisoni
Vascular access complications are a major cause of morbidity in patients undergoing hemodialysis, and determining how the risks of different complications vary over the life of an access may benefit the design of prevention strategies. We used data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) to assess the temporal profiles of risks for infectious and noninfectious complications of fistulas, grafts, and tunneled catheters in incident hemodialysis patients. We used longitudinal data to model time from access placement or successful treatment of a previous complication to subsequent complication and considered multiple accesses per patient and repeated access complications using baseline and time-varying covariates to obtain adjusted estimates...
October 2013: Journal of the American Society of Nephrology: JASN
Rachel B Fissell, Douglas S Fuller, Hal Morgenstern, Brenda W Gillespie, David C Mendelssohn, Hugh C Rayner, Bruce M Robinson, Dori Schatell, Hideki Kawanishi, Ronald L Pisoni
PURPOSE: Catheters are associated with worse clinical outcomes than fistulas and grafts in hemodialysis (HD) patients. One potential modifier of patient vascular access (VA) use is patient preference for a particular VA type. The purpose of this study is to identify predictors of patient VA preference that could be used to improve patient care. METHODS: This study uses a cross-sectional sample of data from the Dialysis Outcomes and Practice Patterns Study (DOPPS 3, 2005-09), that includes 3815 HD patients from 224 facilities in 12 countries...
July 2013: Journal of Vascular Access
John M Dopp, Alexei V Agapitov, Christine A Sinkey, William G Haynes, Bradley G Phillips
BACKGROUND: Sildenafil, a selective phosphodiesterase-type-5 (PDE-5) inhibitor, produces vasodilation that improves erectile dysfunction and pulmonary hypertension. Sildenafil could also cause baroreflex sympathetic activation that would enhance vascular tone and oppose direct vasodilation. We tested the hypothesis that sildenafil administration increases sympathetically mediated vascular tone in healthy middle-aged men. METHODS: We randomized 9 healthy, middle-aged, male volunteers (mean age 45±2 years) in a double-blind, crossover fashion to receive a single oral dose of sildenafil 100mg or placebo on 2 separate study days...
June 2013: American Journal of Hypertension
Jeffrey Perl, Jinyao Zhang, Brenda Gillespie, Bjorn Wikström, Joan Fort, Takeshi Hasegawa, Douglas S Fuller, Ronald L Pisoni, Bruce M Robinson, Francesca Tentori
BACKGROUND: Although dialysis after kidney transplant failure (TF) is common, the outcomes of these patients remain unclear. We compared outcomes of TF patients with transplant-naïve (TN) patients wait-listed for kidney transplantation. METHODS: We used data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), including laboratory markers and health-related quality of life (HR-QOL). Mortality and hospitalization of participants with one prior TF versus TN patients were compared using the Cox regression analysis...
December 2012: Nephrology, Dialysis, Transplantation
Clare Castledine, Dirk van Schalkwyk, Terry Feest
INTRODUCTION: The type of vascular access used by haemodialysis patients is thought to be one of the predictors of patient survival. However, many previous studies have been unable to separate the effect of access type from the effects of other differences between patients groups or have included incident patients. Some centres report excellent outcomes using dialysis catheters in stable prevalent patients and challenge the current guidelines about the use of long term catheters. This is an observational UK centre level study reporting on the relationship between the percentage of established prevalent patients using definitive access and the subsequent 1 year survival...
2011: Nephron. Clinical Practice
John M Dopp, Nathan R Philippi, Noah J Marcus, E Burt Olson, Cynthia E Bird, John J M Moran, Scott W Mueller, Barbara J Morgan
BACKGROUND: Xanthine oxidase is a major source of superoxide in the vascular endothelium. Previous work in humans demonstrated improved conduit artery function following xanthine oxidase inhibition in patients with obstructive sleep apnea. OBJECTIVES: To determine whether impairments in endothelium-dependent vasodilation produced by exposure to chronic intermittent hypoxia are prevented by in vivo treatment with allopurinol, a xanthine oxidase inhibitor. METHODS: Sprague-Dawley rats received allopurinol (65 mg/kg/day) or vehicle via oral gavage...
2011: Respiration; International Review of Thoracic Diseases
Bruce Robinson, Douglas Fuller, Dawn Zinsser, Justin Albert, Brenda Gillespie, Francesca Tentori, Marc Turenne, Friedrich Port, Ronald Pisoni
A new initiative of the US Dialysis Outcomes and Practice Patterns Study (DOPPS), the DOPPS Practice Monitor (DPM), provides up-to-date data and analyses to monitor trends in dialysis practice during implementation of the new Centers for Medicare & Medicaid Services (CMS) end-stage renal disease Prospective Payment System (PPS; 2011-2014). We review DPM rationale, design, sampling approach, analytic methods, and facility sample characteristics. Using stratified random sampling, the sample of ~145 US facilities provides results representative nationally and by facility type (dialysis organization size, rural/urban, free standing/hospital based), achieving coverage similar to the CMS sample frame at average values and tails of the distributions for key measures and patient characteristics...
June 2011: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Fernando Galassi, Barbara Giambene, Roberta Varriale
PURPOSE: To investigate the influence of systemic vascular dysregulation on retrobulbar hemodynamics in normal-tension glaucoma (NTG). METHODS: Forty-four untreated patients with NTG and 40 healthy controls matched for age, sex, and intraocular pressure were included. Cold-induced nailfold capillaroscopic features, mean and diastolic ocular perfusion pressures (mOPP, dOPP), endothelin-1 (ET-1) and nitric oxide markers, as nitrates (NO(2)), plasma values were recorded...
June 2011: Investigative Ophthalmology & Visual Science
David A Goodkin, Ronald L Pisoni, Francesco Locatelli, Friedrich K Port, Rajiv Saran
Recognizing that autologous arteriovenous fistula use was associated with improved outcomes in hemodialysis patients, the 1997 Dialysis Outcomes Quality Initiative (DOQI) vascular access practice guidelines from the National Kidney Foundation stressed fistulas as the optimal means of dialysis vascular access. In the United States, this emphasis has continued with the Fistula First Breakthrough Initiative. Much of the data supporting fistulas for dialysis access are derived from longitudinal cohorts, including the Dialysis Outcomes and Practice Patterns Study (DOPPS), dialysis provider databases, and other sources...
December 2010: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rahn Ilsar, Chirapan Chawantanpipat, Kim H Chan, Timothy A Dobbins, Richard Waugh, Annemarie Hennessy, David S Celermajer, Martin K C Ng
BACKGROUND: Despite increasing evidence implicating the pulmonary microcirculation in the pathogenesis of lung conditions such as pulmonary vascular disease, there remain few methods for its evaluation in vivo. We recently demonstrated that the novel index of Doppler-derived pulmonary flow reserve (PFR(dopp)=maximal hyperaemic/basal pulmonary flow) could be reliably measured in high primates. Noting that the microvasculature is the chief regulator of pulmonary blood flow, we hypothesised that PFR(dopp) may detect microcirculatory loss...
October 2010: Heart, Lung & Circulation
Bjorn Wikström, Stefan H Jacobson, Jennifer Bragg-Gresham, Margaret Eichleay, Ron Pisoni, Friedrich Port
OBJECTIVE: To examine the association of adherence to Swedish Society of Nephrology guidelines on haemodialysis treatment and patient outcomes in Sweden. MATERIAL AND METHODS: A prevalent cross-sectional sample of Swedish haemodialysis patients was obtained from the Dialysis Outcomes and Practice Patterns Study (DOPPS II, 2002-2004), an international, prospective, cohort study that investigates relationships between patient outcomes and haemodialysis practices. The sample was used to estimate life-years gained through adherence to six potentially modifiable practice patterns: dialysis dose, anaemia, serum phosphorus, serum calcium, serum albumin and catheter use for vascular access...
March 2010: Scandinavian Journal of Urology and Nephrology
Dana Miskulin, Jennifer Bragg-Gresham, Brenda W Gillespie, Francesca Tentori, Ronald L Pisoni, Hocine Tighiouart, Andrew S Levey, Friedrich K Port
BACKGROUND AND OBJECTIVES: Abstracting information about comorbid illnesses from the medical record can be time-consuming, particularly when a large number of conditions are under consideration. We sought to determine which conditions are most prognostic and whether comorbidity continues to contribute to a survival model once laboratory and clinical parameters have been accounted for. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Comorbidity data were abstracted from the medical records of Dialysis Outcomes and Practice Pattern Study (DOPPS) I, II, and III participants using a standardized questionnaire...
November 2009: Clinical Journal of the American Society of Nephrology: CJASN
Kevin J Reichmuth, John M Dopp, Steven R Barczi, James B Skatrud, Piotr Wojdyla, Don Hayes, Barbara J Morgan
RATIONALE: Impaired endothelium-dependent vasodilation has been documented in patients with sleep apnea. This impairment may result in blood flow dysregulation during apnea-induced fluctuations in arterial blood gases. OBJECTIVES: To test the hypothesis that hypoxic and hypercapnic vasodilation in the forearm and cerebral circulation are impaired in patients with sleep apnea. METHODS: We exposed 20 patients with moderate to severe sleep apnea and 20 control subjects, to isocapnic hypoxia and hyperoxic hypercapnia...
December 1, 2009: American Journal of Respiratory and Critical Care Medicine
Christian Combe, Justin M Albert, Jennifer L Bragg-Gresham, Vittorio E Andreucci, Alex Disney, Shunichi Fukuhara, David A Goodkin, Brenda W Gillespie, Akira Saito, Michel Jadoul, Ronald L Pisoni
BACKGROUND: Hemodialysis patients are at increased risk of amputation, particularly those with diabetes. Limited data exist about the prevalence, incidence, risk factors for, and sequelae of amputation in hemodialysis patients. STUDY DESIGN: A prospective observational study of hemodialysis practices and outcomes. SETTING & PARTICIPANTS: Data from 29,838 patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) from 1996 to 2004 were analyzed...
October 2009: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Brian D Bradbury, Fangfei Chen, Anna Furniss, Ronald L Pisoni, Marcia Keen, Donna Mapes, Mahesh Krishnan
BACKGROUND: Limited data exist describing vascular access conversions during the first year on dialysis therapy or the effect of converting to and from a catheter on subsequent mortality risk. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: We studied a random sample of incident US hemodialysis patients (initiated long-term dialysis < 30 days before study entry) in the Dialysis Outcomes and Practice Patterns Study (DOPPS; 1996-2004)...
May 2009: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ronald L Pisoni, Charlotte J Arrington, Justin M Albert, Jean Ethier, Naoki Kimata, Mahesh Krishnan, Hugh C Rayner, Akira Saito, Jeffrey J Sands, Rajiv Saran, Brenda Gillespie, Robert A Wolfe, Friedrich K Port
BACKGROUND: Previously, the Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown large international variations in vascular access practice. Greater mortality risks have been seen for hemodialysis (HD) patients dialyzing with a catheter or graft versus a native arteriovenous fistula (AVF). To further understand the relationship between vascular access practice and outcomes, we have applied practice-based analyses (using an instrumental variable approach) to decrease the treatment-by-indication bias of prior patient-level analyses...
March 2009: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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