National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (3)
- Blood Thinners (1)
- Cardiovascular Conditions (3)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (4)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Dialysis (3)
- Disparities (2)
- Elderly (4)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (6)
- Falls (1)
- Healthcare Costs (1)
- Health Literacy (1)
- Heart Disease and Health (2)
- Injuries and Wounds (1)
- (-) Kidney Disease and Health (17)
- Low-Income (1)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Mortality (3)
- Outcomes (11)
- (-) Patient-Centered Outcomes Research (17)
- Patient Experience (1)
- Patient Safety (1)
- Prevention (1)
- Quality of Life (1)
- Registries (1)
- Risk (1)
- Sex Factors (2)
- Surgery (6)
- Transplantation (3)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedYao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Lee T, Qian JZ, Zhang Y
Long-term outcomes of arteriovenous fistulas with unassisted versus assisted maturation: a retrospective national hemodialysis cohort study.
The authors retrospectively compared patients with assisted versus unassisted arteriovenous fistula (AVF) maturation for post-maturation AVF outcomes, including functional primary patency loss, AVF abandonment, and frequency of interventions. For the studied group of patients undergoing assisted AVF maturation, they observed a positive association between the number of pre-maturation AVF interventions and the likelihood of functional primary patency loss and frequency of post-maturation interventions.
AHRQ-funded; HS022931.
Citation: Lee T, Qian JZ, Zhang Y .
Long-term outcomes of arteriovenous fistulas with unassisted versus assisted maturation: a retrospective national hemodialysis cohort study.
J Am Soc Nephrol 2019 Nov;30(11):2209-18. doi: 10.1681/asn.2019030318..
Keywords: Kidney Disease and Health, Comparative Effectiveness, Surgery, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
Purnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
AHRQ-funded; HS024600.
Citation: Purnell TS, Luo X, Crews DC .
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
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Keywords: Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Hart A, Gustafson SK, Wey A
The association between loss of Medicare, immunosuppressive medication use, and kidney transplant outcomes.
The purpose of this study was to determine the association between the timing of Medicare loss and immunosuppressive medication fills and kidney allograft loss. Findings indicated that the medication possession ratio (MPR) was lower for recipients with early or late Medicare loss compared with no coverage loss for all immunosuppressive medication types. When recipients were matched by age, posttransplant timing of Medicare loss, and donor risk, the hazard of allograft loss was significantly higher after Medicare loss, with no difference in the hazard for on-time Medicare loss.
AHRQ-funded; HS024527.
Citation: Hart A, Gustafson SK, Wey A .
The association between loss of Medicare, immunosuppressive medication use, and kidney transplant outcomes.
Am J Transplant 2019 Jul;19(7):1964-71. doi: 10.1111/ajt.15293..
Keywords: Kidney Disease and Health, Medicare, Medication, Outcomes, Patient-Centered Outcomes Research, Transplantation
Warsame F, Haugen CE, Ying H
Limited health literacy and adverse outcomes among kidney transplant candidates.
More than one-third of US adults have limited health literacy, putting them at risk of adverse clinical outcomes. In this study the investigators evaluated the prevalence of limited health literacy among 1578 adult kidney transplant (KT) candidates (May 2014-November 2017) and examined its association with listing for transplant and waitlist mortality in this pilot study. The investigators concluded that limited health literacy may be a salient mechanism in access to KT; programs to aid candidates with limited health literacy may improve outcomes and reduce disparities.
AHRQ-funded; HS024600.
Citation: Warsame F, Haugen CE, Ying H .
Limited health literacy and adverse outcomes among kidney transplant candidates.
Am J Transplant 2019 Feb;19(2):457-65. doi: 10.1111/ajt.14994..
Keywords: Health Literacy, Transplantation, Adverse Events, Patient-Centered Outcomes Research, Outcomes, Surgery, Mortality, Kidney Disease and Health
Nguyen OK, Vazquez MA, Charles MA
Association of scheduled vs emergency-only dialysis with health outcomes and costs in undocumented immigrants with end-stage renal disease.
This paper discusses costs and mortality associated with undocumented immigrants with end-stage renal disease (ESRD). If the patient has insurance, the costs and mortality rates are much lower than those who receive emergency-only dialysis.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Vazquez MA, Charles MA .
Association of scheduled vs emergency-only dialysis with health outcomes and costs in undocumented immigrants with end-stage renal disease.
JAMA Intern Med 2019 Feb;179(2):175-83. doi: 10.1001/jamainternmed.2018.5866..
Keywords: Dialysis, Kidney Disease and Health, Healthcare Costs, Mortality, Patient-Centered Outcomes Research
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Elderly, Sex Factors, Surgery, Kidney Disease and Health, Disparities, Outcomes, Patient-Centered Outcomes Research
Lee T, Qian J, Thamer M
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
In this study the investigators evaluated clinically relevant vascular access outcomes in elderly patients receiving an arteriovenous fistulas (AVF) or arteriovenous grafts AVG after hemodialysis therapy initiation. The investigators found that in elderly hemodialysis patients initiating hemodialysis therapy with a catheter, the optimal vascular access selection depended on tradeoffs between shorter catheter dependence and less frequent interventions to make the vascular access (AVG) functional versus longer access patency and fewer interventions after successful use of the vascular access (AVF).
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
Am J Kidney Dis 2018 Oct;72(4):509-18. doi: 10.1053/j.ajkd.2018.03.023..
Keywords: Dialysis, Kidney Disease and Health, Elderly, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Eaton EF, Tamhane A, Davy-Mendez T
Brief report: kidney dysfunction does not contribute significantly to antiretroviral therapy modification in treatment-naive PLWH receiving initial ART.
Antiretroviral therapy (ART) durability, time to modification or cessation, has declined. The objective of this retrospective follow up study was to determine whether kidney dysfunction was contributing to reduced durability. The investigator found that for patients in their study initiated on ART, including TDF-based ART, in the last decade, kidney dysfunction was not a major factor leading to regimen modification.
AHRQ-funded; HS023009.
Citation: Eaton EF, Tamhane A, Davy-Mendez T .
Brief report: kidney dysfunction does not contribute significantly to antiretroviral therapy modification in treatment-naive PLWH receiving initial ART.
J Acquir Immune Defic Syndr 2019 May 1;81(1):e6-e9. doi: 10.1097/qai.0000000000001999..
Keywords: Patient-Centered Outcomes Research, Kidney Disease and Health, Evidence-Based Practice, Outcomes
Domenick Sridharan N, Fish L, Yu L
The associations of hemodialysis access type and access satisfaction with health-related quality of life.
This study sought to understand the impact of hemodialysis (HD) access type on health-related quality of life (HRQOL). The study concluded that HD patients experience greatest satisfaction with fistula, and access satisfaction is significantly associated with better HRQOL. Controlling for access satisfaction, there is no significant independent association of access type on HRQOL.
AHRQ-funded; HS019486.
Citation: Domenick Sridharan N, Fish L, Yu L .
The associations of hemodialysis access type and access satisfaction with health-related quality of life.
J Vasc Surg 2018 Jan;67(1):229-35. doi: 10.1016/j.jvs.2017.05.131..
Keywords: Kidney Disease and Health, Kidney Disease and Health, Patient Experience, Quality of Life, Surgery, Patient-Centered Outcomes Research
Cooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Lee T, Thamer M, Zhang Z
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
This observational study design was used to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed. The study concluded that despite extended central venous catheter dependence, elderly patients initiating hemodialysis with a central venous catheter who underwent arteriovenous fistula placement within 6 months had fewer hospitalizations due to infections and a lower likelihood of death than those receiving an arteriovenous graft.
AHRQ-funded; HS022931; HS021229
Citation: Lee T, Thamer M, Zhang Z .
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
Clin J Am Soc Nephrol 2017 Nov 7;12(11):1823-30. doi: 10.2215/cjn.01410217..
Keywords: Elderly, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research
Bowling CB, Bromfield SG, Colantonio LD
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
The researchers studied adverse outcomes in patients on dialysis as a result of falls. They found that among participants with CKD, cumulative 1-year mortality rates among patients with a serious fall and age-matched controls were 21.0% and 5.5%, respectively, and noted that elevated ACR but not lower eGFR was associated with serious fall injuries. They concluded that evaluation for fall risk factors and fall prevention strategies should be considered for older adults with elevated ACR.
AHRQ-funded; HS023009.
Citation: Bowling CB, Bromfield SG, Colantonio LD .
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
Clin J Am Soc Nephrol 2016 Jul 7;11(7):1236-43. doi: 10.2215/cjn.11111015.
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Keywords: Elderly, Falls, Patient-Centered Outcomes Research, Kidney Disease and Health, Injuries and Wounds
Subramaniam RM, Suarez-Cuervo C, Wilson RF
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
N-acetylcysteine, sodium bicarbonate, statins, and ascorbic acid have been studied for reducing contrast-induced nephropathy (CIN). This study evaluated the comparative effectiveness of interventions to reduce CIN in adults receiving contrast media. It concluded that the greatest reduction in CIN was seen with N-acetylcysteine plus IV saline in patients receiving LOCM and with statins plus N-acetylcysteine plus IV saline.
AHRQ-funded; 290201200007I.
Citation: Subramaniam RM, Suarez-Cuervo C, Wilson RF .
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):406-16. doi: 10.7326/m15-1456.
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Keywords: Adverse Events, Comparative Effectiveness, Kidney Disease and Health, Patient-Centered Outcomes Research, Prevention
Goldstein SL
Automated/integrated real-time clinical decision support in acute kidney injury.
The author argues that early, real-time identification and notification to healthcare providers of patients at risk for, or with, acute or chronic kidney disease can drive simple interventions to reduce harm. Similarly, he believes that screening patients at risk for acute kidney injury with these platforms to alert research personnel will lead to improve study subject recruitment.
AHRQ-funded; HS023763; HS021114.
Citation: Goldstein SL .
Automated/integrated real-time clinical decision support in acute kidney injury.
Curr Opin Crit Care 2015 Dec;21(6):485-9. doi: 10.1097/mcc.0000000000000250.
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Keywords: Clinical Decision Support (CDS), Kidney Disease and Health, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Diagnostic Safety and Quality
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
This study evaluated outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with chronic kidney disease (CKD). It found that In patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps heart attack, with no long-term mortality difference.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
J Am Coll Cardiol 2015 Sep 15;66(11):1209-20. doi: 10.1016/j.jacc.2015.06.1334..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Surgery, Kidney Disease and Health