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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 23 of 23 Research Studies DisplayedAklilu AM, Kumar S, Nugent J
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
This retrospective longitudinal multicenter cohort study’s objective was to assess long-term kidney outcomes of patient who had COVID-19-associated acute kidney injury (AKI). This study was conducted in a large hospital system using electronic health records data on adult hospitalized patients with AKI and COVID-19 or other illnesses. Included patients were those 1) who were hospitalized during the COVID-19 pandemic (March 2020-June 2022), were screened for SARS-CoV-2, had AKI, and survived to discharge, or 2) had been hospitalized during the 5 years before the pandemic (October 2016-January 2020), had a positive influenza A or B test result, had AKI, and survived to discharge. The study cohort included 9624 hospitalized patients (mean age, 69.0 years; 4955 females) with AKI, including 987 patients with COVID-AKI, 276 with influenza-associated AKI, and 8361 with AKI associated with other illnesses (other-AKI). When compared with the other 2 groups, patients with COVID-19-associated AKI were slightly younger in age, had a higher baseline eGFR, worse baseline comorbidity scores, higher markers of illness severity, and longer hospital stay. Compared with the other-AKI group, the COVID-AKI group had lower major adverse kidney events (MAKE) (adjusted hazard ratio [aHR], 0.67) due to lower all-cause mortality (aHR, 0.31) and lower rates of worsened kidney function.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Nugent J .
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
JAMA Intern Med 2024 Apr; 18(4):414-23. doi: 10.1001/jamainternmed.2023.8225..
Keywords: COVID-19, Kidney Disease and Health, Outcomes
Goldman S, Zhao J, Bieber B
Gastric acid suppression therapy and its association with peritoneal dialysis-associated peritonitis in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).
This study’s goal was to determine whether gastric acid suppression (GAS) (proton pump inhibitor (PPI) or histamine-2 receptor antagonists (H2RA)) use was associated with all-cause and organism-specific peritonitis in peritoneal dialysis (PD) patients. The authors used data from the Peritoneal Dialysis Outcomes and Practice Patterns Study (595 facilities, 8 countries, years 2014-2022), and associations between GAS use and time to first episode of all-cause peritonitis was examined. Out of a total of 23,797 baseline study patients, 6020 (25.3%) used PPIs, and 1382 (5.8%) used H2RAs. Overall risks of GAS use and peritonitis risk [adjusted hazard ratio (AHR)=1.05), and use of PPI (AHR 1.06) or H2RA (AHR 1.02) did not reach statistical significance. In organism-specific analyses, GAS users displayed higher peritonitis risks for gram-negative (AHR 1.29), gram-positive (AHR 1.15), culture-negative (AHR 1.20), enteric (AHR 1.23), and particularly Streptococcal (AHR 1.47) peritonitis episodes. GAS was also associated with higher overall mortality (AHR 1.13).
AHRQ-funded; HS025756.
Citation: Goldman S, Zhao J, Bieber B .
Gastric acid suppression therapy and its association with peritoneal dialysis-associated peritonitis in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).
Kidney360 2024 Mar 1; 5(3):370-79. doi: 10.34067/kid.0000000000000325..
Keywords: Kidney Disease and Health, Adverse Events, Risk
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
Warnock DG, Powell TC, Donnelly JP
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
The objective of this study was to categorize hospital-associated acute kidney injury (HA-AKI) based on the timing of minimum and peak inpatient serum creatinine (sCr) and describe the association with inpatient mortality. It concluded that risk of short-term inpatient mortality is associated with AKI, and this risk is attenuated with recovery of kidney function in the hospital.
AHRQ-funded; HS013852.
Citation: Warnock DG, Powell TC, Donnelly JP .
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
Nephron 2015;131(4):227-36. doi: 10.1159/000441956.
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Keywords: Kidney Disease and Health, Adverse Events, Hospitalization, Mortality
Scialla JJ, Parekh RS, Eustace JA
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
In this study, the researchers determined the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. They concluded that aberrant phosphorus homeostasis, reflected by higher phosphorus and FGF23, may be a risk factor for mortality in patients initiating hemodialysis, particularly among African Americans.
AHRQ-funded; HS08365.
Citation: Scialla JJ, Parekh RS, Eustace JA .
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
Am J Nephrol 2015;42(1):25-34. doi: 10.1159/000438999.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Mortality, Kidney Disease and Health
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
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Weiss JW, Peters D, Yang X
Systolic BP and mortality in older adults with CKD.
This study sought to determine whether a nonlinear relationship between BP and mortality - as described for the broader chronic kidney disease (CKD) population and for older adults in the general population - is present for older adults with CKD. It found that in a cohort of older adults, a relationship between higher SBP and mortality was present only for younger members of this cohort and not for those older than 70.
AHRQ-funded; HS019456.
Citation: Weiss JW, Peters D, Yang X .
Systolic BP and mortality in older adults with CKD.
Clin J Am Soc Nephrol 2015 Sep 4;10(9):1553-9. doi: 10.2215/cjn.11391114.
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Keywords: Blood Pressure, Mortality, Elderly, Kidney Disease and Health
Erickson KF, Mell M, Winkelmayer WC
Provider visits and early vascular access placement in maintenance hemodialysis.
This study examined whether patients seen more frequently by their nephrologist or advanced practitioner in the first 90 days of hemodialysis were more likely to undergo surgery to create an AV fistula or place an AV graft during that period. It concluded that patients seen more frequently by care providers in the first 90 days of hemodialysis undergo earlier AV fistula creation or graft placement.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell M, Winkelmayer WC .
Provider visits and early vascular access placement in maintenance hemodialysis.
J Am Soc Nephrol 2015 Aug;26(8):1990-7. doi: 10.1681/asn.2014050464..
Keywords: Care Management, Kidney Disease and Health, Healthcare Utilization, Outcomes
Wang V, Lee SY, Maciejewski ML
Inertia in health care organizations: a case study of peritoneal dialysis services.
The aim of this study was to examine whether strategic and selective factors were associated with the provision of peritoneal dialysis (PD) services in outpatient dialysis facilities in the United States between 1995 and 2003. It found little support for strategic influences and some evidence that selective factors were predictive of dialysis facilities’ PD provision.
AHRQ-funded; HS019479; HS000032.
Citation: Wang V, Lee SY, Maciejewski ML .
Inertia in health care organizations: a case study of peritoneal dialysis services.
Health Care Manage Rev 2015 Jul-Sep;40(3):203-13. doi: 10.1097/hmr.0000000000000024..
Keywords: Kidney Disease and Health, Ambulatory Care and Surgery
Schroeder EB, Powers JD, O'Connor PJ
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
The researchers used a database including over 1 million individuals with diabetes to examine the prevalence of chronic kidney disease (CKD) and trends from 2005 to 2011. They found that CKD prevalence was 20.0 percent using diagnostic codes, 17.7 percent using impaired estimated glomerular filtration rate alone, 11.9 percent using albuminuria, and 32.7 percent when one or more methods suggested CKD.
AHRQ-funded; HS019859
Citation: Schroeder EB, Powers JD, O'Connor PJ .
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
J Diabetes Complications. 2015 Jul;29(5):637-43. doi: 10.1016/j.jdiacomp.2015.04.007.
Keywords: Kidney Disease and Health, Diabetes, Chronic Conditions
Chenoweth CE, Hines SC, Hall KK
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
The purpose of this study was to observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. The researchers found considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68 percent (range, 45 percent–92 percent) across all facilities.
AHRQ-authored; AHRQ-funded; 290200600022I.
Citation: Chenoweth CE, Hines SC, Hall KK .
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
Infect Control Hosp Epidemiol 2015 Jul;36(7):802-6. doi: 10.1017/ice.2015.55..
Keywords: Kidney Disease and Health, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Prevention
Kane-Gill SL, Sileanu FE, Murugan R
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
The authors sought to delineate the determinants of risk for acute kidney injury (AKI) in older compared with younger adults. They found that among the risk factors for AKI in the oldest age category were drugs (vancomycin, aminoglycosides, and nonsteroidal anti-inflammatories), history of hypertension, and sepsis. Fewer variables remained predictive of AKI as age increased and the model for older patients was less predictive.
AHRQ-funded; HS018721.
Citation: Kane-Gill SL, Sileanu FE, Murugan R .
Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study.
Am J Kidney Dis 2015 Jun;65(6):860-9. doi: 10.1053/j.ajkd.2014.10.018.
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Keywords: Elderly, Kidney Disease and Health, Medication, Risk, Sepsis
Shafi T, Meyer TW, Hostetter TH
Free levels of selected organic solutes and cardiovascular morbidity and mortality in hemodialysis patients: results from the Retained Organic Solutes and Clinical Outcomes (ROSCO) investigators.
This study examined the association of baseline free levels of four organic solutes that are secreted in the native kidney —p-cresol sulfate, indoxyl sulfate, hippurate and phenylacetylglutamine—with outcomes in hemodialysis patients. It found that free levels of uremic solutes that are secreted by the native kidney are associated with a higher risk of cardiovascular morbidity and mortality in incident hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Shafi T, Meyer TW, Hostetter TH .
Free levels of selected organic solutes and cardiovascular morbidity and mortality in hemodialysis patients: results from the Retained Organic Solutes and Clinical Outcomes (ROSCO) investigators.
PLoS One 2015 May 4;10(5):e0126048. doi: 10.1371/journal.pone.0126048..
Keywords: Cardiovascular Conditions, Kidney Disease and Health, Mortality
Powell TC, Donnelly JP, Gutierrez OM
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
The researchers sought to determine the association between elevated baseline Cyst-C and long-term rates of community-acquired sepsis. They found that elevated Cyst-C is associated with increased long-term rates of community-acquired sepsis, independent of abnormal eGFR, ACR or hsCRP. Cyst-C may play a role in long-term sepsis risk prediction and prevention.
AHRQ-funded; HS013852.
Citation: Powell TC, Donnelly JP, Gutierrez OM .
Cystatin C and long term risk of community-acquired sepsis: a population-based cohort study.
BMC Nephrol 2015 Apr 23;16:61. doi: 10.1186/s12882-015-0055-z..
Keywords: Community-Acquired Infections, Kidney Disease and Health, Risk, Sepsis
Tangri N, Miskulin DC, Zhou J
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
The researchers studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. They concluded that a higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.
AHRQ-funded; 290200500341I.
Citation: Tangri N, Miskulin DC, Zhou J .
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
Nephrol Dial Transplant 2015 Apr;30(4):667-75. doi: 10.1093/ndt/gfu349.
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Keywords: Comparative Effectiveness, Hospitalization, Kidney Disease and Health, Cardiovascular Conditions, Treatments
Geynisman DM, Hu JC, Liu L
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
The researchers used a large claims database to examine the evolution of treatment patterns and associated costs for 1527 metastatic renal cell carcinoma (mRCC) patients in the United States. They found that the treatment of mRCC has transitioned from cytokines and cytotoxic chemotherapy to almost exclusively targeted therapy. Cost of care for mRCC is rising each year, and out-of-pocket costs for patients are significant.
AHRQ-funded; HS018535; HS020263.
Citation: Geynisman DM, Hu JC, Liu L .
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
Clin Genitourin Cancer 2015 Apr;13(2):e93-100. doi: 10.1016/j.clgc.2014.08.013..
Keywords: Cancer, Kidney Disease and Health, Health Insurance, Healthcare Costs
Abraham AG, Althoff KN, Jing Y
End-stage renal disease among HIV-infected adults in North America.
Given the many potential contributors to ESRD risk, the goal of this study was to assess the relative contributions of clinical and demographic factors to ESRD. It found that HIV-infected ESRD cases were more likely to be of black race, have diabetes mellitus or hypertension, inject drugs, and/or have a prior AIDS-defining illness.
AHRQ-funded; 290201100007C.
Citation: Abraham AG, Althoff KN, Jing Y .
End-stage renal disease among HIV-infected adults in North America.
Clin Infect Dis 2015 Mar 15;60(6):941-9. doi: 10.1093/cid/ciu919..
Keywords: Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Risk, Diabetes
Kozminski MA, Kozminski DJ, Roberts WW
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
The researchers sought to document the rate of and risk factors for the rare complication of symptomatic renal hematoma following ureteroscopic lithotripsy (URSL) for renal calculi. They found that, while symptomatic hematoma is a complication of URSL, the rate of such outcome (0.8 percent) is far less than that reported by prior series with extracorporeal shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL).
AHRQ-funded; HS020927.
Citation: Kozminski MA, Kozminski DJ, Roberts WW .
Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.
J Endourol 2015 Mar;29(3):277-82. doi: 10.1089/end.2014.0176..
Keywords: Kidney Disease and Health, Patient Safety, Risk, Adverse Events
Althoff KN, McGinnis KA, Wyatt CM
Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults.
The objective of this study was to compare the median age at, and risk of, incident diagnosis of 3 age-associated diseases in HIV-infected and demographically similar uninfected adults. It found that HIV-infected adults had a higher risk of these age-associated diseases (myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer), but they occurred at similar ages to those without HIV.
AHRQ-funded; HS018372.
Citation: Althoff KN, McGinnis KA, Wyatt CM .
Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults.
Clin Infect Dis 2015 Feb 15;60(4):627-38. doi: 10.1093/cid/ciu869..
Keywords: Human Immunodeficiency Virus (HIV), Heart Disease and Health, Kidney Disease and Health, Cancer
Erickson KF, Mell MW, Winkelmayer WC
Provider visit frequency and vascular access interventions in hemodialysis.
This study sought to determine whether more frequent face-to-face provider (physician and advanced practitioner) visits lead to more procedures and therapeutic interventions aimed at preserving arteriovenous fistulas and grafts and improved vascular access outcomes. It found that more frequent face-to-ace provider visits were associated with more procedures and therapeutic interventions aimed at preserving vascular accesses, but not with prolonged vascular access survival.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell MW, Winkelmayer WC .
Provider visit frequency and vascular access interventions in hemodialysis.
Clin J Am Soc Nephrol 2015 Feb 6;10(2):269-77. doi: 10.2215/cjn.05540614..
Keywords: Care Management, Dialysis, Kidney Disease and Health, Outcomes, Ambulatory Care and Surgery
Moore CL, Daniels B, Ghita M
Accuracy of reduced-dose computed tomography for ureteral stones in emergency department patients.
The researchers compared the sensitivity and specificity of reduced-dose computed tomography (CT) for diagnosis of clinically important urologic causes of kidney stones likely to require intervention within a 90-day follow-up period. In 201 patients with a range of body mass indexes who received both regular and reduced dose scans contemporaneously, reduced-dose CT were 96% sensitive for stones requiring intervention.
AHRQ-funded; HS018322.
Citation: Moore CL, Daniels B, Ghita M .
Accuracy of reduced-dose computed tomography for ureteral stones in emergency department patients.
Ann Emerg Med 2015 Feb;65(2):189-98.e2. doi: 10.1016/j.annemergmed.2014.09.008..
Keywords: Emergency Medical Services (EMS), Emergency Department, Kidney Disease and Health, Imaging
Muntner P, Gutierrez OM, Zhao H
Validation study of medicare claims to identify older US adults with CKD using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
The researchers compared characteristics and outcomes for individuals with chronic kidney disease (CKD) defined using laboratory measurements versus claims data from 6,982 study participants who had Medicare fee-for-service coverage. They found that CKD, whether identified using a claims-based algorithm or through estimated glomerular filtration rate or albumin-creatinine ratio measurements, is associated with increased risk for all-cause mortality and end-stage renal disease (ESRD).
AHRQ-funded; HS018517.
Citation: Muntner P, Gutierrez OM, Zhao H .
Validation study of medicare claims to identify older US adults with CKD using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
Am J Kidney Dis 2015 Feb;65(2):249-58. doi: 10.1053/j.ajkd.2014.07.012.
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Am J Kidney Dis 2015 Feb;65(2):249-58. doi: 10.1053/j.ajkd.2014.07.012.
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Keywords: Kidney Disease and Health, Outcomes, Comparative Effectiveness, Kidney Disease and Health, Mortality