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- Adverse Events (1)
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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 12 of 12 Research Studies DisplayedChu CD, Xia F, Du Y
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
The purpose of this cohort study was to assess the extent of albuminuria underdetection from lack of testing and examine its association with CKD treatment. Researchers examined records of adults with hypertension or diabetes, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES) and the Optum deidentified electronic health record (EHR) data set of US health care organizations. The total EHR study population included 192,108 patients; 96.6% with hypertension, and 26.2% with diabetes. The study found that 17.5% of patients had albuminuria testing; of whom 34.3% had albuminuria. Among 158,479 patients who were untested, the estimated albuminuria prevalence rate was 13.4%. Thus, only 35.2% of the projected population with albuminuria had been tested. Albuminuria testing was associated with higher adjusted odds of receiving ACEi or ARB treatment, SGLT2i treatment, and having blood pressure controlled to less than 140/90 mm Hg. The researchers concluded that approximately two-thirds of patients with albuminuria were undetected due to lack of testing.
AHRQ-funded; HS026383.
Citation: Chu CD, Xia F, Du Y .
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
JAMA Netw Open 2023 Jul; 6(7):e2326230. doi: 10.1001/jamanetworkopen.2023.26230..
Keywords: Kidney Disease and Health, Chronic Conditions, Diabetes, Blood Pressure, Evidence-Based Practice
Yao 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
Paje D, Rogers MAM, Conlon A
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (CKD). The purpose of this study was to describe the frequency of and characteristics associated with PICC use in hospitalized patients with stage 3b or greater CKD (glomerular filtration rate [GFR] <45 mL/min/1.73 m2).
AHRQ-funded; HS025891.
Citation: Paje D, Rogers MAM, Conlon A .
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Ann Intern Med 2019 Jul 2;171(1):10-18. doi: 10.7326/m18-2937..
Keywords: Kidney Disease and Health, Guidelines, Evidence-Based Practice, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
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
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
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 Y
Association of peritonitis with hemodialysis catheter dependence after modality switch.
This study characterized vascular access use after switch to hemodialysis and its effect on patient mortality. The researchers found that patients using a permanent vascular access 180 days after switching from peritoneal dialysis to hemodialysis had better adjusted survival during the ensuing year than those using a catheter. They concluded that among patients who switch, prior peritonitis is associated with a higher rate of persistent hemodialysis catheter use, which, in turn, is associated with lower patient survival.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Thamer M, Zhang Y .
Association of peritonitis with hemodialysis catheter dependence after modality switch.
Clin J Am Soc Nephrol 2016 Nov 7;11(11):1999-2004. doi: 10.2215/cjn.04970516.
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Keywords: Dialysis, Kidney Disease and Health, Evidence-Based Practice, Mortality, Patient-Centered Healthcare
Raman G, Adam GP, Halladay CW
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
This study compared benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with atherosclerotic renal artery stenosis (ARAS). The strength of evidence regarding the relative benefits and harms of PTRAS versus medical therapy alone for patients with ARAS is low.
AHRQ-funded; 290201500002.
Citation: Raman G, Adam GP, Halladay CW .
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
Ann Intern Med 2016 Nov;165(9):635-49. doi: 10.7326/m16-1053.
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Keywords: Kidney Disease and Health, Treatments, Comparative Effectiveness, Evidence-Based Practice
Pierorazio PM, Johnson MH, Patel HD
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
This review aimed to summarize evidence on effectiveness and comparative effectiveness of active surveillance (AS), thermal ablation (TA), and radical (RN) or partial nephrectomy (PN) for patients with a renal mass suspicious for localized renal cancer. It concluded that comparative studies demonstrated similar cancer-secific survival across management strategies, with some differences in renal functional outcomes, perioperative outcomes, and postoperative harms that should be considered when choosing a management strategy.
AHRQ-funded; 290201200007I.
Citation: Pierorazio PM, Johnson MH, Patel HD .
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
J Urol 2016 Oct;296(4):989-99. doi: 10.1016/j.juro.2016.04.081.
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Keywords: Cancer, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Kidney Disease and Health
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