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Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (1)
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- Communication (1)
- Comparative Effectiveness (1)
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- (-) Dialysis (11)
- Disparities (2)
- Elderly (2)
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- Kidney Disease and Health (11)
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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 11 of 11 Research Studies DisplayedBoehmer KR, Pine KH, Whitman S
Do patients with high versus low treatment and illness burden have different needs? A mixed-methods study of patients living on dialysis.
The authors sought to understand the differences that exist between patients with end-stage kidney disease reporting high versus low treatment and illness burden. They found that patients on dialysis reporting the greatest illness and treatment burden have difficulties that their low-burden counterparts do not report, which may be amenable to intervention.
AHRQ-funded; HS026379.
Citation: Boehmer KR, Pine KH, Whitman S .
Do patients with high versus low treatment and illness burden have different needs? A mixed-methods study of patients living on dialysis.
PLoS One 2021 Dec 28;16(12):e0260914. doi: 10.1371/journal.pone.0260914..
Keywords: Dialysis, Kidney Disease and Health, Chronic Conditions
Thorsness R, Wang V, Patzer RE
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
This study examines rates of home dialysis and transplant at dialysis facilities that serve patients with high social risk to understand how they fare under the End-Stage Renal Disease Treatment Choices Model.
AHRQ-funded; HS028285.
Citation: Thorsness R, Wang V, Patzer RE .
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
JAMA 2021 Dec 14;326(22):2323-25. doi: 10.1001/jama.2021.18372..
Keywords: Dialysis, Kidney Disease and Health, Transplantation, Risk
Nair D, Malhotra S, Lupu D
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
This paper uses case vignettes to highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the COVD-19 pandemic for patients with kidney disease. The authors include best practice recommendations to mitigate those issues and conclude with implications for interdisciplinary models of care in crisis settings. Concerns about certain biomarkers, demographics, and medical comorbidities that can predict an increased risk for mortality among patients with COVID-19 and kidney disease are discussed, because there may be communication barriers related to physical exposure and conservation of personal protective equipment with those at-risk patients.
AHRQ-funded; HS026395.
Citation: Nair D, Malhotra S, Lupu D .
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-97. doi: 10.1097/mnh.0000000000000689..
Keywords: COVID-19, Dialysis, Kidney Disease and Health, Shared Decision Making, Clinician-Patient Communication, Communication, Chronic Conditions
Davies SJ, Zhao Morgenstern, H Davies SJ, Zhao J, Morgenstern H
Low serum potassium levels and clinical outcomes in peritoneal dialysis-international results from PDOPPS.
Characteristics/treatments associated with hypokalemia included protein-energy wasting indicators, lower urine volume, lower blood pressure, higher dialysis dose, greater diuretic use and not being prescribed a renin-angiotensin system inhibitor. Persistent hypokalemia was associated with 80% higher subsequent peritonitis rates and 40% higher mortality.
AHRQ-funded; HS025756.
Citation: Davies SJ, Zhao Morgenstern, H Davies SJ, Zhao J, Morgenstern H .
Low serum potassium levels and clinical outcomes in peritoneal dialysis-international results from PDOPPS.
Kidney Int Rep 2021 Feb;6(2):313-24. doi: 10.1016/j.ekir.2020.11.021..
Keywords: Dialysis, Kidney Disease and Health, Mortality, Outcomes
Thorsteinsdottir B, Hickson LJ, Giblon R
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
Prognosis provides critical knowledge for shared decision making between patients and clinicians. While several prognostic indices for mortality in dialysis patients have been developed, their performance among elderly patients initiating dialysis is unknown, despite great need for reliable prognostication in that context. The purpose of this study was to assess the performance of 6 previously validated prognostic indices to predict 3 and/or 6 months mortality in a cohort of elderly incident dialysis patients.
AHRQ-funded; HS025517; HS025164; HS025402.
Citation: Thorsteinsdottir B, Hickson LJ, Giblon R .
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
PLoS One 2021 Jan 20;16(1):e0244081. doi: 10.1371/journal.pone.0244081..
Keywords: Elderly, Dialysis, Kidney Disease and Health, Mortality, Shared Decision Making
Bakre S, Hollingsworth JM, Yan PL
Accountable care organizations and spending for patients undergoing long-term dialysis.
This study analyzed Medicare data to examine time trends in long-term dialysis beneficiary alignment to Accountable Care Organizations (ACOs) and differences in spending for those who were Accountable Care Organization aligned versus nonaligned. Beneficiaries on long-term dialysis between 2009 and 2016 were identified using a 20% random sample of Medicare beneficiaries. Trends in alignment to an ACO alignment were compared with alignment of the general Medicare population. The cohort included 135,152 beneficiaries during the study period. Alignment to an ACO of long-term dialysis beneficiaries increased from 6% to 23% from 2012 to 2016. In the time series analysis, ACO spending was $143 less per beneficiary-quarter than spending for non-aligned beneficiaries. This savings was limited to care by a primary care physician.
AHRQ-funded; HS024525; HS026908; HS024728.
Citation: Bakre S, Hollingsworth JM, Yan PL .
Accountable care organizations and spending for patients undergoing long-term dialysis.
Clin J Am Soc Nephrol 2020 Dec 7;15(12):1777-84. doi: 10.2215/cjn.02150220..
Keywords: Healthcare Costs, Dialysis, Kidney Disease and Health, Medicare
Qian JZ, McAdams-DeMarco M, Ng DK
Arteriovenous fistula placement, maturation, and patency loss in older patients initiating hemodialysis.
The current clinical guidelines for vascular access do not have specific recommendations for older hemodialysis patients. This retrospective cohort study aimed to determine the association of age with arteriovenous fistula (AVF) placement, maturation, and primary and secondary patency loss among older hemodialysis recipients. The authors conclude that the likelihood of AVF maturation is an important consideration for vascular access planning.
AHRQ-funded; HS022931.
Citation: Qian JZ, McAdams-DeMarco M, Ng DK .
Arteriovenous fistula placement, maturation, and patency loss in older patients initiating hemodialysis.
Am J Kidney Dis 2020 Oct;76(4):480-89.e1. doi: 10.1053/j.ajkd.2020.02.449..
Keywords: Elderly, Dialysis, Kidney Disease and Health, Surgery
Lee H, Caldwell JT, Maene C
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
Investigators examined whether neighborhood racial composition contributes to racial/ethnic inequities in access to high-quality dialysis care in Chicago. Data from the United States Renal Data System was merged with the ESRD Quality Incentive Program file and the American Community Survey (2005-2009) for facility and neighborhood characteristics. The investigators concluded that expanding opportunities for Blacks and Hispanics to gain access to racially integrated and minority neighborhoods may help alleviate racial/ethnic inequities in access to quality care among kidney disease patients.
AHRQ-funded; HS00078.
Citation: Lee H, Caldwell JT, Maene C .
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
J Racial Ethn Health Disparities 2020 Oct;7(5):854-64. doi: 10.1007/s40615-020-00708-8..
Keywords: Racial and Ethnic Minorities, Access to Care, Urban Health, Dialysis, Disparities, Quality of Care, Kidney Disease and Health
Purnell TS, Bae S, Luo X
National trends in the association of race and ethnicity with predialysis nephrology care in the United States From 2005 to 2015.
Predialysis nephrology care is associated with better survival among patients with end-stage kidney disease. The purpose of this study was to examine national trends in racial/ethnic disparities in receipt of predialysis nephrology care at least 1 year before dialysis initiation in the United States from 2005 to 2015. The study findings suggested that national strategies to address racial/ethnic disparities in predialysis nephrology care are needed.
AHRQ-funded; HS024600.
Citation: Purnell TS, Bae S, Luo X .
National trends in the association of race and ethnicity with predialysis nephrology care in the United States From 2005 to 2015.
JAMA Netw Open 2020 Aug;3(8):e2015003. doi: 10.1001/jamanetworkopen.2020.15003..
Keywords: Kidney Disease and Health, Dialysis, Racial and Ethnic Minorities, Chronic Conditions, Disparities
Butler AM, Layton JB, Dharnidharka VR
Comparative effectiveness of high-dose versus standard-dose influenza vaccine among patients receiving maintenance hemodialysis.
This study compared outcomes of routine dialysis patients who received either the standard dose vaccine (SDV) for influenza or a high-dose vaccine (HDV). Out of 22,215 influenza patient-seasons among adults 65 years and older, 97.4% received SDV and 2.6% received HDV. There did not seem to be any additional protection provided by the HDV for all-cause mortality or influenza-related outcomes.
AHRQ-funded; HS019455.
Citation: Butler AM, Layton JB, Dharnidharka VR .
Comparative effectiveness of high-dose versus standard-dose influenza vaccine among patients receiving maintenance hemodialysis.
Am J Kidney Dis 2020 Jan;75(1):72-83. doi: 10.1053/j.ajkd.2019.05.018..
Keywords: Vaccination, Influenza, Comparative Effectiveness, Dialysis, Kidney Disease and Health, Hospitalization, Outcomes
Clark-Cutaia MN, Jarrin OF, Thomas-Hawkins C
The perfect storm: stakeholder perspectives on factors contributing to hospital admissions for patients undergoing maintenance hemodialysis.
This study examined reasons why end stage renal disease (ESRD) patients undergoing hemodialysis experience frequent complications and hospitalizations. Interviews and focus groups were conducted with 21 patients living with ESRD, 10 caregivers, and three focus groups with health care professionals. There were four main themes that came out of the discussions: graft site/catheter/access issues, low resistance, breathing problems, and “The perfect storm”. The goal of these interviews were to promote more research to improve transitional care and care delivery for hemodialysis patients.
AHRQ-funded; HS022406.
Citation: Clark-Cutaia MN, Jarrin OF, Thomas-Hawkins C .
The perfect storm: stakeholder perspectives on factors contributing to hospital admissions for patients undergoing maintenance hemodialysis.
Nephrol Nurs J 2020 Jan-Feb;47(1):11-20..
Keywords: Kidney Disease and Health, Dialysis, Adverse Events, Hospitalization, Patient Safety