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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 147 Research Studies Displayed
Remigio RV., Hel. H, Raimann JG
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States.
Researchers investigated the impact of air pollution exposure among end-stage kidney disease (ESKD) patients and its potential modifying effect from extreme heat events (EHE). Data on daily all-cause mortality and all-cause hospital admissions was taken from Fresenius Kidney Care records from selected northeastern US counties. Their findings suggested interdependent effects of EHE and air pollution among ESKD patients for all-cause mortality risks. They recommended national level assessments in order to consider the ESKD population as a sensitive population and to inform treatment protocols during extreme heat and degraded pollution episodes.
AHRQ-funded; HS027716.
Citation:
Remigio RV., Hel. H, Raimann JG .
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States.
Sci Total Environ 2022 Mar 15;812:152481. doi: 10.1016/j.scitotenv.2021.152481..
Keywords:
Kidney Disease and Health
Remigio RV, Turpin R, Raimann JG, et al.
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
This study investigated whether pre-dialysis systolic blood pressure (preSBP) and interdialytic weight gain (IDWG) in individuals with end-stage kidney disease (ESKD) can independently mediate the association between ambient temperature, all-cause hospital admissions (ACHA), and all-cause mortality (ACM). The study population consisted of 1981 ESKD patients receiving hemodialysis treatments at Fresenius Medical Care facilities in Philadelphia County, PA, from 2011 to 2019. Within a time-to-event framework, the authors estimated the association between daily maximum dry-bulb temperature (TMAX) and, as separate models, ACHA and ACM during warmer calendar months. Based on Lag 2- Lag 1 temporal ordering, and a 1 °C increase in daily maximum dry-bulb temperature (TMAX), the authors found an increased hazard of ACHA by 1.4% and ACM 7.5%. Short-term lag exposures to 1 °C increase in temperature predicted mean reductions in IDWG and preSBP by 0.013-0.015% and 0.168-0.229 mmHg.
AHRQ-funded; HS027716.
Citation:
Remigio RV, Turpin R, Raimann JG, et al..
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
Environ Res 2022 Mar;204(Pt B):112127. doi: 10.1016/j.envres.2021.112127..
Keywords:
Kidney Disease and Health, Chronic Conditions, Hospitalization
Al Sahlawi M, Zhao J, McCullough K
Variation in peritoneal dialysis-related peritonitis outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).
This observational prospective cohort study describes the likelihood of a cure after a peritonitis episode from peritoneal dialysis (PD), exploring its association with various patient, peritonitis, and treatment characteristics. The cohort included 1,631 peritonitis episodes (1,190 patients, 126 facilities) in Australia, New Zealand, Canada, Japan, Thailand, the United Kingdom, and the United States. Outcomes looked at included cure, defined as absence of death, transfer to hemodialysis (HD), PD catheter removal, relapse, or recurrent peritonitis within 50 days of a peritonitis episode. Odds of cure were lower for Gram-negative, polymicrobial, and fungal peritonitis compared with Gram-positive peritonitis. Odds of cure were also higher with automated PD versus continuous ambulatory PD, facility icodextrin use, empirical aminoglycoside user, and ciprofloxacin use versus ceftazidime use for Gram-negative peritonitis. Prior peritonitis episodes were also associated with lower odds of a cure.
AHRQ-funded; HS025756.
Citation:
Al Sahlawi M, Zhao J, McCullough K .
Variation in peritoneal dialysis-related peritonitis outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).
Am J Kidney Dis 2022 Jan;79(1):45-55.e1. doi: 10.1053/j.ajkd.2021.03.022..
Keywords:
Dialysis, Kidney Disease and Health
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.
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
Kilgallon JL, Gannon M, Burns Z
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
This study’s objective is to develop an intervention for the primary care management of uncontrolled hypertension (HTN) in chronic kidney disease (CKD) utilizing user-centered design principles and behavioral economic principles, test the effectiveness of that intervention, and collect implementation data that will facilitate the application of the intervention in other practice settings. One hundred and eighty-four eligible clinical physicians from 15 practices of The Brigham and Women's Practice -Based Research Network are enrolled in the study. The researchers will use the Reach Effectiveness Adoption Implementation Maintenance framework to assess the intervention’s effectiveness in impacting a change in mean systolic blood pressure between baseline and 6 months.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation:
Kilgallon JL, Gannon M, Burns Z .
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
BMJ Open 2021 Dec 22;11(12):e054065. doi: 10.1136/bmjopen-2021-054065..
Keywords:
Kidney Disease and Health, Blood Pressure, Hypertension, Clinical Decision Support (CDS), Health Information Technology (HIT)
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
Racila AM, O'Shea AMJ, Nair R
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
This article describes a planned study; the objective is to determine the clinical efficacy and effectiveness of a novel intervention using nasal povidone-iodine to prevent bloodstream infections among patients in hemodialysis units. Findings will be presented at international meetings, and the study team will publish findings in peer-reviewed journals, making each accepted peer-reviewed manuscript publicly available.
AHRQ-funded; HS026724.
Citation:
Racila AM, O'Shea AMJ, Nair R .
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
BMJ Open 2021 Dec 3;11(12):e048830. doi: 10.1136/bmjopen-2021-048830..
Keywords:
Healthcare-Associated Infections (HAIs), Kidney Disease and Health, Prevention
Barreto EF, Schreier DJ, May HP
Incidence of serum creatinine monitoring and outpatient visit follow-up among acute kidney injury survivors after discharge: a population-based cohort study.
This study evaluated the frequency of follow-up after hospital discharge among acute kidney injury (AKI) survivors. This population-based cohort study included adult residents of Olmsted County hospitalized from an episode of stage II or II AK between 2006 and 2014. Follow-up visits at 30-days, 90 days, and 1 year were included. In the 627 included AKI survivors, the cumulative incidence of a follow-up serum creatinine (SCr) level was 80%, a healthcare visit 82%, or both was 70%. At 90 days and 1 year after discharge, cumulative incidents of meeting both follow-up criteria rose to 82 and 91% respectively. Independent predictors of receiving both were not related to demographic or socioeconomic factors but to lower estimated glomerular filtration rate at discharge, higher comorbidity burden, longer length of hospitalization, and greater maximum AKI severity.
AHRQ-funded; HS028060.
Citation:
Barreto EF, Schreier DJ, May HP .
Incidence of serum creatinine monitoring and outpatient visit follow-up among acute kidney injury survivors after discharge: a population-based cohort study.
Am J Nephrol 2021;52(10-11):817-26. doi: 10.1159/000519375..
Keywords:
Kidney Disease and Health, Hospital Discharge, Care Management, Healthcare Utilization
Nguyen KH, Thorsness R, Hayes S
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
This study examined the impact of COVID-19 on initiation of kidney failure treatment during the first 4 months of the pandemic with a focus on racial, ethnic, and socioeconomic disparities. The study population included 127,149 patients with incident kidney failure between January 2018 and June 2020. The mean age of patients was 62.8 years, and were 41.7% female, 25.9% non-Hispanic Black and 15.6% Hispanic/Latino. There were significant decreases in the proportion of patients with incident kidney failure receiving preemptive transplantation and initiating hemodialysis treatment with an arteriovenous fistula during the first 4 months of the pandemic compared to the pre-COVID-19 period. These decreases were most significant among non-Hispanic Black patients. There were also significant decreases in patients residing in counties in the highest quintile of COVID-19 mortality rates, but not for patients residing in other counties. Treatment initiation was approximately 30% lower than projected in April 2020.
AHRQ-funded; HS028285.
Citation:
Nguyen KH, Thorsness R, Hayes S .
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
JAMA Netw Open 2021 Oct;4(10):e2127369. doi: 10.1001/jamanetworkopen.2021.27369..
Keywords:
COVID-19, Kidney Disease and Health, Racial / Ethnic Minorities, Disparities
Montgomery JR, Waits SA, Dimick JB
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
The purpose of this study was to determine whether patients with chronic kidney disease experienced higher rates of perioperative complications after roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy. The investigators concluded that among well-matched cohorts of RYGB and sleeve gastrectomy patients, incidence of primary outcomes were similar. Among secondary outcomes, only acute kidney injury was statistically-significantly higher among RYGB patients; however, the E-value for this difference was small and relatively weak confounder(s) could abrogate the statistical difference.
AHRQ-funded; HS025778.
Citation:
Montgomery JR, Waits SA, Dimick JB .
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
Ann Surg 2021 Oct 1;274(4):e328-e35. doi: 10.1097/sla.0000000000003627..
Keywords:
Surgery, Obesity, Kidney Disease and Health, Risk, Chronic Conditions
Kim D, Lee Y, Thorsness R
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.
AHRQ-funded; HS028285.
Citation:
Kim D, Lee Y, Thorsness R .
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..
Keywords:
COVID-19, Racial / Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health
Mian HS, Fiala MA, Sanchez L
Renal failure among multiple myeloma patients utilizing carfilzomib and associated factors in the "real world."
Researchers investigated the rate of renal failure and associated risk factors in real-world populations of patients with multiple myeloma taking carfilzomib. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data, they found that renal failure developed in 22% of patients during the study period. The median time to development of renal failure from first carfilzomib administration was 1.6 months. Increasing age, pre-existing heart failure, and pre-existing chronic kidney disease were associated with a higher risk of developing renal failure. As their study could not determine the exact cause and mechanism of renal failure, they recommended future studies to further understand this cause among patients on carfilzomib and to devise strategies to mitigate the risk.
AHRQ-funded; HS019455.
Citation:
Mian HS, Fiala MA, Sanchez L .
Renal failure among multiple myeloma patients utilizing carfilzomib and associated factors in the "real world."
Ann Hematol 2021 May;100(5):1261-66. doi: 10.1007/s00277-021-04420-3..
Keywords:
Cancer, Kidney Disease and Health, Medication, Adverse Drug Events (ADE), Adverse Events, Risk
Schoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation:
Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords:
Emergency Department, Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Bae S, Johnson M, Massie AB
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Patients with sickle cell disease-associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population. In this study, the investigators aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.
AHRQ-funded; HS024600.
Citation:
Bae S, Johnson M, Massie AB .
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Clin J Am Soc Nephrol 2021 Mar 8;16(3):407-14. doi: 10.2215/cjn.02720320..
Keywords:
Transplantation, Access to Care, Kidney Disease and Health, Mortality
Gregg LP, Hedayati SS, Yang H
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
This study looked at whether blood pressure variability (BPV) is associated with cardiovascular outcomes and end-stage kidney disease (ESKD) in patients with chronic kidney disease. The authors studied US veterans with nondialysis chronic kidney disease stages 1-5 and hypertension on nondiuretic antihypertensive monotherapy. This case-control study compared veterans on only one antihypertensive prescription with those who were prescribed a second antihypertensive prescription. Each group had 31,394 participants. BPV was associated with composite cardiovascular events. It was associated with cardiovascular events and death but not ESKD in patients with chronic kidney disease.
AHRQ-funded; HS022418.
Citation:
Gregg LP, Hedayati SS, Yang H .
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
Hypertension 2021 Mar 3;77(3):948-59. doi: 10.1161/hypertensionaha.120.16117..
Keywords:
Kidney Disease and Health, Blood Pressure, Cardiovascular Conditions, Chronic Conditions
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, 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
Li K, Ferguson T, Embil J
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Investigators sought to determine how interim lower limb complications modify the subsequent risk of progression to kidney failure, all-cause mortality before kidney failure, and cardiovascular events in a cohort of patients with chronic kidney disease (CKD) stages G3 to G5. Patient-level data obtained from several administrative databases from Manitoba, Canada, were analyzed. They found that interim lower limb complications were associated with an increased risk of kidney failure, all-cause mortality before kidney failure, and cardiovascular-related hospitalization. They stated that clinical trials of screening and treatment strategies for patients with CKD at risk for lower limb complications may help determine optimal strategies to manage this risk.
AHRQ-funded; HS018574.
Citation:
Li K, Ferguson T, Embil J .
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Kidney Int Rep 2021 Feb;6(2):381-88. doi: 10.1016/j.ekir.2020.11.010..
Keywords:
Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Adverse Events, 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, Decision Making
Wang W, Rees MA, Leichtman AB
Deceased donors as nondirected donors in kidney paired donation.
As proof of concept, the investigators simulated a revised kidney allocation system that included deceased donor (DD) kidneys as chain-initiating kidneys (DD-CIK) in a kidney paired donation pool (KPDP) and estimated potential increases in number of transplants. They considered chains of length 2 in which the DD-CIK gave to a candidate in the KPDP, and that candidate's incompatible donor donated to the DD waitlist.
AHRQ-funded; HS020610.
Citation:
Wang W, Rees MA, Leichtman AB .
Deceased donors as nondirected donors in kidney paired donation.
Am J Transplant 2021 Jan;21(1):103-13. doi: 10.1111/ajt.16268..
Keywords:
Transplantation, Kidney Disease and Health
Perl J, Fuller DS, Boudville N
Optimizing peritoneal dialysis-associated peritonitis prevention in the United States: from standardized peritoneal dialysis-associated peritonitis reporting and beyond.
Peritoneal dialysis (PD)-associated peritonitis is the leading cause of permanent transition to hemodialysis among patients receiving PD. Optimizing the prevention of peritonitis in the United States will first require standardization of peritonitis definitions, key data elements, and outcomes in an effort to facilitate nationwide reporting. In this paper, the investigators highlighted considerations and challenges in developing standardized definitions and implementation of national reporting of peritonitis rates by PD facilities.
AHRQ-funded; HS025756.
Citation:
Perl J, Fuller DS, Boudville N .
Optimizing peritoneal dialysis-associated peritonitis prevention in the United States: from standardized peritoneal dialysis-associated peritonitis reporting and beyond.
Clin J Am Soc Nephrol 2020 Dec 31;16(1):154-61. doi: 10.2215/cjn.11280919..
Keywords:
Kidney Disease and Health, Quality Improvement, Quality of Care
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
Edwards GC, Shipe ME, Smith L
Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation.
The objective of this study was to explore patient willingness to accept a kidney from Hepatitis C virus-infected donors compared to donors with active intravenous drug use and donors with longstanding diabetes and hypertension. Using electronic surveys, results showed that utilization of kidneys from Hepatitis C virus-infected donors to expand the donor pool appeared to be an acceptable option to patients.
AHRQ-funded; HS026122.
Citation:
Edwards GC, Shipe ME, Smith L .
Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation.
BMC Nephrol 2020 Nov 10;21(1):473. doi: 10.1186/s12882-020-02114-y..
Keywords:
Hepatitis, Kidney Disease and Health, Transplantation
Sloan CE, Zhong J, Mohottige D
Fragmentation of care as a barrier to optimal ESKD management.
This article describes the role of care fragmentation in the delivery of optimal ESKD care and identifies research gaps in the evidence across the continuum of care. The authors consider the impact of care fragmentation on ESKD care from the patient and health system perspectives and explore opportunities for system-level interventions aimed at improving care for patients with ESKD.
AHRQ-funded.
Citation:
Sloan CE, Zhong J, Mohottige D .
Fragmentation of care as a barrier to optimal ESKD management.
Semin Dial 2020 Nov;33(6):440-48. doi: 10.1111/sdi.12929..
Keywords:
Kidney Disease and Health, Care Management, Healthcare Delivery, Quality of Care
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
