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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
176 to 199 of 199 Research Studies DisplayedWang 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
Banerjee T, Kim SJ, Astor B
Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study.
The researchers investigated the association between access type and inflammatory marker levels in 583 dialysis patients. They found that central venous catheters, compared with arteriovenous fistulas, are associated with a greater state of inflammation and the association of catheter use and mortality may be mediated by access-induced inflammation.
AHRQ-funded; HS008365
Citation: Banerjee T, Kim SJ, Astor B .
Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study.
Am J Kidney Dis. 2014 Dec;64(6):954-61. doi: 10.1053/j.ajkd.2014.07.010..
Keywords: Kidney Disease and Health, Mortality, Comparative Effectiveness
Mold JW, Aspy CB, Smith PD
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
This study was conducted to determine whether practice-based research networks (PBRNs) could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. After the intervention, the initial four PBRNs increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices, which also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. The researchers concluded that, with some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices.
AHRQ-funded; HS019945.
Citation: Mold JW, Aspy CB, Smith PD .
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Implement Sci 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.
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Keywords: Practice-Based Research Network (PBRN), Primary Care, Kidney Disease and Health, Chronic Conditions, Guidelines, Implementation
Scialla JJ, Liu J, Crews DC
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
The estimated glomerular filtration rate (eGFR) at dialysis initiation has been rising. This study described geographic variation in estimated glomerular filtration rate (eGFR) at dialysis initiation and determine its association with mortality. It found no associated harm or benefit with early dialysis initiation in the United States.
AHRQ-funded; 290200500341I.
Citation: Scialla JJ, Liu J, Crews DC .
An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.
Kidney Int 2014 Oct;86(4):798-809. doi: 10.1038/ki.2014.110..
Keywords: Kidney Disease and Health, Outcomes, Patient Safety, Registries
Zhang Y, Thamer M, Kshirsagar O
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
The purpose of this paper is to investigate the effect of dialysis facility chain status on renal transplantation therapy. The researchers concluded that dialysis chain affiliation expands previously observed ownership-related differences in placement on the waiting list, and for-profit ownership of dialysis chain facilities appears to be a significant impediment to access to renal transplants.
AHRQ-funded; HS020243.
Citation: Zhang Y, Thamer M, Kshirsagar O .
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
Transplantation 2014 Sep 15;98(5):543-51. doi: 10.1097/tp.0000000000000106.
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Keywords: Kidney Disease and Health, Transplantation, Access to Care
Petrov ME, Kim Y, Lauderdale DS
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
The investigators determined the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate. They found that, in this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years.
AHRQ-funded; HS013852.
Citation: Petrov ME, Kim Y, Lauderdale DS .
Objective sleep, a novel risk factor for alterations in kidney function: the CARDIA study.
Sleep Med 2014 Sep;15(9):1140-6. doi: 10.1016/j.sleep.2014.05.021.
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Keywords: Risk, Sleep Problems, Kidney Disease and Health
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation
Valencia V, Moghadassi M, Kriesel DR
Study of Tomography Of Nephrolithiasis Evaluation (STONE): methodology, approach and rationale.
This paper describes the rationale and methods of STONE (Study of Tomography Of Nephrolithiasis Evaluation), a pragmatic randomized comparative effectiveness trial comparing different imaging strategies for patients with suspected urolithiasis. It concluded that the detailed methodology of STONE will provide a roadmap for comparative effectiveness studies of diagnostic imaging conducted in an ED setting.
AHRQ-funded; HS019312.
Citation: Valencia V, Moghadassi M, Kriesel DR .
Study of Tomography Of Nephrolithiasis Evaluation (STONE): methodology, approach and rationale.
Contemp Clin Trials 2014 May;38(1):92-101. doi: 10.1016/j.cct.2014.03.006..
Keywords: Comparative Effectiveness, Imaging, Kidney Disease and Health, Research Methodologies
Scialla JJ, Kao WH, Crainceanu C
Biomarkers of vascular calcification and mortality in patients with ESRD.
This study evaluated the association between selected calcification biomarkers and long-term mortality in a large prospective cohort of dialysis patients. It found that factors such as osteoprotegerin and fetuin-A may be risk factors for all-cause and cardiovascular mortality in patients undergoing dialysis, but they do not improve risk prediction.
AHRQ-funded; HS008365
Citation: Scialla JJ, Kao WH, Crainceanu C .
Biomarkers of vascular calcification and mortality in patients with ESRD.
Clin J Am Soc Nephrol. 2014 Apr;9(4):745-55. doi: 10.2215/CJN.05450513..
Keywords: Kidney Disease and Health, Mortality, Chronic Conditions
Minsinger KD, Kassis HM, Block CA
Meta-analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of contrast-induced nephropathy.
The researchers conducted a meta-analysis examining the currently published evidence on the reduction of contrast volume and the possible reduction of contrast-induced nephropathy (CIN) with the use of automated contrast injectors (ACIs) versus manual injection. They found that the incidence of contrast-induced nephropathy was significantly reduced by 15% for those using ACIs compared with manual injection.
AHRQ-funded; HS018443.
Citation: Minsinger KD, Kassis HM, Block CA .
Meta-analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of contrast-induced nephropathy.
Am J Cardiol 2014 Jan;113(1):49-53. doi: 10.1016/j.amjcard.2013.08.040..
Keywords: Heart Disease and Health, Kidney Disease and Health, Risk
Beaubrun AC, Kanda E, Bond TC
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
The purpose of this study was to compare predialysis erythropoietin-simulating agents (ESA) care reported on Form CMS-2728 with Medicare claims for ESA treatment submitted for patients 67 years and older at initiation of dialysis with Medicare as the primary payer. It found that the agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes.
AHRQ-funded; HS000032.
Citation: Beaubrun AC, Kanda E, Bond TC .
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
Ren Fail 2013;35(3):320-6. doi: 10.3109/0886022x.2012.747967..
Keywords: Medicare, Data, Elderly, Quality of Care, Kidney Disease and Health