National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
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- (-) Kidney Disease and Health (17)
- Medication (3)
- Mortality (1)
- Outcomes (3)
- Palliative Care (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Practice Patterns (1)
- Quality of Life (1)
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- Respiratory Conditions (1)
- Risk (3)
- Sex Factors (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 17 of 17 Research Studies DisplayedAklilu AM, Kumar S, Yamamoto Y
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
This retrospective study examined the association of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use with patients who have KDIGO-defined acute kidney injury (AKI) during acute heart failure (AHF) hospitalizations and their kidney function recovery at 14 days and 30 days using time-varying multivariable Cox-regression analyses. The study looked at 3305 adults hospitalized across 5 Yale New Haven Health Systems between January 2020 and May 2022 with AHF complicated by KDIGO-defined AKI. Of those individuals hospitalized with AHF and AKI, 356 received SGLT2i following AKI diagnosis either as initiation or continuation. The rate of renal recovery was not significantly different among those exposed and unexposed to SGLT2i following AKI (adjusted HR 0.94). SGLT2i exposure was associated with lower risk of 30-day mortality (adjusted HR 0.45). Rates of renal recovery were similar between the exposed and nonexposed cohorts regardless of the proximity of SGLT2i exposure to AKI diagnosis.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Yamamoto Y .
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
Kidney360 2023 Oct; 4(10):1371-81. doi: 10.34067/kid.0000000000000250..
Keywords: Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Inpatient Care, Medication, Outcomes
Pokorney SD, Black-Maier E, Hellkamp AS
Oral anticoagulation and cardiovascular outcomes in patients with atrial fibrillation and end-stage renal disease.
The objective of this study was to describe patterns of oral anticoagulant (OAC) use in end-stage renal disease (ESRD) patients with atrial fibrillation (AF) and their associations with cardiovascular outcomes. Medicare fee-for-service 5% claims data from 2007 to 2013 was analyzed in a cohort of patients with ESRD and AF. A cohort of 8,410 patients with AF and ESRD was identified, with a total of 3,043 (36.2%) patients treated with OAC during the study period. Treatment with OAC was not associated with hospitalization for stroke, or death but was associated with increased hospitalization for bleeding and intracranial hemorrhage.
AHRQ-funded; HS021092.
Citation: Pokorney SD, Black-Maier E, Hellkamp AS .
Oral anticoagulation and cardiovascular outcomes in patients with atrial fibrillation and end-stage renal disease.
J Am Coll Cardiol 2020 Mar 24;75(11):1299-308. doi: 10.1016/j.jacc.2020.01.019..
Keywords: Blood Thinners, Medication, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Chronic Conditions, Outcomes
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Brescia AA, Wu X, Paone G
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
Researchers explored whether there a sex-related difference on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. A prospective, observational study was conducted of 17,363 patients not on dialysis undergoing the procedure between 2011 and 2016 across 41 institutions from the Perfusion Measure and Outcomes registry. There was no sex-related differences found for nadir hematocrit or rates of acute kidney injury.
AHRQ-funded; HS026003; HS022535.
Citation: Brescia AA, Wu X, Paone G .
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
J Thorac Cardiovasc Surg 2019 Oct;158(4):1073-80.e4. doi: 10.1016/j.jtcvs.2019.03.042..
Keywords: Injuries and Wounds, Sex Factors, Kidney Disease and Health, Adverse Events, Surgery, Heart Disease and Health, Cardiovascular Conditions
Dunn T, Saeed MJ, Shpigel A
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
This study examined whether the use of preoperative cardiac stress testing of patients undergoing kidney transplantation reduced 30-day- death and myocardial infarction post-transplantation. ESRD patients 40 years or older with primary Medicare insurance between 2006 and 2013 were identified using the United States Renal Data System. In a matched cohort of 17,304 patients, there was little difference in 30-day post-transplantation mortality and myocardial infarction between those receiving a stress test and those who did not.
AHRQ-funded; HS019455.
Citation: Dunn T, Saeed MJ, Shpigel A .
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
PLoS One 2019 Feb;14(2):e0211161. doi: 10.1371/journal.pone.0211161..
Keywords: Transplantation, Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Surgery
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Plantinga LC, King LM, Masud T
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Pulmonary edema is prevalent and may be a common cause of hospital readmissions in hemodialysis patients. In this retrospective cohort study, the investigators aimed to estimate the national burden of, and identify correlates of, readmissions related to pulmonary edema among hemodialysis patients. The investigators concluded that readmissions related to pulmonary edema were common in hemodialysis patients. They suggest that interventions aimed at preventing such readmissions could have a substantial impact on readmissions overall, particularly targeted at incident hemodialysis patients with a prior history of heart failure and patients initially admitted for pulmonary edema.
AHRQ-funded; HS025018.
Citation: Plantinga LC, King LM, Masud T .
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Nephrol Dial Transplant 2018 Jul;33(7):1215-23. doi: 10.1093/ndt/gfx335..
Keywords: Adverse Events, Dialysis, Heart Disease and Health, Hospital Readmissions, Hospitalization, Kidney Disease and Health
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
Amin AP, Bach RG, Caruso ML
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
The purpose of this study was to examine the national variation in acute kidney injury (AKI) incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after percutaneous coronary intervention (PCI). This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for percutaneous coronary intervention (PCI) in the United States.
AHRQ-funded; HS022481.
Citation: Amin AP, Bach RG, Caruso ML .
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
JAMA Cardiol 2017 Sep;2(9):1007-12. doi: 10.1001/jamacardio.2017.2156..
Keywords: Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Patient Safety, Heart Disease and Health, Practice Patterns
Bostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Patel PA, Liang L, Khazanie P
Antihyperglycemic medication use among Medicare beneficiaries with heart failure, diabetes mellitus, and chronic kidney disease.
The authors sought to investigate the overall use and safety of antihyperglycemic medications (AHMs) among patients with diabetes mellitus, heart failure, and chronic kidney disease. They found that treatment of diabetes mellitus in patients with HF and chronic kidney disease is complex, and these patients are commonly treated with renal contraindicated AHMs, including over 6% receiving a thiazolidinedione, despite known concerns regarding HF. They recommended more research regarding safety and efficacy of various AHMs among HF patients.
AHRQ-funded; HS021092.
Citation: Patel PA, Liang L, Khazanie P .
Antihyperglycemic medication use among Medicare beneficiaries with heart failure, diabetes mellitus, and chronic kidney disease.
Circ Heart Fail 2016 Jul;9(7). doi: 10.1161/circheartfailure.115.002638.
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Keywords: Diabetes, Elderly, Heart Disease and Health, Kidney Disease and Health, Medication
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
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
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
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