A5027154690- Dialysis and Renal Disease Management
- Acute Kidney Injury Research
- Central Venous Catheters and Hemodialysis
- Chronic Kidney Disease and Diabetes
- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
- Renal and Vascular Pathologies
- Blood Pressure and Hypertension Studies
- Vascular Procedures and Complications
- Muscle and Compartmental Disorders
- Parathyroid Disorders and Treatments
- Erythropoietin and Anemia Treatment
- Healthcare cost, quality, practices
- Cardiac Arrest and Resuscitation
- Chronic Disease Management Strategies
- COVID-19 and healthcare impacts
- Trauma and Emergency Care Studies
- COVID-19 Clinical Research Studies
- Advanced Glycation End Products research
- Hemodynamic Monitoring and Therapy
- Urinary Tract Infections Management
- Liver Disease and Transplantation
- Organ Donation and Transplantation
- Renal function and acid-base balance
- Iron Metabolism and Disorders
University Hospitals of Derby and Burton NHS Foundation Trust
2021-2025
Royal Derby Hospital
2014-2024
NHS England
2015-2022
University of Leicester
2021
University of Nottingham
2006-2020
National Health Service
2014-2019
Southmead Hospital
2007-2015
Helperby Therapeutics (United Kingdom)
2015
Renal Association
2015
Glan Clwyd Hospital
2015
Many patients with AKI are cared for by non-nephrologists. This can result in variable standards of care that contribute to poor outcomes.To improve recognition, a real-time, hospital-wide, electronic reporting system was designed based on current Acute Kidney Injury Network criteria. allowed prospective data collection incidence and outcomes such as mortality rate, length hospital stay, renal recovery. The setting 1139-bed teaching tertiary referral nephrology unit.An successfully...
Abstract Background Multimorbidity is a growing concern for healthcare systems, with many countries experiencing demographic transition to older population profiles. Chronic kidney disease (CKD) common but often considered in isolation. The extent and prognostic significance of its comorbidities not well understood. This study aimed assess the 11 people CKD stage 3. Methods A prospective cohort 1741 3 was recruited from primary care between August 2008 March 2010. Participants underwent...
Variable standards of care may contribute to poor outcomes associated with AKI. We evaluated whether a multifaceted intervention (AKI e-alerts, an AKI bundle, and education program) would improve delivery patient at organizational level.A multicenter, pragmatic, stepped-wedge cluster randomized trial was performed in five UK hospitals, involving patients aged ≥18 years. The introduced sequentially across fixed three-month periods according randomly determined schedule until all hospitals...
Home dialysis modalities (home hemodialysis [HD] and peritoneal [PD]) are associated with greater patient autonomy treatment satisfaction compared in-center modalities, yet the level of home-dialysis use worldwide is low. Reasons for limited utilization context-dependent, informed by local resources, costs, access to healthcare, health system policies, provider bias or preferences, cultural beliefs, individual lifestyle concerns, potential care-partner time, financial burdens. In May 2021,...
Vascular access practice is strongly associated with clinical outcomes. There substantial international variation in the use of arteriovenous fistulas (AVFs) and grafts (AVGs), as well AVF maturation time location.Prospective cohort study.Hemodialysis patients participating prospective Dialysis Outcomes Practice Patterns Study (DOPPS) from United States, Japan, Europe/ANZ (Belgium, France, Germany, Italy, Spain, Sweden, Kingdom, Australia, New Zealand), including 3,850 receiving 4,247 new...
Background Initial reports indicate a high incidence of acute kidney injury (AKI) in Coronavirus Disease 2019 (COVID-19), but more data are required to clarify if COVID-19 is an independent risk factor for AKI and how COVID-19–associated may differ from due other causes. We therefore sought study the relationship between COVID-19, AKI, outcomes retrospective cohort patients admitted 2 hospitals Derby, United Kingdom. Methods findings extracted electronic 4,759 hospitalised who were tested 5...
Grade 2) according to balance of benefits, risk, burden and cost.The quality or level evidence is assessed as 'high' (Grade A), 'moderate' B), 'low' C) 'very low' (D) depending on factors such study design, directness consistency results [1][2][3][4].
Background A recent report has highlighted suboptimal standards of care for acute kidney injury (AKI) patients in England. The objective this study was to ascertain if improvement basic standard by implementing a bundle (CB) with interruptive alert improved outcomes AKI. Methods An AKI CB linked electronic recognition AKI, coupled an alert, introduced improve delivered Outcomes were compared who had the completed within 24 hours (early group) versus those didn't have or it after hours....
Native arteriovenous fistula (AVF) is the vascular access of choice and its use cf. catheters associated with sustained reduction in mortality. This may be due to factors beyond dialysis catheter-associated sepsis. study aimed investigate impact AVF formation on spectrum cardiovascular that might important pathophysiology diseases chronic kidney disease (CKD) patients.We recruited 43 pre-dialysis patients who underwent formation. Patients were studied 2 weeks prior operation 3 months...
Consensus guidelines for acute kidney injury (AKI) have recommended prompt treatment including attention to fluid balance, drug dosing and avoidance of nephrotoxins. These simple measures can be incorporated in a care bundle facilitate early implementation. The objective this study was assess the effect compliance with AKI (AKI-CB) on in-hospital case-fatality progression.In larger, propensity score-matched cohort multifactorial AKI, we examined impact an AKI-CB 3717 consecutive episodes...
Tissue advanced glycation end products (AGE) accumulation is a measure of cumulative metabolic stress. Assessment tissue AGE by skin autofluorescence (SAF) correlates well with cardiovascular (CV) outcomes in diabetic, transplant, and dialysis patients, may be useful marker CV risk earlier stages chronic kidney disease (CKD).1707 patients estimated GFR 59 to 30 ml/min per 1.73 m(2) were recruited from primary care practices for the Renal Risk In Derby (RRID) study. Detailed medical history...
The high mortality rates that follow the onset of acute kidney injury (AKI) are well recognised. However, mode death in patients with AKI remains relatively under-studied, particularly general hospitalised populations who represent majority those affected. We sought to describe primary cause a large group prospectively identified AKI.All sustaining at our centre between 1(st) October 2010 and 31(st) 2011 were by real-time, hospital-wide, electronic reporting based on Acute Kidney Injury...
Background Body Mass Index (BMI) as a marker of obesity is an established risk factor for chronic kidney disease (CKD) and cardiovascular (CVD). However, BMI can overestimate obesity. Anthropomorphic measurements that include central fat deposition are emerging more important factor. We studied BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip (WHR) conicity index (CI) in cohort patients with CKD stage 3 compared the associations other known factors progression CVD....
Background To reduce over-diagnosis of chronic kidney disease (CKD) resulting from the inaccuracy creatinine-based estimates glomerular filtration rate (GFR), UK and international guidelines recommend that cystatin-C-based GFR be used to confirm or exclude diagnosis in people with 45–59 ml/min/1.73 m2 no albuminuria (CKD G3aA1). Whilst there is good evidence for cystatin C being a marker risk CKD, its use define CKD this manner has not been evaluated primary care, setting which most range...
What you need to know• Acute kidney injury (AKI) may be common in patients with covid-19 and is associated an increased risk of dying• AKI caused by volume depletion, multi-organ failure, viral infection leading directly tubular injury, thrombotic vascular processes, glomerulonephritis, or rhabdomyolysis• Maintaining optimal fluid status (euvolaemia) critical reducing the incidence • Regular assessments management plans are necessary, those who intravenous fluids choice replacement should...
Background and objectives Fatigue is a very common debilitating symptom identified by patients as critically important core outcome to be included in all trials involving receiving hemodialysis. A valid, standardized measure for fatigue needed yield meaningful relevant evidence about this outcome. This study validated patient-reported Design, setting, participants, & measurements longitudinal cohort was conducted assess the validity reliability of new (Standardized Outcomes...