A5033218952- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Palliative Care and End-of-Life Issues
- Healthcare Policy and Management
- COVID-19 and healthcare impacts
- Geriatric Care and Nursing Homes
- Health Systems, Economic Evaluations, Quality of Life
- Organ Donation and Transplantation
- COVID-19 Clinical Research Studies
- Peripheral Artery Disease Management
- Renal and Vascular Pathologies
- Renal Transplantation Outcomes and Treatments
- Healthcare cost, quality, practices
- COVID-19 and Mental Health
- Long-Term Effects of COVID-19
- Blood Pressure and Hypertension Studies
- Central Venous Catheters and Hemodialysis
- Muscle and Compartmental Disorders
- Patient Dignity and Privacy
- Cerebrovascular and Carotid Artery Diseases
- Heart Failure Treatment and Management
- Family and Patient Care in Intensive Care Units
- Acute Kidney Injury Research
- SARS-CoV-2 and COVID-19 Research
- Renal Diseases and Glomerulopathies
VA Puget Sound Health Care System
2016-2025
Health Services Research & Development
2015-2025
University of Washington
2016-2025
Denver Health Medical Center
2020-2024
University of Colorado Denver
2020-2024
VA Portland Health Care System
2024
VA Palo Alto Health Care System
2024
University of Michigan
2020-2024
VA Ann Arbor Healthcare System
2024
Durham VA Medical Center
2024
The optimal intensity of renal-replacement therapy in critically ill patients with acute kidney injury is controversial.We randomly assigned and failure at least one nonrenal organ or sepsis to receive intensive less therapy. primary end point was death from any cause by day 60. In both study groups, hemodynamically stable underwent intermittent hemodialysis, unstable continuous venovenous hemodiafiltration sustained low-efficiency dialysis. Patients receiving the treatment strategy...
Chronic kidney disease (CKD) is common among the elderly. However, little known about how clinical implications of CKD vary with age. We examined age-specific incidence death, treated end-stage renal (ESRD), and change in estimated glomerular filtration rate (eGFR) 209,622 US veterans stages 3 to 5 followed for a mean 3.2 years. Patients aged 75 years or older at baseline comprised 47% overall cohort accounted 28% 9227 cases ESRD that occurred during follow-up. Among patients all ages, rates...
<h3>Importance</h3> Identifying independent risk factors for adverse outcomes in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can support prognostication, resource utilization, and treatment. <h3>Objective</h3> To identify excess associated hospitalization, mechanical ventilation, mortality SARS-CoV-2 infection. <h3>Design, Setting, Participants</h3> This longitudinal cohort study included 88 747 tested nucleic acid by polymerase chain reaction between...
Although renal insufficiency is a recognized risk factor for coronary artery disease, little known about the epidemiology of lower-extremity peripheral arterial disease (PAD) in persons with insufficiency.We examined cross-sectional association PAD, defined as an ankle-brachial index (ABI) <0.9, and insufficiency, estimated creatinine clearance (CRCL) <60 mL. min(-1). 1.73 m(-2), among 2229 eligible participants National Health Nutrition Examination Survey (NHANES) 1999 to 2000. An 1.2+/-0.3...
Current National Kidney Foundation Disease Outcomes Quality Initiative staging criteria for chronic kidney disease (CKD) are intended to apply all age groups. However, it is unclear whether different levels of estimated GFR (eGFR) have the same prognostic significance in older and younger patients. The study cohort was composed Department Veterans Affairs (VA) patients who were aged 18 100 yr had at least one outpatient serum creatinine measurement between October 1, 2001, September 30, 2002...
A low ankle-arm index (AAI) is a strong predictor of mortality and cardiovascular events. high AAI also appears to be associated with higher risk in select populations. However, across the spectrum have not been described more broadly defined population.We examined total events among 5748 participants Cardiovascular Health Study (CHS). The mean age sample population was 73+/-6 years, included 3289 women (57%) 883 blacks (15%). median duration follow-up 11.1 (0.1 12) years for 9.6 12.1) There...
acteristics and risk taking (P=.32), stress from uncertainty (P=.30), malpractice fear (P=.26) were not predictive of head CT use.Even after controlling for the patient factors, physician identity was still strongly associated with use (PϽ.001), suggesting that significant variation in exists among physicians.Comment.We found ED trauma patients explained by factors tolerance or fear.Variation physicians has been demonstrated previously, 8,9 but specifically patients.Because well-validated...
Aging kidneys undergo structural and functional changes that decrease autoregulatory capacity increase susceptibility to acute injury. Acute kidney injury associates with duration location of hospitalization, mortality risk, progression chronic disease, status in daily living. Definition diagnosis are based on creatinine, which is an inadequate marker might identify patients when it too late. The incidence rising increases advancing age, yet clinical studies have been slow address geriatric...
Background: End-stage renal disease disproportionately affects black Americans. However, the impact of residential segregation by race—a prominent feature many U.S. cities—on outcomes patients receiving dialysis and on facility performance has not been evaluated. Objective: To examine relationship among racial composition ZIP codes in metropolitan areas, dialysis, characteristics facilities. Design: Retrospective cohort study cross-sectional Setting: with differing percentages residents....
Summary Estimates suggest that one third of United States health care spending results from overuse or misuse tests, procedures, and therapies. The American Board Internal Medicine Foundation, in partnership with Consumer Reports , initiated the “Choosing Wisely” campaign to identify areas patient resource use most open improvement. Nine subspecialty organizations joined campaign; each organization identified five therapies are overused, misused, could potentially lead harm unnecessary...