<h3>Importance</h3> Little is known about how US clinicians have responded to resource limitation during the coronavirus disease 2019 (COVID-19) pandemic. <h3>Objective</h3> To describe perspectives and experiences of involved in institutional planning for and/or patient care <h3>Design, Setting, Participants</h3> This qualitative study used inductive thematic analysis semistructured interviews conducted April May 2020 with a national group (eg, intensivists, nephrologists, nurses) clinical...

For patients with advanced kidney disease, especially hospitalized patients, dialysis may be presented as the opposite end of treatment spectrum from comfort care. Collaborative efforts and amended policies could allow to have a better range options.

This paper addresses the just distribution of vaccines against SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline essential workers, people at high risk severe disease or death, infection. Section I makes case vaccine should occur a global level in order to accelerate development fair, efficient allocation. II puts values guide including helping with greatest need, reducing health disparity, saving most lives promoting narrow social utility. It also responds...

Pediatric dialysis is thought to be burdensome on caregivers given their need assume dual responsibilities of parental and medical management child's chronic illness. In this study, we seek describe the experience children receiving for end-stage kidney disease.We performed semistructured interviews primary with disease peritoneal or hemodialysis at least 8 weeks from March 2016 April 2017 3 pediatric centers in United States. We a thematic analysis inductively derive identify themes...

To describe the prevalence and outcomes of renal transplantation in children with ID we performed a retrospective cohort analysis all receiving first kidney-alone transplant UNOS dataset from 2008 to 2011. Recipients definite, probable, without were compared using chi-square tests. Kaplan-Meier curves constructed for patient graft survival. Cox proportional hazard models used estimate association between failure Over study period, 332 definite (117) or probable (215) underwent transplant,...

As health care practices have evolved from a disease-oriented to patient-focused paradigm, patient and family engagement (PFE) has been recognized as an important aspect of delivery outcomes. While pediatricians long approached with family-centered lens, PFE may be less familiar concept situate among related concepts such shared decision-making, self-efficacy, activation, care. Children CKD their families indicate need desire for enhanced efforts in pediatric nephrology. Improving offers the...

ABSTRACT Many transplant programs worldwide are likely to impose vaccine mandates for pediatric solid organ candidates; some already do. Three potential benefits that advocates invoke justify improved patient outcomes, efficient allocation, and contributions community protection. We show none of these can mandates. The medical unlikely outweigh the risks denying life‐saving care, threaten trust equity in impact on protection is negligible, while burden unvaccinated children would be...

ABSTRACT Background Some adult transplant surgeons consider to be contraindicated in patients receiving palliative care (PC). Little is known about pediatric surgeons' attitudes toward PC. We sought ascertain kidney perspectives regarding the routine integration of PC for children with chronic disease. Method administered a cross‐sectional web‐based survey members American Society Transplant Surgeons listserv summer 2021. adapted from previously validated Provider Survey Palliative Care...

Abstract In this era of rapidly advancing biomedical technologies, it is not unusual for parents children with profound cognitive disabilities to ask clinicians provide invasive life‐sustaining treatments. Parental requests such interventions pose a moral dilemma the treating medical team, as there may be discrepancy between team's perception child's best interest and apparent rationale underlying parent's request. This gap highlights limitation standard in cases where, due...

COVID-19 has sickened more than one million people and outpaced the capacity of hospitals around world to meet demand for vital medical resources, such as ventilators, intensive care unit (ICU)...

Objective: To examine parent protection and its correlates among 8-year-old ELBW children compared with normal birth weight (NBW) controls. Methods: The population included 217 eight-year-old born 1992–1995 (92% of the surviving cohort; mean weight, 811 g; gestational age, 26.4 weeks) 176 NBW primary outcome measure, Parent Protection Scale (PPS), a total score four domains including Supervision, Separation, Dependence, Control. Multivariate analyses were performed to predictors parental...

To determine the frequency of parents' requests for alternative childhood immunization schedules (ACISs) and pediatricians' comfort with willingness to use ACISs.Washington State primary care pediatricians were asked complete an Internet-based survey on ACISs. The main outcome measures ACISs, their use, ACISs individual vaccines. In addition, respondents characterize practices provide demographic information.Of 311 (response rate: 65%), 209 met inclusion criteria included in analyses....

<h3>Importance</h3> To be considered for a kidney transplant, patients with advanced disease must participate in formal evaluation and selection process. Little is known about how this process proceeds real-world clinical settings. <h3>Objective</h3> characterize the transplant among representative national sample of US veterans who were referred to center. <h3>Design, Setting, Participants</h3> This qualitative study was thematic analysis clinician notes electronic health records...

ABSTRACT Objective: We sought to describe the prevalence and outcomes of liver transplantation in children with intellectual disability (ID). hypothesized that recipients ID have comparable short‐term compared those without ID. Methods: performed a retrospective cohort analysis receiving first liver‐alone transplant United Network for Organ Sharing dataset from 2008 2013. Recipients definite or probable were using χ 2 tests. Kaplan‐Meier curves constructed patient graft survival. Cox...

Abstract Background Studies of HRQoL after kidney transplant have yielded conflicting results. We sought to assess the impact on HRQoL. Methods performed a retrospective study using PedsQL3.0ESRD module during dialysis and at 3 12 months following in 56 recipients. For entire cohort, we described scores each time point used ANOVA models test for associations between demographic transplant‐related factors post‐transplant scores. linear mixed investigate interactions estimate differences mean...

Disqualifying patients with intellectual disabilities (ID) from transplantation has received growing attention the media, state legislatures, Office of Civil Rights, and recently National Council on Disability, as well internationally. Compared evidence-based criteria used to determine transplant eligibility, ID criterion remains controversial because its potential be discriminatory, subjective, relationship outcomes is uncertain. Use in determining candidacy may stem partly perceived worse...

Children with chronic kidney disease (CKD) are subject to physical and psychosocial challenges, which may confer greater risk of developing psychiatric disorders. We sought examine key diagnoses in children CKD compared those the general pediatric population assess correlation between parent-reported diagnosis self-reported symptoms depression.Cross-sectional.Children ages 2-17 years receiving current medical care who participated Chronic Kidney Disease Study (CKiD) or National Survey...

This study assesses food insecurity and acute health care utilization among pediatric patients with end-stage kidney disease undergoing peritoneal dialysis or hemodialysis.