A5051475251- Dialysis and Renal Disease Management
- Renal Transplantation Outcomes and Treatments
- Healthcare Policy and Management
- Chronic Kidney Disease and Diabetes
- Organ Donation and Transplantation
- Systemic Lupus Erythematosus Research
- Geriatric Care and Nursing Homes
- Health Systems, Economic Evaluations, Quality of Life
- Central Venous Catheters and Hemodialysis
- Blood Pressure and Hypertension Studies
- Chronic Disease Management Strategies
- Healthcare cost, quality, practices
- Heart Failure Treatment and Management
- Organ Transplantation Techniques and Outcomes
- Palliative Care and End-of-Life Issues
- Renal and Vascular Pathologies
- Parathyroid Disorders and Treatments
- Patient Satisfaction in Healthcare
- Potassium and Related Disorders
- Lipoproteins and Cardiovascular Health
- Patient-Provider Communication in Healthcare
- Liver Diseases and Immunity
- Systemic Sclerosis and Related Diseases
- Healthcare professionals’ stress and burnout
- Family and Patient Care in Intensive Care Units
University of California, San Francisco
2009-2025
San Francisco General Hospital
2009-2025
Center for Rheumatology
2024
Emory University
2014-2023
Geriatric Research Education and Clinical Center
2023
Duke University
2023
Creative Commons
2023
Augusta University
2022
Children's Healthcare of Atlanta
2021
National Kidney Foundation
2020
Prevalence of chronic kidney disease (CKD) in people with diagnosed diabetes is known to be high, but little about the prevalence CKD those undiagnosed or prediabetes. We aimed estimate and compare community among diabetes, prediabetes, no diabetes.The 1999 through 2006 National Health Nutrition Examination Survey a representative survey civilian, noninstitutionalized US population. Participants who were aged > =20 years; responded questionnaire; had fasting plasma glucose (FPG), serum...
<h3>Background</h3> Despite speculation that clinical information technologies will improve and financial outcomes, few studies have examined this relationship in a large number of hospitals. <h3>Methods</h3> We conducted cross-sectional study urban hospitals Texas using the Clinical Information Technology Assessment Tool, which measures hospital's level automation based on physician interactions with system. After adjustment for potential confounders, we whether greater hospital was...
The impact of recent guidelines for early detection and prevention chronic kidney disease (CKD) on patient awareness factors that might be associated with have not been well described.Awareness rates were assessed in 2992 adults (age, > or =20 years) CKD stages 1 to 4 from a nationally representative, cross-sectional survey (National Health Nutrition Examination Survey 1999-2004). Awareness was defined by an answer yes "Have you ever told weak failing kidneys?" Potential predictors included...
Background: The influence of type dialysis on survival patients with end-stage renal disease (ESRD) is controversial. Objective: To compare risk for death among ESRD who receive peritoneal or hemodialysis. Design: Prospective cohort study. Setting: 81 clinics in 19 U.S. states. Patients: 1041 starting (274 receiving and 767 hemodialysis) at baseline. Measurements: Patients were followed up to 7 years censored transplantation loss follow-up. Cox proportional hazards regression stratified by...
ContextIn light of conflicting evidence differential effects dialysis modality on survival, patient experience becomes a more important consideration in choosing between hemodialysis and peritoneal dialysis.ObjectiveTo compare satisfaction with cohort patients who have recently begun dialysis.Design SettingCross-sectional survey at enrollment prospective inception study started 37 centers participating the Choices for Healthy Outcomes Caring End-stage Renal Disease (CHOICE) study, national...
Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there only limited information on its prevalence and association with patient outcomes. This study examines the correlates of self-reported fatigue at initiation dialysis after 1 yr assesses extent to which was associated health-related quality life survival. Design, setting, participants, measurements: A longitudinal cohort 917 incident hemodialysis peritoneal who completed CHOICE...
Awareness of chronic kidney disease (CKD) among providers and patients is low. Whether clinical cues prompt recognition CKD unknown. We examined whether markers that should trigger are associated with higher individual awareness.CKD awareness was assessed in 1852 adults an estimated GFR <60 ml/min per 1.73 m(2) using 1999 to 2008 National Health Nutrition Examination Survey data. a "yes" answer "Have you ever been told have weak or failing kidneys?" Participants were grouped by distribution...
The use of peritoneal dialysis (PD) has declined in the United States over past decade and technique failure is also reportedly higher PD compared to hemodialysis (HD), but there are little data addressing factors outcomes associated with switching modalities from HD.In a prospective cohort study 262 patients enrolled 28 clinics 13 U.S. states, we examined potential predictors HD (including demographics, clinical factors, laboratory values) association mortality. Cox proportional hazards...
Dialysis facilities in the United States are required to educate patients with end-stage renal disease about all treatment options, including kidney transplantation. Patients receiving dialysis typically require a referral for transplant evaluation at center from facility start transplantation process, but proportion of referred is unknown.To describe variation facility-level and factors associated among initiating Georgia, US state lowest rates.Examination Renal Data System data cohort...
<h3>PURPOSE</h3> Because avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) is recommended for most individuals with chronic kidney disease (CKD), we sought to characterize patterns NSAID use among persons CKD in the United States. <h3>METHODS</h3> A total 12,065 adult (aged 20 years or older) participants cross-sectional National Health and Nutrition Examination Survey (1999–2004) responded a questionnaire regarding their over-the-counter prescription NSAIDs. NSAIDs (excluding...
Georgia has the lowest kidney transplant rates in United States and substantial racial disparities transplantation. We determined effectiveness of a multicomponent intervention to increase referral patients on dialysis for evaluation Reducing Disparities Access kidNey Transplantation Community Study (RaDIANT), randomized, facility–based, controlled trial involving >9000 receiving from 134 facilities Georgia. In December 2013, we selected with either low or disparity referral. The...
Before the 2014 implementation of a new kidney allocation system by United Network for Organ Sharing, white patients were more likely than black or Hispanic to receive transplant. To determine effect on these disparities, we examined data 179,071 transplant waiting list events in period June 2013–September 2016, and calculated monthly transplantation rates (34,133 actually received transplants). Implementation was associated with narrowing disparities average 0.29 percentage point blacks...
The impact of a new national kidney allocation system (KAS) on access to the deceased-donor waiting list (waitlisting) and racial/ethnic disparities in waitlisting among US end-stage renal disease (ESRD) patients is unknown. We examined pre- post-KAS incident (N = 1 253 100) prevalent 556 954) ESRD from United States Renal Data System database (2005-2015) using multivariable time-dependent Cox interrupted time-series models. adjusted rate was 9% lower (hazard ratio [HR]: 0.91; 95% confidence...
Longer nephrology care before end-stage renal disease (ESRD) has been linked with better outcomes. We investigated whether longer pre-end-stage was associated lower mortality at both the patient and state levels among 443 761 incident ESRD patients identified in USA between 2006 2010. Overall, 33% of new had received no prior care, while 28% for >12 months. At level, predictors months included having health insurance, white race, younger age, diabetes, hypertension US region. pre-ESRD...
Recent guidelines recommending more aggressive blood pressure control in patients with chronic kidney disease have unknown impact. We assessed trends and predictors of 8829 adult National Health Nutrition Examination Survey 1999–2006 participants hypertension (self-report, measured pressure, or use antihypertensive medications), without (n=7178) (n=1651) disease. Uncontrolled was defined as follows: general definition, systolic ≥140 mm Hg diastolic ≥90 Hg, disease-specific ≥130 ≥85...
Patients with chronic kidney disease are at high risk for sepsis and sepsis-related mortality.To assess whether statin use is associated a reduction in events [corrected] dialysis patients.National prospective cohort study that enrolled 1041 incident patients 81 US not-for-profit outpatient clinics from October 1995 to June 1998, follow-up January 2005. Statin was determined by medical record review. Rates of between users control were compared using multivariate regression models,...
Hypertension is both a cause and consequence of chronic kidney disease, but the prevalence disease throughout diagnostic spectrum blood pressure has not been established. We determined within categories in 17 794 adults surveyed by National Health Nutrition Examination Survey during 1999–2006. Diagnosed hypertension was defined as self-reported provider diagnosis (n=5832); undiagnosed systolic ≥140 mm Hg or diastolic ≥90 Hg, without report (n=3046); prehypertension ≥120 <140 ≥80 <90...