A5076091003- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Health Systems, Economic Evaluations, Quality of Life
- Parathyroid Disorders and Treatments
- Peripheral Artery Disease Management
- Healthcare Policy and Management
- Central Venous Catheters and Hemodialysis
- Blood Pressure and Hypertension Studies
- Heavy Metal Exposure and Toxicity
- Renal Transplantation Outcomes and Treatments
- Heart Failure Treatment and Management
- Organ Donation and Transplantation
- Renal and Vascular Pathologies
- Erythropoietin and Anemia Treatment
- Frailty in Older Adults
- Acute Kidney Injury Research
- Healthcare cost, quality, practices
- Chronic Disease Management Strategies
- Geriatric Care and Nursing Homes
- Cardiac electrophysiology and arrhythmias
- Hemoglobinopathies and Related Disorders
- Renal function and acid-base balance
- Potassium and Related Disorders
- Heart Rate Variability and Autonomic Control
- Iron Metabolism and Disorders
Johns Hopkins University
2016-2025
Welch Foundation
2012-2024
Johns Hopkins Medicine
2015-2024
Nephrology Center of Maryland
2013-2022
National Kidney Foundation
2011-2022
MedStar Union Memorial Hospital
2021
MedStar Good Samaritan Hospital
2011-2021
University of Alabama at Birmingham
2020
St Bernard's Hospital
2015-2019
University of California, San Francisco
2011-2018
Total cholesterol level is inversely associated with mortality in dialysis patients, a group at high risk of cardiovascular disease (CVD). This paradox may be explained by systemic inflammation and/or malnutrition, which are lower levels and higher mortality.To determine the relationship between outcome patients undergoing dialysis, accounting for malnutrition.Prospective study 823 enrolled from October 1995 to June 1998 who recently initiated 79 clinics, classified absence or presence...
ABSTRACT. Chronic kidney disease (CKD) is an increasing cause of morbidity and mortality in the United States. Prospective data on risk factors for CKD are limited to men, few studies examine importance smoking. The authors performed a community-based, prospective observational study 20-yr duration association between hypertension smoking future 23,534 men women Washington County, Maryland. was identified as end-stage renal Health Care Financing Administration database or listed death...
Septicemia in dialysis patients: Incidence, risk factors, and prognosis.BackgroundInfection is second to cardiovascular disease as a cause of death patients with end-stage renal (ESRD), septicemia causes majority these infectious deaths. To identify at high characterize modifiable factors for septicemia, we examined the incidence, prognosis large, representative group U.S. patients.MethodsWe conducted longitudinal cohort study incident ESRD case-mix Renal Data System seven years follow-up...
Objectives To quantify the prevalence of frailty in adults all ages undergoing chronic hemodialysis, its relationship to comorbidity and disability, association with adverse outcomes mortality hospitalization. Design Prospective cohort study. Setting Single hemodialysis center B altimore, M aryland. Participants One hundred forty‐six individuals enrolled between J anuary 2009 arch 2010 followed through A ugust 2012. Measurements Frailty, comorbidity, disability on enrollment study subsequent...
Chronic kidney disease is a growing public health problem. Screening for early identification could improve but also lead to unnecessary harms and excess costs.To assess the value of periodic, population-based dipstick screening detection urine protein in adults with neither hypertension nor diabetes hypertension.Cost-effectiveness analysis using Markov decision analytic model compare strategy annual no (usual care) proteinuria at age 50 years followed by treatment an angiotensin-converting...
Environmental cadmium and lead exposures are widespread, both metals nephrotoxic at high exposure levels. Few studies have evaluated the associations between low-level clinical renal outcomes, particularly with respect to joint exposure. The geometric mean levels of blood were 0.41 μg/L (3.65 nmol/L) 1.58 μg/dL (0.076 μmol/L), respectively, in 14,778 adults aged ≥20 years who participated National Health Nutrition Examination Survey (1999–2006). After adjustment for survey year,...
Diabetes and hypertension are the predominant risk factors for chronic kidney disease (CKD) globally. Infectious diseases resulting in glomerulonephritis also important low-income countries [1, 2]. However, past two decades, a severe form of CKD has been reported individuals without these factors. unknown etiology (CKDu) affects adults their third to fifth decade is often fatal due progression lack dialysis or transplant options involved geographic areas. CKDu Sri Lanka, several Central...
Background and objectives Patients of all ages undergoing hemodialysis (HD) have a high prevalence cognitive impairment worse function than healthy controls, those with dementia are at risk death. Frailty has been associated poor in older adults without kidney disease. We hypothesized that frailty might also be HD. Design, setting, participants, & measurements At HD initiation, 324 enrolled (November 2008 to July 2012) longitudinal cohort study (Predictors Arrhythmic Cardiovascular Risk...
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...
Abstract Background Patients undergoing hemodialysis are at high risk of falls, with subsequent complications including fractures, loss independence, hospitalization, and institutionalization. Factors associated falls poorly understood in this population. We hypothesized that insights derived from studies the elderly might apply to adults all ages hemodialysis; we focused on frailty, a phenotype physiological decline strongly elderly. Methods In prospective, longitudinal study 95 patients...
Recently Centers for Medicare and Medicaid Services (CMS) began asking providers on Form-2728 whether they informed patients about transplantation, if not, to select a reason. The goals of this study were describe national transplant education practices analyze associations between access transplantation (ATT), based United States Renal Data System (USRDS) data from 2005 2007. Multinomial logistic regression was used examine factors associated with not being modified Poisson ATT (all models...
Objective: To investigate the association between retinopathy and chronic kidney disease.Methods: In this observational, cross-sectional study, 2605 patients of Chronic Renal Insufficiency Cohort (CRIC) a multicenter study disease, were offered participation.Nonmydriatic fundus photographs disc macula in both eyes obtained 1936 these subjects.The reviewed masked fashion at central photograph reading center using standard protocols.Presence severity (diabetic, hypertensive, or other) vessel...
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...
Cardiac troponin T is independently associated with cardiovascular events and mortality in patients chronic kidney disease (CKD). Serum levels of high sensitivity cardiac (hs-TnT) reflect subclinical myocardial injury ambulatory patients. We sought to determine the distribution predictors hs-TnT CKD without overt (CVD). studied 2464 participants within multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. considered renal non-renal factors as potential...