A5069296608- Dialysis and Renal Disease Management
- Central Venous Catheters and Hemodialysis
- Chronic Kidney Disease and Diabetes
- Health Systems, Economic Evaluations, Quality of Life
- Blood Pressure and Hypertension Studies
- Climate Change and Health Impacts
- Healthcare cost, quality, practices
- Iron Metabolism and Disorders
- Parathyroid Disorders and Treatments
- Healthcare Policy and Management
- COVID-19 Clinical Research Studies
- Hemodynamic Monitoring and Therapy
- Erythropoietin and Anemia Treatment
- Organ Donation and Transplantation
- Potassium and Related Disorders
- Renal and Vascular Pathologies
- Gastrointestinal Bleeding Diagnosis and Treatment
- COVID-19 and healthcare impacts
- Artificial Intelligence in Healthcare
- Thermoregulation and physiological responses
- Global Health Care Issues
- Muscle and Compartmental Disorders
- Air Quality and Health Impacts
- Pharmacological Effects and Toxicity Studies
- Venous Thromboembolism Diagnosis and Management
Fresenius Medical Care (Germany)
2012-2025
MetroHealth Medical Center
2025
Case Western Reserve University
2025
Fresenius Medical Care (United States)
2015-2024
Fresenius Medical Care North America (United States)
2015-2024
Renal Research Institute
2015-2024
Fresenius Medical Care (India)
2020-2022
BG Medicine (United States)
2021
RELX Group (United States)
2018
Massachusetts General Hospital
2015-2016
Background— Dabigatran and rivaroxaban are new oral anticoagulants that eliminated through the kidneys. Their use in dialysis patients is discouraged because these drugs can bioaccumulate to precipitate inadvertent bleeding. We wanted determine whether prescription of dabigatran or was occurring population practices were safe. Methods Results— Prevalence plots used describe point prevalence (monthly) among 29 977 hemodialysis with atrial fibrillation. Poisson regression compared rate...
Abstract Intradialytic hypotension ( IH ) is a frequent complication of hemodialysis HD and associated with increased patient mortality cardiovascular events. We studied to determine its variability, correlates, clinical impact in 13 outpatient facilities. Blood pressure was captured by machine download. defined as >30 mmHg decrease systolic blood <90 . Risk factors were assessed logistic regression hospitalization P oisson regression. Time death first using K aplan– M eier analysis...
Accurate identification of risk factors for calcific uremic arteriolopathy (CUA) is necessary to develop preventive strategies this morbid disease. We investigated whether baseline recorded at hemodialysis initiation would identify patients future CUA in a matched case-control study using data from large dialysis organization. Hemodialysis with newly diagnosed ( n =1030) between January 1, 2010, and December 31, 2014, were by age, sex, race 1:2 ratio without =2060). Mean ages controls 54 55...
Sudden death is a leading cause of in patients on maintenance hemodialysis therapy. During sessions, the gradient between serum and dialysate levels results rapid electrolyte shifts, which may contribute to arrhythmias sudden death. Controversies exist about optimal concentration dialysate; specifically, it unclear whether patient outcomes differ among those treated with potassium 3 mEq/L compared 2 mEq/L.Prospective cohort study.55,183 from 20 countries Dialysis Outcomes Practice Patterns...
Approximately one million Americans initiated chronic dialysis over the past decade; first-year mortality rate reported by U.S. Renal Data System was 19.6% in 2007. This estimate has historically excluded first 90 days of dialysis.To characterize and hospitalization risks for patients starting renal replacement therapy, we followed all initiating 1733 facilities throughout United States (n = 303,289). Mortality hospitalizations within were compared with outcomes after this period, results...
Despite the high costs of treatment people with kidney disease and associated comorbid conditions, amount reliable information available to guide care such patients is very limited. Some treatments have been assessed in randomized trials, but most trials too small detect effects a magnitude that would be realistic achieve single intervention. Therefore, KDIGO convened an international, multidisciplinary controversies conference titled "Challenges Conduct Clinical Trials Nephrology" identify...
Hemodialysis patients often do not attend their scheduled treatment session. We investigated factors associated with missed appointments and whether such nonadherence poses significant harm to increases overall health care utilization in an observational analysis of 44 million hemodialysis treatments for 182,536 ESRD the United States. assessed risk hospitalization, emergency room visit, or intensive-coronary unit (ICU-CCU) admission 2 days after a relative who received hemodialysis. Over...
Fluid overload and interdialytic weight gain (IDWG) are discrete components of the dynamic fluid balance in haemodialysis patients. We aimed to disentangle their relationship, prognostic importance two clinically distinct, bioimpedance spectroscopy (BIS)-derived measures, pre-dialysis post-dialysis (FOpre FOpost) versus IDWG.We conducted a retrospective cohort study on 38 614 incident patients with one or more BIS measurement within 90 days initiation (1 October 2010 through 28 February...
Background Hypertension remains a leading global cause for premature death and disease. Most treatment guidelines emphasize the importance of risk factors, but not all are known, modifiable, or easily avoided. Population blood pressure correlates with latitude is lower in summer than winter. Seasonal variations sunlight exposure account these differences, temperature believed to be main contributor. Recent research indicates that UV light enhances nitric oxide availability by mobilizing...
In maintenance hemodialysis patients, intradialytic hypotension (IDH) is a frequent complication that has been associated with poor clinical outcomes. Prediction of IDH may facilitate timely interventions and eventually reduce rates.We developed machine learning model to predict in in-center patients 15-75 min advance. was defined as systolic blood pressure (SBP) <90 mmHg. Demographic, clinical, treatment-related laboratory data were retrieved from electronic health records merged sent...
Staphylococcus bacteremia is a common and life-threatening medical emergency, but it treatable with appropriate antibiotic therapy. To identify opportunities that may reduce morbidity mortality associated S. aureus, we analyzed data from 293,094 chronic hemodialysis outpatients to characterize practices of selection. In the study population, overall rate was 15.4 per 100 outpatient-years; incidence for methicillin-sensitive (MSSA) 2.1 outpatient-years, methicillin-resistant (MRSA) aureus 1.9...
Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, this trend is projected to continue as part of ongoing climate change. There a paucity data regarding how EHEs may affect highly vulnerable populations, such patients with end-stage renal disease (ESRD). Such needed inform ESRD patient management guidelines changing climate.To investigate the association between risk hospital admission or mortality among further characterize vary races/ethnicities preexisting...
Significance Statement Routine incorporation of pragmatic trials into clinical care delivery has potential to generate answers important questions, such as optimal approaches for fundamental components maintenance hemodialysis. The Time Reduce Mortality in ESRD (TiME) trial was a large demonstration project designed determine if hemodialysis session duration longer than many patients the United States currently receive improves outcomes. Although accomplished its objectives, including rapid...
Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether also exists with hospitalization risk.All 8776 adult patients Medical Outcomes Study Short Form 36 survey results treated Fresenius Care North America facilities 2006 were followed for 1 year from the date of survey, all events lasting >24 hours tracked. A score was derived responses two questions ("down dumps" "downhearted...
Health-related quality of life (HrQoL) varies among dialysis patients. However, little is known about the association modality with HrQoL over time. We describe longitudinal patterns chronic patients by treatment modality.National retrospective cohort study adult who initiated in-center or a home (peritoneal hemodialysis) between 1/2013 and 6/2015. Patients remained on same for first 120 days two years. was assessed Kidney Disease Quality Life-36 (KDQOL) survey in years after initiation....
Cold hemodialysis (HD) prevented intradialysis hypotension (IDH) in small, short-term, randomized trials selected patients with IDH. Whether this treatments prevents IDH and mortality the HD population at large is unknown.We investigated relationship between dialysate temperature risk of IDH, i.e. nadir blood pressure <90 mmHg (generalized estimating equation model) all-cause (Cox's regression) an incident cohort (n = 8071). To control for confounding by bias indication other factors we...
Results from the CONVINCE clinical trial suggest a 23% mortality risk reduction among patients receiving high-volume (> 23 L) hemodiafiltration. We assessed real-world effectiveness of blood-based kidney replacement therapy (KRT) with hemodiafiltration vs. hemodialysis in large, unselected patient population treated prior to and during COVID-19 pandemic. In this retrospective cohort study, we analyzed pseudonymized data 85,117 adults in-center care across NephroCare clinics Europe, Middle...