Jeffrey Perl
A5002399875- Dialysis and Renal Disease Management
- Central Venous Catheters and Hemodialysis
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare cost, quality, practices
- Renal Transplantation Outcomes and Treatments
- Chronic Kidney Disease and Diabetes
- Muscle and Compartmental Disorders
- Acute Kidney Injury Research
- SARS-CoV-2 and COVID-19 Research
- Pharmacological Effects and Toxicity Studies
- Organ Donation and Transplantation
- Blood Pressure and Hypertension Studies
- COVID-19 Clinical Research Studies
- Potassium and Related Disorders
- Heart Failure Treatment and Management
- Geriatric Care and Nursing Homes
- Pregnancy and Medication Impact
- Vaccine Coverage and Hesitancy
- Parathyroid Disorders and Treatments
- Neurological Complications and Syndromes
- Renal function and acid-base balance
- Philosophy, Ethics, and Existentialism
- Modernist Literature and Criticism
- Atrial Fibrillation Management and Outcomes
- COVID-19 and healthcare impacts
St. Michael's Hospital
2016-2025
University of Toronto
2016-2025
Institute for Clinical Evaluative Sciences
2016-2025
Arbor Research Collaborative for Health
2015-2024
Nova Scotia Health Authority
2024
Dalhousie University
2024
Unity Health Toronto
2021-2023
University Health Network
2006-2022
Public Health Ontario
2022
Sunnybrook Health Science Centre
2022
Several comparisons of peritoneal dialysis (PD) and hemodialysis (HD) in incident patients with ESRD demonstrate superior survival PD-treated within the first 1 to 2 years. These differences may be due higher HD-related mortality as a result high rates central venous catheter (CVC) use or an initial advantage conferred by PD. We compared PD those who initiated HD CVC (HD-CVC) functional arteriovenous fistula graft (HD-AVF/AVG). used multivariable piece-wise exponential nonproportional...
Abstract Objective To determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis transplantation) conservative management. Design International cross sectional survey. Setting Society of Nephrology (ISN) survey 182 countries from July September 2018. Participants Key stakeholders identified by ISN’s national regional leaders. Main outcome measures Markers core components Results Responses were received 160 (87.9%)...
Rationale & ObjectivePeritoneal dialysis (PD)-related peritonitis carries high morbidity for PD patients. Understanding the characteristics and risk factors can guide regional development of prevention strategies. We describe rates associations selected facility practices with among countries participating in Peritoneal Dialysis Outcomes Practice Patterns Study (PDOPPS).Study DesignObservational prospective cohort study.Setting Participants7,051 adult patients 209 facilities across 7...
The global nephrology community recognizes the need for a cohesive strategy to address growing problem of end-stage kidney disease (ESKD). In March 2018, International Society Nephrology hosted summit on integrated ESKD care, including 92 individuals from around globe with diverse expertise and professional backgrounds. attendees were 41 countries, 16 participants 11 low- lower-middle-income countries. purpose was develop strategic plan improve worldwide access by identifying prioritizing...
Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere functioning and diminish life satisfaction. Until recently, the focus of nephrology care for patients has been related primarily to numerical targets laboratory measures, outcomes such as cardiovascular disease mortality. Routine assessment is not universal or standardized in care. Even when symptoms are identified, treatment options limited initiated infrequently, part...
Home dialysis modalities (home hemodialysis [HD] and peritoneal [PD]) are associated with greater patient autonomy treatment satisfaction compared in-center modalities, yet the level of home-dialysis use worldwide is low. Reasons for limited utilization context-dependent, informed by local resources, costs, access to healthcare, health system policies, provider bias or preferences, cultural beliefs, individual lifestyle concerns, potential care-partner time, financial burdens. In May 2021,...
New staging systems for CKD account both reduced eGFR and albuminuria; whether each measure associates with greater risk of hemorrhage is unclear. In this retrospective cohort study (2002–2010), we grouped 516,197 adults ≥40 years old by (≥90, 60 to <90, 45 <60, 30 <45, 15 <30, or <15 ml/min per 1.73 m 2 ) urine albumin-to-creatinine ratio (ACR; >300, 30–300, <30 mg/g) examine incidence hemorrhage. The 3-year cumulative increased 20-fold across declining increasing ACR...
As the importance of providing patient-centered palliative care for patients with advanced illnesses gains attention, standard dialysis delivery may be inconsistent goals many ESRD. Many life expectancy <1 year desire a approach to care, which focuses on aligning patient treatment patients' informed preferences. This commentary elucidates what comprises and describes its potential appropriate use. It also reviews barriers integrating such an into current clinical paradigm existing...
♦Extending technique survival on peritoneal dialysis (PD) remains a major challenge in optimizing outcomes for PD patients while increasing utilization. The primary objective of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is to identify modifiable practices associated with improvements patient survival. In collaboration International Society (ISPD), PDOPPS seeks standardize PD-related data definitions provide forum effective international collaborative clinical...
The absence of accepted patient-centered outcomes in research can limit shared decision-making peritoneal dialysis (PD), particularly because PD-related treatments be associated with mortality, technique failure, and complications that impair quality life. We aimed to identify patient caregiver priorities for PD, describe the reasons their choices.
Significance Statement Serology studies of coronavirus disease 2019 vaccines in the maintenance dialysis population have found weak antibody responses to one dose vaccine and lower two doses than among healthy controls. However, it is undetermined how these serologic correlate with prevention infection, hospitalization, mortality this immunosuppressed population. We identified 13,759 individuals receiving Ontario, Canada. One reduced risk infection severe outcomes by 41% 46%, respectively,...
Rationale: Diffuse alveolar hemorrhage (DAH) is a life-threatening manifestation of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The Plasma Exchange (PLEX) and Glucocorticoids (GC) in Severe AAV (PEXIVAS;NCT00987389) trial was the largest first to enroll participants with DAH requiring mechanical ventilation. Objectives: Evaluate characteristics, treatment effects, outcomes for patients without DAH. Methods: PEXIVAS randomized 704 PLEX or no-PLEX reduced...