A5023461981- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Blood Pressure and Hypertension Studies
- Chronic Disease Management Strategies
- Health Literacy and Information Accessibility
- Heart Failure Treatment and Management
- Nutritional Studies and Diet
- Diabetes Management and Education
- Mobile Health and mHealth Applications
- Health Systems, Economic Evaluations, Quality of Life
- Cardiovascular Health and Risk Factors
- Sodium Intake and Health
- Global Public Health Policies and Epidemiology
- Optimism, Hope, and Well-being
- Renal function and acid-base balance
- Hemodynamic Monitoring and Therapy
- Acute Kidney Injury Research
- Healthcare Policy and Management
- Diabetes Treatment and Management
- Neonatal Respiratory Health Research
- Emergency and Acute Care Studies
- Cardiovascular Health and Disease Prevention
- Renal and Vascular Pathologies
- Advanced Glycation End Products research
- Global Maternal and Child Health
University of Pennsylvania
2016-2025
National Kidney Foundation
2023
Hospital of the University of Pennsylvania
2016-2022
Children's Hospital of Philadelphia
2020
Pennsylvania Hospital
2015
Michigan State University
2006-2012
Although diabetic kidney disease is the leading cause of ESKD in United States, identifying those patients who progress to difficult. Efforts are under way determine if plasma biomarkers can help identify these high-risk individuals.In our case-cohort study 894 Chronic Renal Insufficiency Cohort Study participants with diabetes and an eGFR <60 ml/min per 1.73 m2 at baseline, were randomly selected for subcohort; cases developed progressive (ESKD or 40% decline). Using a multiplex system, we...
Insulin resistance contributes to the metabolic syndrome, which is associated with development of kidney disease. However, it unclear if insulin independently an increased risk chronic disease (CKD) progression or CKD complications. Additionally, predisposing factors responsible for in absence diabetes are not well described. This study aimed describe and characterize relationship progression, cardiovascular events death among a cohort non-diabetics CKD. Data was utilized from Chronic Renal...
Individuals with chronic kidney disease (CKD) generally have poor participation in self-care. We hypothesized that greater knowledge and health literacy would associate better
Significance Statement Identifying novel biomarkers of kidney function decline in children may have clinical value and help elucidate the biologic mechanisms CKD progression. In CKiD prospective cohort study, authors evaluated 651 with measured plasma collected 5 months after enrollment. After multivariable adjustment, risk progression was significantly higher among concentrations a biomarker tubular injury (KIM-1) or either two inflammation (TNF receptor–1 [TNFR-1] TNFR-2) highest quartile...
Adults with chronic kidney disease (CKD) are hospitalized more frequently than those without CKD, but the magnitude of this excess morbidity and factors associated hospitalizations not well known.Data from 3,939 participants enrolled in Chronic Renal Insufficiency Cohort (CRIC) Study between 2003 2008 at 7 clinical centers United States were used to estimate primary causes hospitalizations, hospitalization rates, baseline participant all-cause, cardiovascular, non-cardiovascular during a...
Significance Statement Although there is increasing emphasis on out-of-office BP measurement, few studies have evaluated the prognostic significance of ambulatory monitoring in patients with CKD. In this cohort 1502 participants CKD, metrics derived from (masked hypertension, 24-hour and nighttime BP, reverse dipper [higher BP] diurnal profile) were strongly independently associated clinical outcomes. For example, presence masked uncontrolled hypertension higher mean high risk cardiovascular...
<h3>Rationale & Objective</h3> Cardiovascular disease (CVD) is a major cause of mortality among people with diabetic kidney (DKD). The pathophysiology inadequately explained by traditional CVD risk factors. uremic solutes trimethylamine-<i>N</i>-oxide (TMAO) and asymmetric symmetric dimethylarginine (ADMA, SDMA) have been linked to in failure replacement therapy (KFRT), but data are limited populations diabetes less severe disease. <h3>Study Design</h3> Observational cohort. <h3>Settings...
ABSTRACT Background Chronic kidney disease (CKD) is associated with atherosclerotic cardiovascular (ASCVD) risk, especially among those diabetes. Altered metabolism of solutes that accumulate in CKD [asymmetric dimethylarginine (ADMA), symmetric (SDMA) and trimethylamine N-oxide (TMAO)] may reflect pathways linking ASCVD. Methods This case–cohort study included Renal Insufficiency Cohort participants baseline diabetes, estimated glomerular filtration rate &lt;60 mL/min/1.73 m2, without...
Education and literacy are key determinants of health but do not necessarily ensure (HL). The Institute Medicine's (IOM) definition HL is widely accepted, there no consensus over its constituent parts. Developing a practical measure priority, challenging. We aimed to derive in data from the Demographic Health Surveys (DHS) Program administered by United States Agency for International Development (USAID), which includes items representing domains as defined IOM. accessed DHS conducted Zambia...
We sought to develop and evaluate a health literacy measure in multi-national study examine demographic characteristics associated with literacy. Data were obtained from Demographic Health Surveys conducted between 2006-15 14 countries Sub-Saharan Africa. the same all but translated local languages as appropriate. identified eight questions that corresponded National Academy of Medicine (NAM) definition Factor analysis was used extract one Logistic regression employed relationship A total...
Significance Statement Among individuals with CKD, decreases in eGFR, or increases that are steeper than the average loss, have been associated increased risks of death and cardiovascular events. Sarcopenia chronic illness might explain why apparent eGFR improvement relates to poor outcomes. The authors investigated association between slopes (defined yearly eGFR) events a prospective cohort adults CKD. They found declines greater loss were events, despite multiple adjustments. However,...
Adherence to healthy behaviors reduces risks of cardiovascular disease and death in the general population. However, among people with kidney disease, a group at higher risk for such benefits have not been established.We pooled data from three cohort studies total 27,271 participants. Kidney function was categorized on basis eGFR (≥60, 45 <60, <45 ml/min per 1.73 m2). We used proportional hazard frailty models estimate associations between (not smoking, recommended body mass index [BMI],...
Background: We have previously studied biomarkers of tubular health (EGF), injury (KIM-1), dysfunction (alpha-1 microglobulin), and inflammation (TNFR-1, TNFR-2, MCP-1, YKL-40, suPAR), demonstrated that plasma KIM-1, TNFR-1, TNFR-2 urine EGF, alpha-1 microglobulin are each independently associated with CKD progression in children. In this study, we used bootstrapped survival trees to identify a combination predict Methods: The CKiD Cohort Study prospectively enrolled children 6 months 16...
Background: Individual kidney tubule biomarkers are associated with risks for chronic disease (CKD) progression and mortality in persons diabetes. Integrating multiple using a latent variable method of exploratory factor analysis could define distinct dimensions health, their associations adverse outcomes. Methods: We conducted 17 candidate urine plasma 1,256 participants diabetes estimated glomerular filtration rate (eGFR) <60ml/min/1.73 m 2 from the Chronic Renal Insufficiency Cohort...
BackgroundEducation and literacy are key determinants of health, but these do not ensure health literacy. A definition from the US Institute Medicine (IOM) is widely accepted, there no consensus on traits by which can be measured. Some questions in Demographic Health Surveys (DHS) represent domains as defined IOM (ie, capacity to interpret, obtain, understand information; ability make appropriate decisions), could a valuable untapped resource for measurement Building pilot work Zambia, we...
Key Points Among adults with diabetes and CKD, biomarkers of kidney tubule health were associated a greater risk death, independent eGFR, albuminuria, additional factors. Higher urine levels YKL-40 KIM-1 death. For cause-specific UMOD was independently inversely the cardiovascular Background Kidney disease assessed by serum creatinine albuminuria are strongly mortality in diabetes. These markers primarily reflect glomerular function injury. Urine recently failure persons CKD Associations...
IntroductionA cornerstone of kidney disease management is participation in guideline-recommended health behaviors. However, the relationship these behaviors with outcomes, and identification barriers to behavior engagement, have not been described among younger older adults chronic disease.MethodsData from a cohort study 5499 individuals was used identify patterns latent class analysis stratified by age <65 ≥65 years. Cox models, diabetes, assessed association (CKD) progression,...