A5090436808- Dialysis and Renal Disease Management
- Central Venous Catheters and Hemodialysis
- Chronic Kidney Disease and Diabetes
- Health Systems, Economic Evaluations, Quality of Life
- Parathyroid Disorders and Treatments
- Blood Pressure and Hypertension Studies
- Renal Transplantation Outcomes and Treatments
- Muscle and Compartmental Disorders
- Healthcare cost, quality, practices
- Diabetes Management and Research
- Patient Satisfaction in Healthcare
- Pharmacological Effects and Toxicity Studies
- Acute Kidney Injury Research
- Diabetes Treatment and Management
- Geriatric Care and Nursing Homes
- Potassium and Related Disorders
- Diverse Approaches in Healthcare and Education Studies
- Vascular Procedures and Complications
- Magnesium in Health and Disease
- Hormonal and reproductive studies
- Neurological and metabolic disorders
- Patient-Provider Communication in Healthcare
- Vitamin D Research Studies
- Heart Failure Treatment and Management
- Healthcare Policy and Management
University of Washington
2015-2025
Northwest Kidney Centers
2024-2025
Harborview Medical Center
2014-2021
Kidney Research UK
2014-2017
Massachusetts General Hospital
2012
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...
Stationary hemodialysis machines hinder mobility and limit activities of daily life during dialysis treatments. New technologies are needed to improve patient autonomy enhance quality life.We conducted a FDA-approved human trial wearable artificial kidney, miniaturized, machine, based on dialysate-regenerating sorbent technology. We aimed determine the efficacy kidney in achieving solute, electrolyte, volume homeostasis up 10 subjects over 24 hours.During study, all remained hemodynamically...
Individuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for relief in this population. To stimulate innovation management, data on patient prioritization and treatment preferences needed. We undertook study to (
Home dialysis, which comprises peritoneal dialysis (PD) or home hemodialysis (home HD), offers patients with ESRD greater flexibility and independence. Although disproportionately affects racial/ethnic minorities, data on disparities in use outcomes are sparse. We analyzed of who initiated maintenance between 2007 2011 were admitted to any 2217 facilities 43 states operated by a single large organization, follow-up through December 31, (n =: 162,050, 17,791 underwent PD 2536 HD for ≥91...
Uncorrected serum calcium concentration is the first mineral metabolism metric planned for use as a quality measure in United States ESRD population. Few studies patients undergoing either peritoneal dialysis (PD) or hemodialysis (HD) have assessed association of uncorrected with clinical outcomes. We obtained data from 129,076 on (PD, 10,066; HD, 119,010) treated DaVita, Inc. facilities between July 1, 2001, and June 30, 2006. After adjustment potential confounders, <8.5 ≥10.2 mg/dl were...
Individuals receiving in-center maintenance hemodialysis bear a high burden of both physical and mood symptoms. More than half patients on report sleep disturbance, muscle cramps, fatigue. Patients describe symptoms as having deleterious effect their quality life, suggesting that symptom alleviation may meaningfully improve patient-reported outcomes. Moreover, have identified management key area for research innovation, prioritizing over other health outcomes such mortality biochemical...
Hospitalization is a major source of morbidity among patients with ESRD undergoing maintenance hemodialysis and significant contributor to health care costs. To identify subgroups at the highest risk hospitalization, we analyzed by sex, age, race, adjusting for demographic clinical characteristics, hospitalization rates, 30-day readmissions 333,756 hospitalizations 111,653 in facilities operated large dialysis organization United States (2007–2011). The overall rate was 1.85 per person-year...
Background Elevated levels of biochemical markers myocardial necrosis have been associated with worsened outcomes in Acute Respiratory Distress Syndrome (ARDS), but there are few prospective data on this relationship. We investigated elevated cardiac troponin T (cTnT) and their relationship outcome patients ARDS. Methods A cohort study ARDS was conducted at a tertiary-care academic medical center. Patients had blood taken within 48 hours onset assayed for cTnT. were followed the 60-day...
In individuals undergoing in-center hemodialysis (HD), use of central venous catheters (CVCs) is associated with worse clinical outcomes compared arteriovenous access. However, it unclear whether a similar difference in risk by vascular access type present patients home HD.Our study examined the associations all-cause mortality, hospitalization, and transfer to HD who initiated from 2007 2011 464 facilities 43 states United States. Patients were followed through December 31, 2011. Data...
Little is known about the utility of self-rated general health assessments in persons with moderate-to-severe CKD. This study examined ability a single measure to predict all-cause mortality and kidney disease progression cohort 443 patients stages 3-4 CKD, recruited between 2005 2011, followed until end 2012. The performance models incorporating measures was compared previously published predictive more complex comprising multibiomarker panel.Participants were asked "In general, would you...
Neither uncorrected- nor albumin-corrected total calcium reliably predict ionized in patients with end-stage renal disease. However, little is known about the consequences of inaccurate assessment concentration using calcium.We hypothesized that hidden hypercalcemia (ie, elevated normal calcium) and apparent are both associated increased mortality risk.We identified 874 incident hemodialysis measured serum calcium, albumin, phosphorus, bicarbonate from October 2007 to December 2011, data a...
Background and objectives The population of patients with kidney failure in the United States using home dialysis modalities is growing rapidly. Unlike for in-center hemodialysis, there no patient-reported experience measure assessment patient care peritoneal or hemodialysis. We sought to develop establish content validity a undergoing mixed methods multiple stakeholder approach. Design, setting, participants, & measurements conducted structured literature review, followed by concept...
1Division of Nephrology, Department Medicine, University Washington School and Northwest Kidney Centers, Seattle, WA 2Division Brigham Women's Hospital, Harvard Medical School, Boston, MA aCorresponding author: Dr. Mallika Mendu, [email protected]
Background: Kidney failure and its treatments disrupt glucose homeostasis in ways that may promote both hyperglycemia hypoglycemia. Continuous monitoring (CGM) delineates detailed glycemic profiles, but published studies kidney are limited to small, select groups. We aimed characterize the spectrum of glycemia determinants a large, diverse maintenance dialysis population. Methods: conducted prospective community-based cohort study people treated with dialysis. Each participant wore Dexcom G6...