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1. Patient-Level Pooled Analysis of Endovascular Ultrasound Renal Denervation or a Sham Procedure 6 Months After Medication Escalation: The RADIANCE Clinical Trial Program

Author

Azizi, Michel, Sharp, Andrew S.P., Fisher, Naomi D.L., Weber, Michael A., Lobo, Melvin D., Daemen, Joost, Lurz, Philipp, Mahfoud, Felix, Schmieder, Roland E., Basile, Jan, Bloch, Michael J., Saxena, Manish, Wang, Yale, Sanghvi, Kintur, Jenkins, J. Stephen, Devireddy, Chandan, Rader, Florian, Gosse, Philippe, Claude, Lisa, Augustin, Dimitri A., McClure, Candace K., Kirtane, Ajay J., Wang, Yale, Skeik, Nedaa, Bae, Richard, McMeans, Amy, Goldman, JoAnne, Peterson, Rose, Stephen Jenkins, James, Tutor, Isabelle, Harrison, Michael, Penning, Angel, Devireddy, Chandan, Lea, Janice, Fiebach, Amanda, Merlin, Claudia, Rader, Florian, Dohad, Suhail, Tran, Anne, Bhatia, Kirin, Fisher, Naomi D.L., Sobieszczyk, Piotr, Halliday, Ian, Munson, Tay, Lindsey, Jason, Laster, Steven, Bunte, Mathew, Hart, Anthony, King, Dana, Hall, Jamie, Sanghvi, Kintur, Krathen, Courtney, Lewis, Luot, Willitts, Ashley, Todoran, Thomas, Basile, Jan, Awkar, Anthony, Palmer, Casey, Tecklenburg, Anna, Schindler, John, Pacella, John, Muldoon, Matthew, Albright, MaryJo, Nicholson, Tracy, Flack, John, Chami, Youseff, Hafiz, Abdul Moiz, Starkey, Emily, Adams, Kristal, Bernardo, Nelson, Veis, Judith, Hashim, Hayder, Singh, Suman, Whitman, Donna, Stouffer, Rick, Hinderliter, Alan, Allen, Meghan, Scholl, Tatum, Fong, Pete, Gainer, James, Crook, Sherron, Hatchcock, Ellen, Cohen, Debbie, Giri, Jay, Kobayashi, Taisei, Neubauer, Robin, Naidu, Suveeksha, Kirtane, Ajay J., Radhakrishnan, Jai, Batres, Candido, Edwards, Suzanne, Khuddus, Matheen, Zentko, Suzanne, Touchton, Abby, Roberson, Marti, Bloch, Michael J., Akinapelli, Abhilash, English, Lisa, Neumann, Bridget, Mendelsohn, Farrel, Brantley, Hutton, Cawthon, Thomas, DeRamus, Susan, Wade, Wesley, Fishman, Robert, Tuohy, Edward, LeBlanc, Jessica, McCurry, Tina, Krishnaswamy, Amar, Laffin, Luke, Bajzer, Christopher, Boros, Marilyn, Branche, Monica, Abraham, Josephine, Abraham, Anu, Stijleman, Inge, Hsi, David, Martin, Scott, Portnay, Edward, Fiebach, Maryann, Garavito, Carolina, Adams, Todd, Teklinski, Andrew, Leech, Adam, Drilling, Patrick, Tulik, Lynda, Benzuly, Keith, Paparello, James, Fintel, Dan, Ramirez, Haydee, Kats, Lauren, Huang, Paul, Biswas, Santanu, Risher, Serena, Pratt, Kristina, Ibebuogu, Uzoma, Johnson, Karen, Cushman, William, Jones, Lisa, Jackson, Leigh, Landers, David, Pasala, Tilak, Salazer, Thomas, Canino, Peter, Arakelian, Patricia, Yang, Yi-Ming, Khaliq, Asma, Weinberg, Mitchell, Abetu, Yihenew, Gulliver, Alana, Reilly, J.P., Garasic, Joseph, Chugh, Atul, Bertolet, Barry, Go, Brian, Gallapudi, Raghava, Cohn, Joel, Rogers, Kevin, Saxena, Manish, Mathur, Anthony, Jain, Ajay, Balawon, Armida, Zongo, Oliver, Topham, Christine, Sharp, Andrew, Anderson, Richard, Thompson, Elizabeth, Spiro, Nikki, Hodges, Elizabeth, Holder, Jaqueline, Ellam, Timothy, Bagnall, Alan, Jackson, Ralph, Bridgett, Victoria, Wilson, Peter, Das, Neelanjan, Doulton, Timothy, Loader, David, Hector, Gemma, Levy, Terry, Bent, Clare, Kodoth, Vivek, Horler, Stephanie, Nix, Sara, Robinson, Nicholas, Al-Janabi, Firas, Sayer, Jeremy, Ganesh Iyer, Sudha, Redman, Emily, Ramirez, Jonaifah, Padmanabhan, Sandosh, Sharif, Faisal, Alhmoudi, Aishah, Lunardi, Mattia, Coen, Eileen, Glynn, Nicola, Mahfoud, Felix, Lauder, Lucas, Kulenthiran, Saarraaken, Koch, Christina, Wachter, Angelika, Schmieder, Roland, Schmid, Axel, Kannenkeril, Dennis, Heinritz, Ulrike, Endres-Frohlich, Kerstin, Lurz, Philipp, Rommel, Karl, Fengler, Petzold, Martin, Büttner, Margit, Weil, Joachim, Agdirlioglu, Tolga, Köllner, Tanja, Stephan, Jeannine, Dagkonakis, Nikolaos, Hamann, Frank, Ettl, Ute, Petzsche, Ulrike, Reimer, Peter, Hausberg, Martin, Hinrichs, Ralf, Di Ponio-Voit, Isabella, Lutz, Matthias, Gosse, Philippe, Cremer, Antoine, Papadopoulos, Panteleimon, Gaudissard, Julie, Maire, Florent, Azizi, Michel, Sapoval, Marc, Livrozet, Marine, Regrag, Asma, Paquet, Valerie, Delsart, Pascal, Hennicaux, Justin, Sommeville, Coralie, Bertrand, Fabien, Daemen, Joost, Lafeber, Melvin, Zeijen, Victor, Ruiter, Amo, Huijskens, Elisabeth, van Ramshorst, Jan, Xaplanteris, Panagiotis, Briki, Rachid, de Hemptinne, Quentin, Pascal, Severine, Renard, Katty, Ferdinande, Bert, Iglesias, Juan F., Ehert, Georg, Gallego, Laetitia, Dobretz, Kevin, Bottone, Sylviane, Sanghvi, Kintur, Costello, Josh, Krathan, Courtney, Lewis, Luot, McElvarr, Andrew, Reilly, John, Jenkins, Stephen, Cash, Michael, Williams, Shannon, Jarvis, Maria, Fong, Pete, Laffer, Cheryl, Gainer, James, Robbins, Mark, Crook, Sherron, Maddel, Sarita, Hsi, David, Martin, Scott, Portnay, Edward, Ducey, Maryanne, Rose, Suzanne, DelMastro, Elizabeth, Bangalore, Sripal, Williams, Stephen, Cabos, Stanley, Rodriguez Alvarez, Carolina, Todoran, Thomas, Basile, Jan, Powers, Eric, Hodskins, Emily, Paladugu, Vijay, Tecklenburg, Anna, Devireddy, Chandan, Lea, Janice, Wells, Bryan, Fiebach, Amanda, Merlin, Claudia, Rader, Florian, Dohad, Suhail, Kim, Hyun-Min, Rashid, Mohammad, Abraham, Josephine, Owan, Theophilus, Abraham, Anu, Lavasani, Iran, Neilson, Hailey, Calhoun, David, McElderry, Thomas, Maddox, William, Oparil, Suzanne, Kinder, Sheila, Kirtane, Ajay J., Radhakrishnan, Jai, Batres, Candido, Edwards, Suzanne, Garasic, Joseph, Drachman, Doug, Zusman, Randy, Rosenfield, Kenneth, Do, Danny, Khuddus, Matheen, Zentko, Suzanne, O’Meara, James, Barb, Ilie, Foster, Abby, Boyette, Alice, Wang, Yale, Jay, Desmond, Skeik, Nedaa, Schwartz, Robert, Peterson, Rose, Goldman, Jo Anne, Goldman, Jessie, Ledley, Gary, Katof, Nancy, Potluri, Srinivasa, Biedermann, Scott, Ward, Jacquelyn, White, Megan, Fisher, Naomi D.L., Mauri, Laura, Sobieszczky, Piotr, Smith, Alex, Aseltine, Laura, Stouffer, Rick, Hinderliter, Alan, Pauley, Eric, Wade, Tyrone, Zidar, David, Shishehbor, Mehdi, Effron, Barry, Costa, Marco, Semenec, Terence, Bloch, Michael J., Roongsritong, Chanwit, Nelson, Priscilla, Neumann, Bridget, Cohen, Debbie, Giri, Jay, Neubauer, Robin, Vo, Thu, Chugh, Atul R., Huang, Pei-Hsiu, Jose, Powell, Flack, John, Fishman, Robert, Jones, Michael, Adams, Todd, Bajzer, Christopher, Saxena, Manish, Lobo, Melvin D., Mathur, Anthony, Jain, Ajay, Balawon, Armida, Zongo, Olivier, Levy, Terry, Bent, Clare, Beckett, David, Lakeman, Nicki, Kennard, Sarah, Sharp, Andrew, D’Souza, Richard J., Statton, Sarah, Wilkes, Lindsay, Anning, Christine, Sayer, Jeremy, Ganesh Iyer, Sudha, Robinson, Nicholas, Sevillano, Annaliza, Ocampo, Madelaine, Gerber, Robert, Faris, Mohamad, John Marshall, Andrew, Sinclair, Janet, Pepper, Hayley, Davies, Justin, Chapman, Neil, Burak, Paula, Carvelli, Paula, Jadhav, Sachin, Quinn, Jane, Christian Rump, Lars, Stegbauer, Johannes, Schimmöller, Lars, Potthoff, Sebastian, Schmid, Claudia, Roeder, Sylvia, Weil, Joachim, Hafer, Lukas, Agdirlioglu, Tolga, Köllner, Tanja, Mahfoud, Felix, Böhm, Michael, Ewen, Sebastian, Kulenthiran, Saarraaken, Wachter, Angelika, Koch, Christina, Lurz, Philipp, Fengler, Karl, Rommel, Karl-Philipp, Trautmann, Kai, Petzold, Martin, Schmieder, Roland E., Ott, Christian, Schmid, Axel, Uder, Michael, Heinritz, Ulrike, Fröhlich-Endres, Kerstin, Genth-Zotz, Sabine, Kämpfner, Denise, Grawe, Armin, Höhne, Johannes, Kaesberger, Bärbel, von zur Mühlen, Constantin, Wolf, Dennis, Welzel, Markus, Gosse, Philippe, Cremer, Antoine, Trillaud, Hervé, Papadopoulos, Panteleimon, Maire, Florent, Gaudissard, Julie, Azizi, Michel, Sapoval, Marc, Cornu, Erika, Fouassier, David, Livrozet, Marine, Lorthioir, Aurélien, Paquet, Valérie, Pathak, Atul, Honton, Benjamin, Cottin, Marianne, Petit, Frédéric, Lantelme, Pierre, Berge, Constance, Courand, Pierre-Yves, Langevin, Fatou, Delsart, Pascal, Longere, Benjamin, Ledieu, Guillaume, Pontana, François, Sommeville, Coralie, Bertrand, Fabien, Daemen, Joost, Feyz, Lida, Zeijen, Victor, Ruiter, Arno, Huyskens, Elisabeth, Blankestijn, Peter, Voskuil, Michiel, Rittersma, Zwaantina, Dolmans, Helma, Kroon, A.A., van Zwam, W.H., Vranken, Jeannique, de Haan, Claudia, Persu, Alexandre, Renkin, Jean, Maes, Frédéric, Beauloye, Christophe, Lengelé, Jean-Philippe, Huyberechts, Dominique, Bouvier, Anne, Witkowski, Adam, Januszewicz, Andrzej, Kądziela, Jacek, Prejbisj, Aleksander, Hering, Dagmara, Ciecwierz, Dariusz, Jaguszewski, Milosz J., Owczuk, Radoslaw, Ciecwierz, Dariusz, Jaguszewski, Milosz J., Wang, Yale, Jay, Desmond, Skeik, Nedaa, Schwartz, Robert, Rader, Florian, Dohad, Suhail, Victor, Ronald, Sanghvi, Kintur, Costello, Josh, Walsh, Courtney, Abraham, Josephine, Owan, Theophilus, Abraham, Anu, Fisher, Naomi D.L., Mauri, Laura, Sobieszczky, Piotr, Williams, Jonathan, Bloch, Michael J., Roongsritong, Chanwit, Todoran, Thomas, Basile, Jan, Powers, Eric, Hodskins, Emily, Fong, Pete, Laffer, Cheryl, Gainer, James, Robbins, Mark, Reilly, John, Cash, Michael, Goldman, Jessie, Aggarwal, Sandeep, Ledley, Gary, Hsi, David, Martin, Scott, Portnay, Edward, Calhoun, David, McElderry, Thomas, Maddox, William, Oparil, Suzanne, Huang, Pei-Hsiu, Jose, Powell, Khuddus, Matheen, Zentko, Suzanne, O’Meara, James, Barb, Ilie, Garasic, Joseph, Drachman, Doug, Zusman, Randy, Rosenfield, Kenneth, Devireddy, Chandan, Lea, Janice, Wells, Bryan, Stouffer, Rick, Hinderliter, Alan, Pauley, Eric, Potluri, Srinivasa, Biedermann, Scott, Bangalore, Sripal, Williams, Stephen, Zidar, David, Shishehbor, Mehdi, Effron, Barry, Costa, Marco, Kirtane, Ajay J., Radhakrishnan, Jai, Lobo, Melvin D., Mathur, Anthony, Jain, Ajay, Sayer, Jeremy, Ganesh Iyer, Sudha, Robinson, Nicholas, Ali Edroos, Sadat, Levy, Terry, Patel, Amit, Beckett, David, Bent, Clare, Davies, Justin, Chapman, Neil, Shun Shin, Matthew, Howard, James, Sharp, Andrew S.P., Joseph, Anil, D’Souza, Richard, Gerber, Robert, Faris, Mohamad, John Marshall, Andrew, Elorz, Cristina, Lurz, Philipp, Höllriegel, Robert, Fengler, Karl, Rommel, Karl-Philipp, Mahfoud, Felix, Böhm, Michael, Ewen, Sebastian, Lucic, Jelena, Schmieder, Roland E., Ott, Christian, Schmid, Axel, Uder, Michael, Rump, Christian, Stegbauer, Johannes, Kröpil, Patric, Azizi, Michel, Sapoval, Marc, Cornu, Erika, Fouassier, David, Gosse, Philippe, Cremer, Antoine, Trillaud, Hervé, Papadopoulos, Panteleimon, Pathak, Atul, Honton, Benjamin, Lantelme, Pierre, Berge, Constance, Courand, Pierre-Yves, Daemen, Joost, Feyz, Lida, Blankestijn, Peter, Voskuil, Michiel, Rittersma, Zwaantina, Kroon, A.A., van Zwam, W.H., Persu, Alexandre, and Renkin, Jean

Published
2024
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2. Effectiveness of a Web-Based Provider Communications Platform in Reducing Hospital Readmissions Among Patients Receiving Dialysis: A Pilot Pre-Post Study.

Author

Khakharia, Anjali, Hoge, Courtney, Vandenberg, Ann, Lea, Janice, Masud, Tahsin, Gray, Carol, ODonnell, Christopher, James, Kyle, Mutell, Rich, Jaar, Bernard, and Plantinga, Laura

Subjects
Care coordination, dialysis, end-stage renal disease, hospital readmission, intervention, provider communication
Abstract

RATIONALE & OBJECTIVE: Suboptimal care coordination between dialysis facilities and hospitals is an important driver of 30-day hospital readmissions among patients receiving dialysis. We examined whether the introduction of web-based communications platform (DialysisConnect) was associated with reduced hospital readmissions. STUDY DESIGN: Pilot pre-post study. SETTING & PARTICIPANTS: A total of 4,994 index admissions at a single hospital (representing 2,419 patients receiving dialysis) during the study period (January 1, 2019-May 31, 2021). INTERVENTION: DialysisConnect was available to providers at the hospital and 4 affiliated dialysis facilities (=intervention facilities) during the pilot period (November 1, 2020-May 31, 2021). OUTCOMES: The primary outcome was 30-day readmission; secondary outcomes included 30-day emergency department visits and observation stays. Interrupted time series and linear models with generalized estimating equations were used to assess pilot versus prepilot differences in outcomes; difference-in-difference analyses were performed to compare these differences between intervention versus control facilities. Sensitivity analyses included a third, prepilot/COVID-19 period (March 1, 2020-October 31, 2020). RESULTS: There was no statistically significant difference in the monthly trends in the 30-day readmissions pilot versus prepilot periods (-0.60 vs -0.13, P = 0.85) for intervention facility admissions; the difference-in-difference estimate was also not statistically significant (0.54 percentage points, P = 0.83). Similar analyses including the prepilot/COVID-19 period showed that, despite a substantial drop in admissions at the start of the pandemic, there were no statistically significant differences across the 3 periods. The age-, sex-, race-, and comorbid condition-adjusted, absolute pilot versus prepilot difference in readmissions rate was 1.8% (-3.7% to 7.3%); similar results were found for other outcomes. LIMITATIONS: Potential loss to follow-up and pandemic effects. CONCLUSIONS: In this pilot, the introduction of DialysisConnect was not associated with reduced hospital readmissions. Tailored care coordination solutions should be further explored in future, multisite studies to improve the communications gap between dialysis facilities and hospitals.

Published
2022

3. Racial and Ethnic Disparities in Kidney Replacement Therapies Among Adults With Kidney Failure: An Observational Study of Variation by Patient Age.

Author

Franch, Harold, Lea, Janice, Patzer, Rachel, Wilk, Adam, Cummings, Janet, and Plantinga, Laura

Subjects
Kidney failure, RRT modality, access to care, age, end-stage renal disease (ESRD), health disparities, home dialysis, race/ethnicity, renal replacement therapy (RRT), social determinants of health, transplantation, Adult, Ethnicity, Healthcare Disparities, Hemodialysis, Home, Hispanic or Latino, Humans, Renal Insufficiency, Retrospective Studies, Young Adult
Abstract

RATIONALE & OBJECTIVE: Non-Hispanic Black and Hispanic patients present with kidney failure at younger ages than White patients. Younger patients are also more likely to receive transplants and home dialysis than in-center hemodialysis (ICHD), but it is unknown whether racial and ethnic disparities in treatment differ by age. We compared use of kidney replacement therapies between racial and ethnic groups among patients with incident kidney failure overall and by age. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: 830,402 US adult (age >21 years) patients initiating kidney failure treatment during the period of 2011-2018. EXPOSURES: Patient race and ethnicity (non-Hispanic Black, non-Hispanic White, Hispanic, or other) and age group (22-44, 45-64, 65-74, or 75-99 years). OUTCOME: Treatment modality (transplant, peritoneal dialysis [PD], home hemodialysis [HHD], or ICHD) as of day 90 of treatment. ANALYTICAL APPROACH: Differences in treatment modalities were quantified for patient subgroups defined by race and ethnicity and by age. Log-binomial regression models were fit to estimate adjusted risk ratios. RESULTS: 81% of patients were treated with ICHD, 3.0% underwent transplants (85% preemptive, 57% living-donor), 10.5% were treated with PD, and 0.7% were treated with HHD. Absolute disparities in treatment were most pronounced among patients aged 22-44 years. Compared with non-Hispanic White patients, whose percentages of treatment with transplant, PD, and HHD were 10.9%, 19.0%, and 1.2%, respectively, non-Hispanic Black patients were less commonly treated with each modality (unadjusted percentages, 1.8%, 13.8%, and 0.6%, respectively), as were Hispanic patients (4.4%, 16.9%, and 0.5%, respectively; all differences P < 0.001). After adjustment, the largest relative disparities were observed for transplant among the 22-44-year age group; compared with non-Hispanic White patients, the adjusted risk ratios for non-Hispanic Black and Hispanic patients were 0.21 (95% CI, 0.19-0.23) and 0.47 (95% CI, 0.43, 0.51), respectively. LIMITATIONS: Race and ethnicity data not self-reported. CONCLUSIONS: Among adults with incident kidney failure, racial and ethnic disparities in transplant and home dialysis use are most pronounced among the youngest adult patient age group.

Published
2022

4. A Web-Based, Provider-Driven Mobile App to Enhance Patient Care Coordination Between Dialysis Facilities and Hospitals: Development and Pilot Implementation Study.

Author

Plantinga, Laura, Hoge, Courtney, Vandenberg, Ann, James, Kyle, Masud, Tahsin, Khakharia, Anjali, Gray, Carol, Jaar, Bernard, Lea, Janice, ODonnell, Christopher, and Mutell, Richard

Subjects
advanced practice providers, care coordination, dialysis, hospitals, mobile app, nurses, physicians
Abstract

BACKGROUND: We piloted a web-based, provider-driven mobile app (DialysisConnect) to fill the communication and care coordination gap between hospitals and dialysis facilities. OBJECTIVE: This study aimed to describe the development and pilot implementation of DialysisConnect. METHODS: DialysisConnect was developed iteratively with focus group and user testing feedback and was made available to 120 potential users at 1 hospital (hospitalists, advanced practice providers [APPs], and care coordinators) and 4 affiliated dialysis facilities (nephrologists, APPs, nurses and nurse managers, social workers, and administrative personnel) before the start of the pilot (November 1, 2020, to May 31, 2021). Midpilot and end-of-pilot web-based surveys of potential users were also conducted. Descriptive statistics were used to describe system use patterns, ratings of multiple satisfaction items (1=not at all; 3=to a great extent), and provider-selected motivators of and barriers to using DialysisConnect. RESULTS: The pilot version of DialysisConnect included clinical information that was automatically uploaded from dialysis facilities, forms for entering critical admission and discharge information, and a direct communication channel. Although physicians comprised most of the potential users of DialysisConnect, APPs and dialysis nurses were the most active users. Activities were unevenly distributed; for example, 1 hospital-based APP recorded most of the admissions (280/309, 90.6%) among patients treated at the pilot dialysis facilities. End-of-pilot ratings of DialysisConnect were generally higher for users versus nonusers (eg, I can see the potential value of DialysisConnect for my work with dialysis patients: mean 2.8, SD 0.4, vs mean 2.3, SD 0.6; P=.02). Providers most commonly selected reduced time and energy spent gathering information as a motivator (11/26, 42%) and a lack of time to use the system as a barrier (8/26, 31%) at the end of the pilot. CONCLUSIONS: This pilot study found that APPs and nurses were most likely to engage with the system. Survey participants generally viewed the system favorably while identifying substantial barriers to its use. These results inform how best to motivate providers to use this system and similar systems and inform future pragmatic research in care coordination among this and other populations.

Published
2022

6. Age, Comorbid Conditions, and Racial Disparities in COVID-19 Outcomes.

Author

Wiley, Zanthia, Kubes, Julianne, Cobb, Jason, Jacob, Jesse, Franks, Nicole, Lea, Janice, and Plantinga, Laura

Subjects
Acute kidney injury, Age, COVID-19, Comorbidities, Disparities, Race, Adult, COVID-19, Humans, Racial Groups, Retrospective Studies, SARS-CoV-2, White People
Abstract

BACKGROUND: Black patients are disproportionately affected by COVID-19. The purpose of this study was to compare risks of hospitalization of Black and non-Black COVID-19 patients presenting to the emergency department and, of those hospitalized, to compare mortality and acute kidney injury. METHODS: A retrospective cohort of 831 adult COVID-19 patients (68.5% Black) who presented to the emergency departments of four academic hospitals, March 1, 2020-May 31, 2020. The primary outcome was risk of hospitalization among Blacks vs. non-Blacks. Secondary outcomes were mortality and acute kidney injury, among hospitalized patients. RESULTS: The crude odds of hospitalization were not different in Black vs. non-Black patients; however, with adjustment for age, Blacks had 55% higher odds of hospitalization. Mortality differed most in the model adjusted for age alone. Acute kidney injury was more common in the Black hospitalized patients, regardless of adjustment. Stratified analyses suggested that disparities in the risk of hospitalization and of in-hospital acute kidney injury were highest in the youngest patients. CONCLUSIONS: Our report shows that Black and non-Black patients presenting to the emergency department with COVID-19 had similar risks of hospitalization and, of those who were hospitalized, similar mortality when adjusted for multiple factors. Blacks had higher risk of acute kidney injury. Our results suggest that examination of disparities without exploration of the individual effects of age and comorbidities may mask important patterns. While stratified analyses suggest that disparities in outcomes may differ substantially by age and comorbid conditions, further exploration among these important subgroups is needed to better target interventions to reduce disparities in COVID-19 clinical outcomes.

Published
2022

9. COVID-19 infection control measures and outcomes in urban dialysis centers in predominantly African American communities.

Author

Apata, Ibironke, Cobb, Jason, Navarrete, Jose, Burkart, John, Lea, Janice, and Plantinga, Laura

Subjects
COVID-19, Dialysis, Infection control, SARS-CoV-2, Black or African American, Aged, Ambulatory Care Facilities, COVID-19, COVID-19 Nucleic Acid Testing, Disease Susceptibility, Female, Georgia, Humans, Infection Control, Male, Middle Aged, Renal Dialysis, SARS-CoV-2, Telemedicine, Urban Population, Vulnerable Populations
Abstract

BACKGROUND: Emory Dialysis serves an urban and predominantly African American population at its four outpatient dialysis facilities. We describe COVID-19 infection control measures implemented and clinical characteristics of patients with COVID-19 in the Emory Dialysis facilities. METHODS: Implementation of COVID-19 infection procedures commenced in February 2020. Subsequently, COVID-19 preparedness assessments were conducted at each facility. Patients with COVID-19 from March 1-May 31, 2020 were included; with a follow-up period spanning March-June 30, 2020. Percentages of patients diagnosed with COVID-19 were calculated, and characteristics of COVID-19 patients were summarized as medians or percentage. Baseline characteristics of all patients receiving care at Emory Dialysis (i.e. Emory general dialysis population) were presented as medians and percentages. RESULTS: Of 751 dialysis patients, 23 (3.1%) were diagnosed with COVID-19. The median age was 67.0 years and 13 patients (56.6%) were female. Eleven patients (47.8%) were residents of nursing homes. Nineteen patients (82.6%) required hospitalization and 6 patients (26.1%) died; the average number of days from a positive SARS-CoV-2 (COVID) test to death was 16.8 days (range 1-34). Two patients dialyzing at adjacent dialysis stations and a dialysis staff who cared for them, were diagnosed with COVID-19 in a time frame that may suggest transmission in the dialysis facility. In response, universal masking in the facility was implemented (prior to national guidelines recommending universal masking), infection control audits and re-trainings of PPE were also done to bolster infection control practices. CONCLUSION: We successfully implemented recommended COVID-19 infection control measures aimed at mitigating the spread of SARS-CoV-2. Most of the patients with COVID-19 required hospitalizations. Dialysis facilities should remain vigilant and monitor for possible transmission of COVID-19 in the facility.

Published
2021

10. Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications

Author

Wang, Yale, Jay, Desmond, McLaurin, Brent, Lomboy, Carl, Allaqaband, Suhail, Jan, Fuad, Gummadi, Bharat, Litt, Marc, Garcia, Fidel, Singh, Jasvindar, Brown, Angela, Choi, James, Paul, Ashley, Sharp, Andrew, Coulson, James, Nanjundappa, Aravinda, Thakker, Ganpat, Campbell, James, Honton, Benjamin, Farah, Bruno, Patel, Manesh, Gutierrez, Antonio, Tyson, Crystal, Svetkey, Laura, Fudim, Marat, Pagidipati, Neha, Jones, Schuyler, Vemulapalli, Sreekanth, Devireddy, Chandan, Kulshreshtha, Ambar, Wells, Bryan, Lea, Janice, Batson, Bryan, Wilkins, Robert, Sharif, Faisal, Khair, Abdullahi Mohamed, Pallippattu, Abhishek Wilson, Alhmoudi, Aishah Matar, Gaffney, Brian, Cawley, Christian, Gorry, Colin, Hamed, Hanan, Carron, Jennifer, Birrane, John, Rosseel, Liesbeth, Lunardi, Mattia, Cronin, Michael, McKittrick, Myles, Almagal, Naeif, Khalid, Noman, Shehahd, Qussai, Shahzad, Shirjeel, Fezzi, Simone, Tyulkin, Stanislav, Bel, Xavier Armario, Jolly, Sanjit, Yip, Gordon, Schwalm, Jon-David, Tsang, Michael, Mehta, Shamir, Lurz, Philipp C., Binner, Christian, Obradovic, Danilo, Fahr, Florian, Richter, Ines, Rotta detto Loria, Johannes, Fengler, Karl, Rommel, Karl-Philipp, Cuartas, Mateo Marin, Lerche, Matthias, Hartung, Philipp, Münch, Phillip, Höllriegel, Robert, John, Silke, Otsuji, Satoru, Kusumoto, Hirofumi, Tamaru, Hiroto, Ishibuchi, Kasumi, Hasegawa, Katsuyuki, Sugimoto, Ken, Kakishita, Mikio, Ishii, Rui, Takiuchi, Shin, Yasuda, Shingo, Nakabayashi, Sho, Yamamoto, Wataru, Higashino, Yorihiko, Shimatani, Yuji, Taniguchi, Yusuke, Tsioufis, Konstantinos, Kasiakogias, Alexandros, Konstantinidis, Dimitris, Andrikou, Eirini, Konstantinou, Konstantinos, Dimitriadis, Kyriakos, Kalos, Theodoros, Cohen, Debbie, Rene, Garvey, Cohen, Jordana, Bonanni, Maria, Denker, Matthew, Wickramisinghe, Rasi, Wilensky, Robert, Kobayashi, Tai, Anjan, Venkatesh, Huan, Yonghong, Haught, Walter Herbert, Krasnow, Joshua, Vasquez, Alejandro, Gessler, Carl, Roth, Christopher, Drenning, David, Velasquez, Enrique, Soliman, George, Murphy, James, Jain, Kaushik, Butler, Michael, Kanitkar, Mihir, Laney, Phillip, Hunter, Ross, Cheng, Shi-Chi, Wright, Thomas, Chapman, Neil, Arnold, Ahran, Nowbar, Alexandra, Janmohamed, Azara, Corden, Ben, Cook, Christopher, Rajkumar, Christopher, Keene, Daniel, Thompson, David, Seligman, Henry, Howard, James, Davies, Justin, Sweeney, Mark, Shun-Shin, Matthew, Foley, Michael, Quaife, Nicholas, Al-Lamee, Rasha, Hadjiphilippou, Savvas, Sen, Sayan, Ahmad, Yousif, Kario, Kazuomi, Shimizu, Hayato, Waki, Hirotaka, Narita, Keisuke, Shimpo, Masahisa, Hoshide, Satoshi, Komori, Takahiro, Ogoyama, Yukako, Ogata, Yukiyo, Oba, Yusuke, Bisharat, Mohanned, Lishmanov, Anton, Jeffords, Travis, Ghali, Magdi, Chia, Beth, Onsrud, Rachel, Rough, Randolph, Aoki, Jiro, Tomii, Daijiro, Mori, Fumiko, Kikushima, Hosei, Ninomiya, Kai, Yahagi, Kazuyuki, Tanabe, Kengo, Nakamura, Kosuke, Komiyama, Kota, Nakase, Masaaki, Asami, Masahiko, Setoguchi, Naoto, Tanaka, Tetsu, Horiuchi, Yu, Watanabe, Yusuke, Feldman, Dmitriy, Bergman, Geoffrey, Sherifi, Ines, Kim, Luke, Amin, Nivee, Minutello, Robert, Wong, S. Chiu, McCullough, Stephen, D'Souza, Richard, Kurdi, Hibba, Statton, Sarah, Watkinson, Tony, Bertolet, Barry, Gupta, Amit, Blossom, Benjamin, Bell, Chris, Hill, Douglas, Sierra, Francisco, Johnson, James, Estess, John, Adams, Joseph, McDuffie, Katie, Ferguson, Lee, Little, Nelson, Ballard, Richard Dane, Williams, Roger, Ikeda, Wanda, Calhoun, William, Carroll, William, Singh, Avneet, Hirsh, Benjamin, Meraj, Perwaiz, Jauhar, Rajiv, Golwala, Harsh, Rueda, Jose, Graham, Kellie, Al-Hakim, Ramsey, Rope, Robert, Kandzari, David, Bahrami, Dariush, Reedus, Denise, David, Shukri, Rehman, Iram, Zakaria, Khalid, Choksi, Nishit, Kazziha, Samer, Kumar, Sarwan, Saba, Souheil, Steigerwalt, Susan, Sirajeldin, Yassir, Hyder, Omar, Aronow, Herbert, Connors, Andrea, Shemin, Douglas, Bent, Clare, Levy, Terry, Kodoth, Vivek, Schlaich, Markus, Kiuchi, Marcio, Carnagarin, Revathy, Shetty, Sharad, Torre, Sabino, Levitt, Howard, Chen, Lin, Fan, Sarah, Waxman, Sergio, Porr, Wendy, Mangos, George, Smyth, Brendan, Lane, Cathie, Sader, Mark, Patel, Kirit Kumar, Rao, Anjani, Milford, Brett, Ahluwalia, Guneet, Sennott, Jaqueline, Field, Justin, Jena, Nihar, Loree, Stacy, Graham, John, Al-Hesayen, Abdul, Bagai, Akshay, Shite, Junya, Kozuki, Amane, Suzuki, Atsushi, Masuko, Eri, Soga, Fumitaka, Asada, Hiroyuki, Shibata, Hiroyuki, Nagoshi, Ryoji, Fujiwara, Ryudo, Kyo, Shokan, Miyata, Tomohiro, Kijima, Yoichi, Weil, Joachim, Griesinger, Lena, Hafer, Lukas, Starick, Rene-Alexander, Keil, Sebastian, Agdirlioglu, Tolga, Desch, Udo, Saito, Shigeru, Koyama, Eiji, Yamanaka, Futoshi, Yokoyama, Hiroaki, Tobita, Kazuki, Shishido, Koki, Yamaguchi, Masashi, Murakami, Masato, Moriyama, Noriaki, Takahashi, Saeko, Mizuno, Shingo, Yokota, Shohei, Hayashi, Takahiro, Yamada, Takashi, Yamagishi, Tamiharu, Sugiyama, Yoichi, Mashimo, Yuka, Tamaki, Yusuke, Tanaka, Yutaka, Lee, David, Ma, Adrian, Yeung, Alan, Noel, Thomas, Umana, Ernesto, Katopodis, John, Dixon, William, Walton, Tony, Rischin, Adam, Chee, Adrian, Leaney, Alexandra, Fernando, Himavan, Hopper, Ingrid, Bloom, Jason, Fairley, Jessica, Stehli, Julia, Segan, Julian, Sharma, Meenal, Fitzgerald, Melissa, Papandony, Michelle, Whyler, Naomi, Noaman, Samer, Ali, Shazeea, Jefferson, Brian, Reyes, David, Johnston, Thomas, Böhm, Michael, Höfling, Alexander, Berger, Ann-Kathrin, Cremers, Bodo, Millenaar, Dominic, Mahfoud, Felix, Zivanovic, Ina, Lucic, Jelena, Dederer, Juliane, Lauder, Lucas, Fischer, Patrick, Kulenthiran, Saarraangan, Ewen, Sebastian, Bewarder, Yvonne, Schmieder, Roland, Bosch, Agnes, Schmid, Axel, Ott, Christian, Kannenkeril, Dennis, Akarca, Ertan, Kistner, Iris, Kolwelter, Julie, Bihlmaier, Karl, Striepe, Kristina, Karg, Marina, Günes-Altan, Merve, Anna Friedrich, Stefanie Sofia, Jung, Susanne, Dienemann, Thomas, Ziakas, Antonios, Kouparanis, Antonios, Pagiantza, Areti, Peteinidou, Emmanouela, Didagelos, Matthaios, Psochias, Polykarpos Akis, Shishehbor, Mehdi, Meade, Ashley, Linetsky, Elena, Robinson, Monique, Kotter, John, Ziada, Khaled, Bachinsky, William, Garton, Alex, Stuck, Jason, Papademetriou, Vasilios, Chung, Annise, Li, Ping, Nagpal, Sameer, Remetz, Michael, Shah, Samit, Lynch, Shannon, Kandzari, David E., Townsend, Raymond R., Weber, Michael A., Schmieder, Roland E., Pocock, Stuart, Konstantinidis, Dimitrios, East, Cara, Cohen, Debbie L., Kobayashi, Taisei, Lee, David P., Schlaich, Markus P., Devireddy, Chandan M., Sharp, Andrew S.P., Anderson, Richard, Fahy, Martin, DeBruin, Vanessa, and Brar, Sandeep

Published
2023
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12. Making sense of DialysisConnect: a qualitative analysis of stakeholder viewpoints on a web-based information exchange platform to improve care transitions between dialysis clinics and hospitals.

Author

Vandenberg, Ann, Jaar, Bernard, James, Kyle, Lea, Janice, ODonnell, Christopher, Masud, Tahsin, Mutell, Rich, and Plantinga, Laura

Subjects
Delivery of Health Care, Hospitals, Humans, Internet, Patient Transfer, Renal Dialysis
Abstract

BACKGROUND: U.S. hospitals and dialysis centers are penalized for 30-day hospital readmissions of dialysis patients, despite little infrastructure to facilitate care transitions between these settings. We are developing a third-party web-based information exchange platform, DialysisConnect, to enable clinicians to view and exchange information about dialysis patients during admission, hospitalization, and discharge. This health information technology solution could serve as a flexible and relatively affordable solution for dialysis facilities and hospitals across the nation who are seeking to serve as true partners in the improved care of dialysis patients. The purpose of this study was to evaluate the perceived coherence of DialysisConnect to key clinical stakeholders, to prepare messaging for implementation. METHODS: As part of a hybrid effectiveness-implementation study guided by Normalization Process Theory, we collected data on stakeholder perceptions of continuity of care for patients receiving maintenance dialysis and a DialysisConnect prototype before completing development and piloting the system. We conducted four focus groups with stakeholders from one academic hospital and associated dialysis centers [hospitalists (n = 5), hospital staff (social workers, nurses, pharmacists; n = 9), nephrologists (n = 7), and dialysis clinic staff (social workers, nurses; n = 10)]. Transcriptions were analyzed thematically within each component of the construct of coherence (differentiation, communal specification, individual specification, and internalization). RESULTS: Participants differentiated DialysisConnect from usual care variously as an information dashboard, a quick-exchange communication channel, and improved discharge information delivery; some could not differentiate it in terms of workflow. The purpose of DialysisConnect (communal specification) was viewed as fully coherent only for communicating outside of the same healthcare system. Current system workarounds were acknowledged as deterrents for practice change. All groups delegated DialysisConnect tasks (individual specification) to personnel besides themselves. Partial internalization of DialysisConnect was achieved only by dialysis clinic staff, based on experience with similar technology. CONCLUSIONS: Implementing DialysisConnect for clinical users in both settings will require presenting a composite picture of current communication processes from all stakeholder groups to correct single-group misunderstandings, as well as providing data about care transitions communication beyond the local context to ease resistance to practice change.

Published
2021

13. Association of Patient-Reported Difficulty with Adherence with Achievement of Clinical Targets Among Hemodialysis Patients.

Author

Snyder, Rachel, Jaar, Bernard, Lea, Janice, and Plantinga, Laura

Subjects
dialysis, diet, end-stage renal disease, fluid restriction, medications, visit adherence
Abstract

BACKGROUND: Non-adherence to dialysis recommendations is common and associated with poor outcomes. We used data from a cohort of in-center hemodialysis patients to determine whether patients reported difficulties with adherence were associated with achievement of clinical targets for treatment recommendations. PATIENTS AND METHODS: We included 799 in-center patients receiving hemodialysis from February 2010 to October 2016 at Emory Dialysis (Atlanta, GA, USA). Patient-reported difficulty with adherence (yes vs no) across multiple domains (coming to dialysis, completing dialysis sessions, fluid restrictions, diet restrictions, taking medications) was obtained from baseline social worker assessments. Achievement of clinical targets for coming to dialysis (missing ≥3 expected sessions), completing dialysis sessions (shortening >3 sessions by ≥15 min), fluid restrictions (mean interdialytic weight gain ≥3 kg), diet restrictions (mean potassium ≥5.0 mEq/L, mean phosphate >5.5 mg/dL), and taking medications (mean phosphate >5.5 mg/dL) was estimated over the following 12 weeks, using electronic medical record data. Crude agreement was assessed, and multivariable logistic regression was used to estimate the associations between these measures. RESULTS: Agreement between reported difficulty in adherence and failure to achieve clinical targets was generally poor across all domains (percent agreement: 52.9-65.3%). After adjustment, patients reporting difficulty with fluid restrictions were 62% more likely to have mean interdialytic weight gain ≥3 kg than those not reporting difficulty (OR: 1.62, 95% CI: 1.08, 2.43). Patients reporting difficulty with coming to dialysis were 41% more likely to miss ≥3 expected dialysis sessions over 12 weeks (OR: 1.41, 95% CI: 0.96, 2.07); however, this association was not statistically significant. There were no significant associations between reported difficulty and failure to achieve clinical targets in other categories. CONCLUSION: While reported difficulty with only fluid restrictions and coming to dialysis were associated with failure to achieve clinical targets in our study, the general lack of agreement between reported difficulty with adherence and failure to achieve clinical targets highlights a gap that could be explored to develop and target educational interventions aimed at increasing adherence among dialysis patients.

Published
2020

14. Hypertension urgencies in the SPYRAL HTN-OFF MED Pivotal trial

Author

Weber, Michael A., Schmieder, Roland E., Kandzari, David E., Townsend, Raymond R., Mahfoud, Felix, Tsioufis, Konstantinos, Kario, Kazuomi, Pocock, Stuart, Tatakis, Fotis, Ewen, Sebastian, Choi, James W., East, Cara, Lee, David P., Ma, Adrian, Cohen, Debbie L., Wilensky, Robert, Devireddy, Chandan M., Lea, Janice P., Schmid, Axel, Fahy, Martin, and Böhm, Michael

Published
2022
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15. Delivery of a patient-friendly functioning report to improve patient-centeredness of dialysis care: a pilot study.

Author

Plantinga, Laura, Jones, Brian, Johnson, Jeremy, Lambeth, Amelia, Lea, Janice, Nadel, Leigh, Vandenberg, Ann, and Bowling, C

Subjects
Hemodialysis, Patient-centered care, Patient-provider communication, Physical functioning, Activities of Daily Living, Delivery of Health Care, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Patient-Centered Care, Pilot Projects, Quality Improvement, Renal Dialysis, Surveys and Questionnaires
Abstract

BACKGROUND: Provider recognition of level of functioning may be suboptimal in the dialysis setting, and this lack of recognition may lead to less patient-centered care. We aimed to assess whether delivery of an app-based, individualized functioning report would improve patients perceptions of patient-centeredness of care. METHODS: In this pre-post pilot study at three outpatient dialysis facilities in metropolitan Atlanta, an individualized functioning report-including information on physical performance, perceived physical functioning, and community mobility-was delivered to patients receiving hemodialysis (n = 43) and their providers. Qualitative and quantitative approaches were used to gather patient and provider feedback to develop and assess the report and app. Paired t test was used to test for differences in patient perception of patient-centeredness of care (PPPC) scores (range, 1 = most patient-centered to 4 = least patient-centered) 1 month after report delivery. RESULTS: Delivery of the reports to both patients and providers was not associated with a subsequent change in patients perceptions of patient-centeredness of their care (follow-up vs. baseline PPPC scores of 2.35 vs. 2.36; P > 0.9). However, patients and providers generally saw the potential of the report to improve the patient-centeredness of care and reacted positively to the individualized reports delivered in the pilot. Patients also reported willingness to undergo future assessments. However, while two-thirds of surveyed providers reported always or sometimes discussing the reports they received, most (98%) participating patients reported that no one on the dialysis care team had discussed the report with them within 1 month. CONCLUSIONS: Potential lack of fidelity to the intervention precludes definitive conclusions about effects of the report on patient-centeredness of care. The disconnect between patients and providers perceptions of discussions of the report warrants future study. However, this study introduces a novel, individualized, multi-domain functional report that is easily implemented in the setting of hemodialysis. Our pilot study provides guidance for improving its use both clinically and in future pragmatic research studies, both within and beyond the dialysis population.

Published
2019

16. Long-term outcomes among Medicare patients readmitted in the first year of hemodialysis: a retrospective cohort study.

Author

Ross, Katherine, Jaar, Bernard, Lea, Janice, Masud, Tahsin, Patzer, Rachel, and Plantinga, Laura

Subjects
Hemodialysis, Hospital readmissions, Kidney transplantation, Morbidity, Mortality, Aged, Cohort Studies, Female, Humans, Kidney Failure, Chronic, Male, Medicare, Middle Aged, Patient Readmission, Renal Dialysis, Retrospective Studies, Time Factors, Treatment Outcome, United States
Abstract

BACKGROUND: Readmission within 30 days of hospital discharge is common and costly among end-stage renal disease (ESRD) patients. Little is known about long-term outcomes after readmission. We estimated the association between hospital admissions and readmissions in the first year of dialysis and outcomes in the second year. METHODS: Data on incident dialysis patients with Medicare coverage were obtained from the United States Renal Data System (USRDS). Readmission patterns were summarized as no admissions in the first year of dialysis (Admit-), at least one admission but no readmissions within 30 days (Admit+/Readmit-), and admissions with at least one readmission within 30 days (Admit+/Readmit+).We used Cox proportional hazards models to estimate the association between readmission pattern and mortality, hospitalization, and kidney transplantation, accounting for demographic and clinical covariates. RESULTS: Among the 128,593 Medicare ESRD patients included in the study, 18.5% were Admit+/Readmit+, 30.5% were Admit+/Readmit-, and 51.0% were Admit-. Readmit+/Admit+ patients had substantially higher long-term risk of mortality (HR = 3.32 (95% CI, 3.21-3.44)), hospitalization (HR = 4.46 (95% CI, 4.36-4.56)), and lower likelihood of kidney transplantation (HR = 0.52 (95% CI, 0.44-0.62)) compared to Admit- patients; these associations were stronger than those among Admit+/Readmit- patients. CONCLUSIONS: Patients with readmissions in the first year of dialysis were at substantially higher risk of poor outcomes than either patients who had no admissions or patients who had hospital admissions but no readmissions. Identifying strategies to both prevent readmission and mitigate risk among patients who had a readmission may improve outcomes among this substantial, high-risk group of ESRD patients.

Published
2019

17. Association of social worker-assessed psychosocial factors with 30-day hospital readmissions among hemodialysis patients.

Author

Adisa, Olufunmilola, Jaar, Bernard, Masud, Tahsin, Sahlie, Abyalew, Obadina, Catherine, Ang, Joshua, Lea, Janice, and Plantinga, Laura

Subjects
Hemodialysis, Hospital readmissions, Mental health, Psychosocial factors, Social worker, Adult, Aged, Anxiety, Depression, Diet, Drinking, Humans, Kidney Failure, Chronic, Male, Marital Status, Middle Aged, Patient Compliance, Patient Readmission, Psychology, Renal Dialysis, Risk Factors, Social Support, Social Work, Substance-Related Disorders
Abstract

BACKGROUND: Evidence regarding the effect of psychosocial factors on hospital readmission in the setting of hemodialysis is limited. We examined whether social worker-assessed factors were associated with 30-day readmission among prevalent hemodialysis patients. METHODS: Data on 14 factors were extracted from the first available psychosocial assessment performed by social workers at three metropolitan Atlanta dialysis centers. Index admissions (first admission preceded by ≥30 days without a previous hospital discharge) were identified in the period 2/1/10-12/31/14, using linked national administrative hospitalization data. Readmission was defined as any admission within 30 days after index discharge. Associations of each of the psychosocial factors with readmission were assessed using multivariable logistic regression with adjustment for patient and index admission characteristics. RESULTS: Among 719 patients with index admissions, 22.1% were readmitted within 30 days. No psychosocial factors were statistically significantly associated with readmission risk. However, history of substance abuse vs. none was associated with a 29% higher risk of 30-day readmission [OR: 1.29, 95% CI: 0.75-2.23], whereas depression/anxiety was associated with 20% lower risk [OR: 0.80, 95% CI: 0.47-1.36]. Patients who were never married and those who were divorced, or widowed had 38 and 17% higher risk of 30-day readmission, respectively, than those who were married [OR: 1.38, 95% CI: 0.84-2.72; OR: 1.17, 95% CI: 0.73-1.90]. CONCLUSIONS: Results suggest that psychosocial issues may be associated with risk of 30-day readmission among dialysis patients. Despite the limitations of lack of generalizability and potential misclassification due to patient self-report of psychosocial factors to social workers, further study is warranted to determine whether addressing these factors through targeted interventions could potentially reduce readmissions among hemodialysis patients.

Published
2018

19. Post-hospitalization dialysis facility processes of care and hospital readmissions among hemodialysis patients: a retrospective cohort study.

Author

Masud, Tahsin, Lea, Janice, Burkart, John, ODonnell, Christopher, Jaar, Bernard, and Plantinga, Laura

Subjects
Dialysis, Fluid overload, Pulmonary edema, Readmission, Rehospitalization, Aged, Cohort Studies, Female, Hemodialysis Units, Hospital, Hospitalization, Humans, Kidney Failure, Chronic, Male, Middle Aged, Patient Readmission, Process Assessment, Health Care, Registries, Renal Dialysis, Retrospective Studies
Abstract

BACKGROUND: Both dialysis facilities and hospitals are accountable for 30-day hospital readmissions among U.S. hemodialysis patients. We examined the association of post-hospitalization processes of care at hemodialysis facilities with pulmonary edema-related and other readmissions. METHODS: In a retrospective cohort comprised of electronic medical record (EMR) data linked with national registry data, we identified unique patient index admissions (n = 1056; 2/1/10-7/31/15) that were followed by ≥3 in-center hemodialysis sessions within 10 days, among patients treated at 19 Southeastern dialysis facilities. Indicators of processes of care were defined as present vs. absent in the dialysis facility EMR. Readmissions were defined as admissions within 30 days of the index discharge; pulmonary edema-related vs. other readmissions defined by discharge codes for pulmonary edema, fluid overload, and/or congestive heart failure. Multinomial logistic regression to estimate odds ratios (ORs) for pulmonary edema-related and other vs. no readmissions. RESULTS: Overall, 17.7% of patients were readmitted, and 8.0% had pulmonary edema-related readmissions (44.9% of all readmissions). Documentation of the index admission (OR = 2.03, 95% CI 1.07-3.85), congestive heart failure (OR = 1.87, 95% CI 1.07-3.27), and home medications stopped (OR = 1.81, 95% CI 1.08-3.05) or changed (OR = 1.69, 95% CI 1.06-2.70) in the EMR post-hospitalization were all associated with higher risk of pulmonary edema-related vs. no readmission; lower post-dialysis weight (by ≥0.5 kg) after vs. before hospitalization was associated with 40% lower risk (OR = 0.60, 95% CI 0.37-0.96). CONCLUSIONS: Our results suggest that some interventions performed at the dialysis facility in the post-hospitalization period may be associated with reduced readmission risk, while others may provide a potential existing means of identifying patients at higher risk for readmissions, to whom such interventions could be efficiently targeted.

Published
2018

21. Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomised, multicentre, single-blind, sham-controlled trial

Author

Sanghvi, Kintur, Costello, Josh, Krathan, Courtney, Lewis, Luot, McElvarr, Andrew, Reilly, John, Jenkins, Stephen, Cash, Michael, Williams, Shannon, Jarvis, Maria, Fong, Pete, Laffer, Cheryl, Gainer, James, Robbins, Mark, Crook, Sherron, Maddel, Sarita, Hsi, David, Martin, Scott, Portnay, Edward, Ducey, Maryanne, Rose, Suzanne, DelMastro, Elizabeth, Bangalore, Sripal, Williams, Stephen, Cabos, Stanley, Rodriguez Alvarez, Carolina, Todoran, Thomas, Basile, Jan, Powers, Eric, Hodskins, Emily, Paladugu, Vijay, Tecklenburg, Anna, Devireddy, Chandan, Lea, Janice, Wells, Bryan, Fiebach, Amanda, Merlin, Claudia, Rader, Florian, Dohad, Suhail, Kim, Hyun-Min, Rashid, Mohammad, Abraham, Josephine, Owan, Theophilus, Abraham, Anu, Lavasani, Iran, Neilson, Hailey, Calhoun, David, McElderry, Thomas, Maddox, William, Oparil, Suzanne, Kinder, Sheila, Kirtane, Ajay J, Radhakrishnan, Jai, Batres, Candido, Edwards, Suzanne, Garasic, Joseph, Drachman, Doug, Zusman, Randy, Rosenfield, Kenneth, Do, Danny, Khuddus, Matheen, Zentko, Suzanne, O'Meara, James, Barb, Ilie, Foster, Abby, Boyette, Alice, Wang, Yale, Jay, Desmond, Skeik, Nedaa, Schwartz, Robert, Peterson, Rose, Goldman, Jo Anne, Goldman, Jessie, Ledley, Gary, Katof, Nancy, Potluri, Srinivasa, Biedermann, Scott, Ward, Jacquelyn, White, Megan, Fisher, Naomi DL, Mauri, Laura, Sobieszczky, Piotr, Smith, Alex, Aseltine, Laura, Stouffer, Rick, Hinderliter, Alan, Pauley, Eric, Wade, Tyrone, Zidar, David, Shishehbor, Mehdi, Effron, Barry, Costa, Marco, Semenec, Terence, Bloch, Michael J, Roongsritong, Chanwit, Nelson, Priscilla, Neumann, Bridget, Cohen, Debbie, Giri, Jay, Neubauer, Robin, Vo, Thu, Chugh, Atul R, Huang, Pei-Hsiu, Jose, Powell, Flack, John, Fishman, Robert, Jones, Michael, Adams, Todd, Bajzer, Christopher, Saxena, Manish, Lobo, Melvin D, Mathur, Anthony, Jain, Ajay, Balawon, Armida, Zongo, Olivier, Levy, Terry, Bent, Clare, Beckett, David, Lakeman, Nicki, Kennard, Sarah, Sharp, Andrew, D'Souza, Richard J, Statton, Sarah, Wilkes, Lindsay, Anning, Christine, Sayer, Jeremy, Iyer, Sudha Ganesh, Robinson, Nicholas, Sevillano, Annaliza, Ocampo, Madelaine, Gerber, Robert, Faris, Mohamad, Marshall, Andrew John, Sinclair, Janet, Pepper, Hayley, Davies, Justin, Chapman, Neil, Burak, Paula, Carvelli, Paula, Jadhav, Sachin, Quinn, Jane, Rump, Lars Christian, Stegbauer, Johannes, Schimmöller, Lars, Potthoff, Sebastian, Schmid, Claudia, Roeder, Sylvia, Weil, Joachim, Hafer, Lukas, Agdirlioglu, Tolga, Köllner, Tanja, Mahfoud, Felix, Böhm, Michael, Ewen, Sebastian, Kulenthiran, Saarraaken, Wachter, Angelika, Koch, Christina, Lurz, Philipp, Fengler, Karl, Rommel, Karl-Philipp, Trautmann, Kai, Petzold, Martin, Schmieder, Roland E, Ott, Christian, Schmid, Axel, Uder, Michael, Heinritz, Ulrike, Fröhlich-Endres, Kerstin, Genth-Zotz, Sabine, Kämpfner, Denise, Grawe, Armin, Höhne, Johannes, Kaesberger, Bärbel, von zur Mühlen, Constantin, Wolf, Dennis, Welzel, Markus, Heinrichs, Gudrun, Trabitzsch, Barbara, Gosse, Philippe, Cremer, Antoine, Trillaud, Hervé, Papadopoulos, Panteleimon, Maire, Florent, Gaudissard, Julie, Azizi, Michel, Sapoval, Marc, Cornu, Erika, Fouassier, David, Livrozet, Marine, Lorthioir, Aurélien, Paquet, Valérie, Pathak, Atul, Honton, Benjamin, Cottin, Marianne, Petit, Frédéric, Lantelme, Pierre, Berge, Constance, Courand, Pierre-Yves, Langevin, Fatou, Delsart, Pascal, Longere, Benjamin, Ledieu, Guillaume, Pontana, François, Sommeville, Coralie, Bertrand, Fabien, Daemen, Joost, Feyz, Lida, Zeijen, Victor, Ruiter, Arno, Huysken, Elisabeth, Blankestijn, Peter, Voskuil, Michiel, Rittersma, Zwaantina, Dolmans, Helma, Kroon, A A, van Zwam, W H, Vranken, Jeannique, de Haan, Claudia, Persu, Alexandre, Renkin, Jean, Maes, Frédéric, Beauloye, Christophe, Lengelé, Jean-Philippe, Huyberechts, Dominique, Bouvie, Anne, Witkowski, Adam, Januszewicz, Andrzej, Kdziela, Jacek, Prejbisj, Aleksander, Hering, Dagmara, Ciecwierz, Dariusz, Jaguszewski, Milosz J, Owczuk, Radoslaw, Reilly, John P, Rump, Lars C, Sharp, Andrew S P, Weber, Michael A, Kably, Benjamin, Barman, Neil C, Reeve-Stoffer, Helen, Coleman, Leslie, and McClure, Candace K

Published
2021
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22. Kidney and cardiovascular-protective benefits of combination drug therapies in chronic kidney disease associated with type 2 diabetes.

Author

Khan, Muhammad Shahzeb and Lea, Janice P.

Abstract

Given the substantial burden of chronic kidney disease associated with type 2 diabetes, an aggressive approach to treatment is required. Despite the benefits of guideline-directed therapy, there remains a high residual risk of continuing progression of chronic kidney disease and of cardiovascular events. Historically, a linear approach to pharmacologic management of chronic kidney disease has been used, in which drugs are added, then adjusted, optimized, or stopped in a stepwise manner based on their efficacy, toxicity, effects on a patient's quality of life, and cost. However, there are disadvantages to this approach, which may result in missing a window of opportunity to slow chronic kidney disease progression. Instead, a pillar approach has been proposed to enable earlier treatment that simultaneously targets multiple pathways involved in disease progression. Combination therapy in patients with chronic kidney disease associated with type 2 diabetes is being investigated in several clinical trials. In this article, we discuss current treatment options for patients with chronic kidney disease associated with type 2 diabetes and provide a rationale for tailored combinations of therapies with complementary mechanisms of action to optimize therapy using a pillar-based treatment strategy. [This article includes a plain language summary as an additional file]. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Past Decline Versus Current eGFR and Subsequent Mortality Risk

Author

Naimark, David MJ, Grams, Morgan E, Matsushita, Kunihiro, Black, Corri, Drion, Iefke, Fox, Caroline S, Inker, Lesley A, Ishani, Areef, Jee, Sun Ha, Kitamura, Akihiko, Lea, Janice P, Nally, Joseph, Peralta, Carmen Alicia, Rothenbacher, Dietrich, Ryu, Seungho, Tonelli, Marcello, Yatsuya, Hiroshi, Coresh, Josef, Gansevoort, Ron T, Warnock, David G, Woodward, Mark, and de Jong, Paul E

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Clinical Research, Prevention, Renal and urogenital, Good Health and Well Being, Aged, Cause of Death, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Proportional Hazards Models, Renal Insufficiency, Chronic, Risk Factors, Time Factors, CKD Prognosis Consortium, chronic kidney disease, epidemiology, glomerular filtration rate, mortality, outcomes, Urology & Nephrology, Clinical sciences
Abstract

A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope 5 ml/min per 1.73 m(2) per year, respectively. Compared with a slope of 0 ml/min per 1.73 m(2) per year, a slope of -6 ml/min per 1.73 m(2) per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m(2) per year also associated with higher all-cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus

Published
2016

29. Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications

Author

Kandzari, David E., primary, Townsend, Raymond R., additional, Kario, Kazuomi, additional, Mahfoud, Felix, additional, Weber, Michael A., additional, Schmieder, Roland E., additional, Pocock, Stuart, additional, Tsioufis, Konstantinos, additional, Konstantinidis, Dimitrios, additional, Choi, James, additional, East, Cara, additional, Lauder, Lucas, additional, Cohen, Debbie L., additional, Kobayashi, Taisei, additional, Schmid, Axel, additional, Lee, David P., additional, Ma, Adrian, additional, Weil, Joachim, additional, Agdirlioglu, Tolga, additional, Schlaich, Markus P., additional, Shetty, Sharad, additional, Devireddy, Chandan M., additional, Lea, Janice, additional, Aoki, Jiro, additional, Sharp, Andrew S.P., additional, Anderson, Richard, additional, Fahy, Martin, additional, DeBruin, Vanessa, additional, Brar, Sandeep, additional, Böhm, Michael, additional, Wang, Yale, additional, Jay, Desmond, additional, McLaurin, Brent, additional, Lomboy, Carl, additional, Allaqaband, Suhail, additional, Jan, Fuad, additional, Gummadi, Bharat, additional, Litt, Marc, additional, Garcia, Fidel, additional, Singh, Jasvindar, additional, Brown, Angela, additional, Paul, Ashley, additional, Sharp, Andrew, additional, Coulson, James, additional, Nanjundappa, Aravinda, additional, Thakker, Ganpat, additional, Campbell, James, additional, Honton, Benjamin, additional, Farah, Bruno, additional, Patel, Manesh, additional, Gutierrez, Antonio, additional, Tyson, Crystal, additional, Svetkey, Laura, additional, Fudim, Marat, additional, Pagidipati, Neha, additional, Jones, Schuyler, additional, Vemulapalli, Sreekanth, additional, Devireddy, Chandan, additional, Kulshreshtha, Ambar, additional, Wells, Bryan, additional, Batson, Bryan, additional, Wilkins, Robert, additional, Sharif, Faisal, additional, Khair, Abdullahi Mohamed, additional, Pallippattu, Abhishek Wilson, additional, Alhmoudi, Aishah Matar, additional, Gaffney, Brian, additional, Cawley, Christian, additional, Gorry, Colin, additional, Hamed, Hanan, additional, Carron, Jennifer, additional, Birrane, John, additional, Rosseel, Liesbeth, additional, Lunardi, Mattia, additional, Cronin, Michael, additional, McKittrick, Myles, additional, Almagal, Naeif, additional, Khalid, Noman, additional, Shehahd, Qussai, additional, Shahzad, Shirjeel, additional, Fezzi, Simone, additional, Tyulkin, Stanislav, additional, Bel, Xavier Armario, additional, Jolly, Sanjit, additional, Yip, Gordon, additional, Schwalm, Jon-David, additional, Tsang, Michael, additional, Mehta, Shamir, additional, Lurz, Philipp C., additional, Binner, Christian, additional, Obradovic, Danilo, additional, Fahr, Florian, additional, Richter, Ines, additional, Rotta detto Loria, Johannes, additional, Fengler, Karl, additional, Rommel, Karl-Philipp, additional, Cuartas, Mateo Marin, additional, Lerche, Matthias, additional, Hartung, Philipp, additional, Münch, Phillip, additional, Höllriegel, Robert, additional, John, Silke, additional, Otsuji, Satoru, additional, Kusumoto, Hirofumi, additional, Tamaru, Hiroto, additional, Ishibuchi, Kasumi, additional, Hasegawa, Katsuyuki, additional, Sugimoto, Ken, additional, Kakishita, Mikio, additional, Ishii, Rui, additional, Takiuchi, Shin, additional, Yasuda, Shingo, additional, Nakabayashi, Sho, additional, Yamamoto, Wataru, additional, Higashino, Yorihiko, additional, Shimatani, Yuji, additional, Taniguchi, Yusuke, additional, Kasiakogias, Alexandros, additional, Konstantinidis, Dimitris, additional, Andrikou, Eirini, additional, Konstantinou, Konstantinos, additional, Dimitriadis, Kyriakos, additional, Kalos, Theodoros, additional, Cohen, Debbie, additional, Rene, Garvey, additional, Cohen, Jordana, additional, Bonanni, Maria, additional, Denker, Matthew, additional, Wickramisinghe, Rasi, additional, Wilensky, Robert, additional, Kobayashi, Tai, additional, Anjan, Venkatesh, additional, Huan, Yonghong, additional, Haught, Walter Herbert, additional, Krasnow, Joshua, additional, Vasquez, Alejandro, additional, Gessler, Carl, additional, Roth, Christopher, additional, Drenning, David, additional, Velasquez, Enrique, additional, Soliman, George, additional, Murphy, James, additional, Jain, Kaushik, additional, Butler, Michael, additional, Kanitkar, Mihir, additional, Laney, Phillip, additional, Hunter, Ross, additional, Cheng, Shi-Chi, additional, Wright, Thomas, additional, Chapman, Neil, additional, Arnold, Ahran, additional, Nowbar, Alexandra, additional, Janmohamed, Azara, additional, Corden, Ben, additional, Cook, Christopher, additional, Rajkumar, Christopher, additional, Keene, Daniel, additional, Thompson, David, additional, Seligman, Henry, additional, Howard, James, additional, Davies, Justin, additional, Sweeney, Mark, additional, Shun-Shin, Matthew, additional, Foley, Michael, additional, Quaife, Nicholas, additional, Al-Lamee, Rasha, additional, Hadjiphilippou, Savvas, additional, Sen, Sayan, additional, Ahmad, Yousif, additional, Shimizu, Hayato, additional, Waki, Hirotaka, additional, Narita, Keisuke, additional, Shimpo, Masahisa, additional, Hoshide, Satoshi, additional, Komori, Takahiro, additional, Ogoyama, Yukako, additional, Ogata, Yukiyo, additional, Oba, Yusuke, additional, Bisharat, Mohanned, additional, Lishmanov, Anton, additional, Jeffords, Travis, additional, Ghali, Magdi, additional, Chia, Beth, additional, Onsrud, Rachel, additional, Rough, Randolph, additional, Tomii, Daijiro, additional, Mori, Fumiko, additional, Kikushima, Hosei, additional, Ninomiya, Kai, additional, Yahagi, Kazuyuki, additional, Tanabe, Kengo, additional, Nakamura, Kosuke, additional, Komiyama, Kota, additional, Nakase, Masaaki, additional, Asami, Masahiko, additional, Setoguchi, Naoto, additional, Tanaka, Tetsu, additional, Horiuchi, Yu, additional, Watanabe, Yusuke, additional, Feldman, Dmitriy, additional, Bergman, Geoffrey, additional, Sherifi, Ines, additional, Kim, Luke, additional, Amin, Nivee, additional, Minutello, Robert, additional, Wong, S. Chiu, additional, McCullough, Stephen, additional, D'Souza, Richard, additional, Kurdi, Hibba, additional, Statton, Sarah, additional, Watkinson, Tony, additional, Bertolet, Barry, additional, Gupta, Amit, additional, Blossom, Benjamin, additional, Bell, Chris, additional, Hill, Douglas, additional, Sierra, Francisco, additional, Johnson, James, additional, Estess, John, additional, Adams, Joseph, additional, McDuffie, Katie, additional, Ferguson, Lee, additional, Little, Nelson, additional, Ballard, Richard Dane, additional, Williams, Roger, additional, Ikeda, Wanda, additional, Calhoun, William, additional, Carroll, William, additional, Singh, Avneet, additional, Hirsh, Benjamin, additional, Meraj, Perwaiz, additional, Jauhar, Rajiv, additional, Golwala, Harsh, additional, Rueda, Jose, additional, Graham, Kellie, additional, Al-Hakim, Ramsey, additional, Rope, Robert, additional, Kandzari, David, additional, Bahrami, Dariush, additional, Reedus, Denise, additional, David, Shukri, additional, Rehman, Iram, additional, Zakaria, Khalid, additional, Choksi, Nishit, additional, Kazziha, Samer, additional, Kumar, Sarwan, additional, Saba, Souheil, additional, Steigerwalt, Susan, additional, Sirajeldin, Yassir, additional, Hyder, Omar, additional, Aronow, Herbert, additional, Connors, Andrea, additional, Shemin, Douglas, additional, Bent, Clare, additional, Levy, Terry, additional, Kodoth, Vivek, additional, Schlaich, Markus, additional, Kiuchi, Marcio, additional, Carnagarin, Revathy, additional, Torre, Sabino, additional, Levitt, Howard, additional, Chen, Lin, additional, Fan, Sarah, additional, Waxman, Sergio, additional, Porr, Wendy, additional, Mangos, George, additional, Smyth, Brendan, additional, Lane, Cathie, additional, Sader, Mark, additional, Patel, Kirit Kumar, additional, Rao, Anjani, additional, Milford, Brett, additional, Ahluwalia, Guneet, additional, Sennott, Jaqueline, additional, Field, Justin, additional, Jena, Nihar, additional, Loree, Stacy, additional, Graham, John, additional, Al-Hesayen, Abdul, additional, Bagai, Akshay, additional, Shite, Junya, additional, Kozuki, Amane, additional, Suzuki, Atsushi, additional, Masuko, Eri, additional, Soga, Fumitaka, additional, Asada, Hiroyuki, additional, Shibata, Hiroyuki, additional, Nagoshi, Ryoji, additional, Fujiwara, Ryudo, additional, Kyo, Shokan, additional, Miyata, Tomohiro, additional, Kijima, Yoichi, additional, Griesinger, Lena, additional, Hafer, Lukas, additional, Starick, Rene-Alexander, additional, Keil, Sebastian, additional, Desch, Udo, additional, Saito, Shigeru, additional, Koyama, Eiji, additional, Yamanaka, Futoshi, additional, Yokoyama, Hiroaki, additional, Tobita, Kazuki, additional, Shishido, Koki, additional, Yamaguchi, Masashi, additional, Murakami, Masato, additional, Moriyama, Noriaki, additional, Takahashi, Saeko, additional, Mizuno, Shingo, additional, Yokota, Shohei, additional, Hayashi, Takahiro, additional, Yamada, Takashi, additional, Yamagishi, Tamiharu, additional, Sugiyama, Yoichi, additional, Mashimo, Yuka, additional, Tamaki, Yusuke, additional, Tanaka, Yutaka, additional, Lee, David, additional, Yeung, Alan, additional, Noel, Thomas, additional, Umana, Ernesto, additional, Katopodis, John, additional, Dixon, William, additional, Walton, Tony, additional, Rischin, Adam, additional, Chee, Adrian, additional, Leaney, Alexandra, additional, Fernando, Himavan, additional, Hopper, Ingrid, additional, Bloom, Jason, additional, Fairley, Jessica, additional, Stehli, Julia, additional, Segan, Julian, additional, Sharma, Meenal, additional, Fitzgerald, Melissa, additional, Papandony, Michelle, additional, Whyler, Naomi, additional, Noaman, Samer, additional, Ali, Shazeea, additional, Jefferson, Brian, additional, Reyes, David, additional, Johnston, Thomas, additional, Höfling, Alexander, additional, Berger, Ann-Kathrin, additional, Cremers, Bodo, additional, Millenaar, Dominic, additional, Zivanovic, Ina, additional, Lucic, Jelena, additional, Dederer, Juliane, additional, Fischer, Patrick, additional, Kulenthiran, Saarraangan, additional, Ewen, Sebastian, additional, Bewarder, Yvonne, additional, Schmieder, Roland, additional, Bosch, Agnes, additional, Ott, Christian, additional, Kannenkeril, Dennis, additional, Akarca, Ertan, additional, Kistner, Iris, additional, Kolwelter, Julie, additional, Bihlmaier, Karl, additional, Striepe, Kristina, additional, Karg, Marina, additional, Günes-Altan, Merve, additional, Anna Friedrich, Stefanie Sofia, additional, Jung, Susanne, additional, Dienemann, Thomas, additional, Ziakas, Antonios, additional, Kouparanis, Antonios, additional, Pagiantza, Areti, additional, Peteinidou, Emmanouela, additional, Didagelos, Matthaios, additional, Psochias, Polykarpos Akis, additional, Shishehbor, Mehdi, additional, Meade, Ashley, additional, Linetsky, Elena, additional, Robinson, Monique, additional, Kotter, John, additional, Ziada, Khaled, additional, Bachinsky, William, additional, Garton, Alex, additional, Stuck, Jason, additional, Papademetriou, Vasilios, additional, Chung, Annise, additional, Li, Ping, additional, Nagpal, Sameer, additional, Remetz, Michael, additional, Shah, Samit, additional, and Lynch, Shannon, additional

Published
2023
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30. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial

Author

Aoki, Jiro, Batson, Bryan, Böhm, Michael, Choi, James W, Cohen, Debbie L, Dangas, George, David, Shukri, Davies, Justin, Devireddy, Chandan M, Kandzari, David, Kario, Kazuomi, Lee, David P, Lurz, Philipp C, Patel, Manesh, Patel, Kiritkumar, Schmieder, Roland E, Sharp, Andrew S P, Singh, Jasvindar, Tsioufis, Konstantinos, Walton, Anthony, Weber, Thomas, Weil, Joachim, Zeller, Thomas, Ziada, Khaled, Tanabe, Kengo, Wilkins, Robert, Mahfoud, Felix, East, Cara, Wilensky, Robert, Contreras, Johanna, Steigerwalt, Susan, Chapman, Neil, Lea, Janice P, Reedus, Denise, Hoshide, Satoshi, Ma, Adrian, Fengler, Karl, Svetkey, Laura, Rao, Anjani, Schmid, Axel, Watkinson, Anthony F, Brown, Angela, Tousoulis, Dimitrios, Hopper, Ingrid, Suppan, Markus, Agdirlioglu, Tolga, Noory, Elias, Chasen, Craig, Townsend, Raymond R, Kandzari, David E, Pocock, Stuart, Weber, Michael A, Ewen, Sebastian, Cohen, Sidney A, DeBruin, Vanessa, Fahy, Martin, Jones, Denise E, and Rothman, Martin

Published
2017
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32. Six-Month Results of Treatment-Blinded Medication Titration for Hypertension Control After Randomization to Endovascular Ultrasound Renal Denervation or a Sham Procedure in the RADIANCE-HTN SOLO Trial

Author

Azizi, Michel, Schmieder, Roland E., Mahfoud, Felix, Weber, Michael A., Daemen, Joost, Lobo, Melvin D., Sharp, Andrew S.P., Bloch, Michael J., Basile, Jan, Wang, Yale, Saxena, Manish, Lurz, Philipp, Rader, Florian, Sayer, Jeremy, Fisher, Naomi D.L., Fouassier, David, Barman, Neil C., Reeve-Stoffer, Helen, McClure, Candace, Kirtane, Ajay J., Jay, Desmond, Skeik, Nedaa, Schwartz, Robert, Dohad, Suhail, Victor, Ronald, Sanghvi, Kintur, Costello, Josh, Walsh, Courtney, Abraham, Josephine, Owan, Theophilus, Abraham, Anu, Mauri, Laura, Sobieszczky, Piotr, Williams, Jonathan, Roongsritong, Chanwit, Todoran, Thomas, Powers, Eric, Hodskins, Emily, Fong, Pete, Laffer, Cheryl, Gainer, James, Robbins, Mark, Reilly, John, Cash, Michael, Goldman, Jessie, Aggarwal, Sandeep, Ledley, Gary, His, David, Martin, Scott, Portnay, Edward, Calhoun, David, McElderry, Thomas, Maddox, William, Oparil, Suzanne, Huang, Pei-Hsiu, Jose, Powell, Khuddus, Matheen, Zentko, Suzanne, O’Meara, James, Barb, Ilie, Garasic, Joseph, Drachman, Doug, Zusman, Randy, Rosenfield, Kenneth, Devireddy, Chandan, Lea, Janice, Wells, Bryan, Stouffer, Rick, Hinderliter, Alan, Pauley, Eric, Potluri, Srinivasa, Biedermann, Scott, Bangalore, Sripal, Williams, Stephen, Zidar, David, Shishehbor, Mehdi, Effron, Barry, Costa, Marco, Radhakrishnan, Jai, Mathur, Anthony, Jain, Ajay, Iyer, Sudha Ganesh, Robinson, Nicholas, Edroos, Sadat Ali, Levy, Terry, Patel, Amit, Beckett, David, Bent, Clare, Davies, Justin, Chapman, Neil, Shin, Matthew Shun, Howard, James, Joseph, Anil, D’Souza, Richard, Gerber, Robert, Faris, Mohamad, Marshall, Andrew John, Elorz, Cristina, Höllriegel, Robert, Fengler, Karl, Rommel, Karl-Philipp, Böhm, Michael, Ewen, Sebastian, Lucic, Jelena, Ott, Christian, Schmid, Axel, Uder, Michael, Rump, Christian, Stegbauer, Johannes, Kröpil, Patric, Sapoval, Marc, Cornu, Erika, Lorthioir, Aurélien, Gosse, Philippe, Cremer, Antoine, Trillaud, Hervé, Papadopoulos, Panteleimon, Pathak, Atul, Honton, Benjamin, Lantelme, Pierre, Berge, Constance, Courand, Pierre-Yves, Feyz, Lida, Blankestijn, Peter, Voskuil, Michiel, Rittersma, Zwaantina, Kroon, A.A., van Zwam, W.H., Persu, Alexandre, and Renkin, Jean

Published
2019
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33. Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation

Author

Azizi, Michel, Mahfoud, Felix, Weber, Michael, Sharp, Andrew, Schmieder, Roland, Lurz, Philipp, Lobo, Melvin, Fisher, Naomi, Daemen, Joost, Bloch, Michael, Basile, Jan, Sanghvi, Kintur, Saxena, Manish, Gosse, Philippe, Jenkins, J. Stephen, Levy, Terry, Persu, Alexandre, Kably, Benjamin, Claude, Lisa, Reeve-Stoffer, Helen, Mcclure, Candace, Kirtane, Ajay, Mullin, Christopher, Thackeray, Lisa, Chertow, Glenn, Kahan, Thomas, Dauerman, Harold, Ullery, Steven, Abbott, J. Dawn, Loening, Andreas, Zagoria, Ron, Costello, John, Krathan, Courtney, Lewis, Luot, Mcelvarr, Andrew, Reilly, John, Cash, Michael, Williams, Shannon, Jarvis, Maria, Fong, Pete, Laffer, Cheryl, Gainer, James, Robbins, Mark, Crook, Sherron, Maddel, Sarita, Hsi, David, Martin, Scott, Portnay, Edward, Ducey, Maryanne, Rose, Suzanne, Delmastro, Elizabeth, Bangalore, Sripal, Williams, Stephen, Cabos, Stanley, Rodriguez Alvarez, Carolina, Todoran, Thomas, Powers, Eric, Hodskins, Emily, Paladugu, Vijay, Tecklenburg, Anna, Devireddy, Chandan, Lea, Janice, Wells, Bryan, Fiebach, Amanda, Merlin, Claudia, Rader, Florian, Dohad, Suhail, Kim, Hyun-Min, Rashid, Mohammad, Abraham, Josephine, Owan, Theophilus, Abraham, Anu, Lavasani, Iran, Neilson, Hailey, Calhoun, David, Mcelderry, Thomas, Maddox, William, Oparil, Suzanne, Kinder, Sheila, Radhakrishnan, Jai, Batres, Candido, Edwards, Suzanne, Garasic, Joseph, Drachman, Doug, Zusman, Randy, Rosenfield, Kenneth, Do, Danny, Khuddus, Matheen, Zentko, Suzanne, O'Meara, James, Barb, Ilie, Foster, Abby, Boyette, Alice, Wang, Yale, Jay, Desmond, Skeik, Nedaa, Schwartz, Robert, Peterson, Rose, Goldman, Jo Anne, Goldman, Jessie, Ledley, Gary, Katof, Nancy, Potluri, Srinivasa, Biedermann, Scott, Ward, Jacquelyn, White, Megan, Mauri, Laura, Sobieszczky, Piotr, Smith, Alex, Aseltine, Laura, Stouffer, Rick, Hinderliter, Alan, Pauley, Eric, Wade, Tyrone, Zidar, David, Shishehbor, Mehdi, Effron, Barry, Costa, Marco, Semenec, Terence, Roongsritong, Chanwit, Nelson, Priscilla, Neumann, Bridget, Cohen, Debbie, Giri, Jay, Neubauer, Robin, Vo, Thu, Chugh, Atul, Huang, Pei-Hsiu, Jose, Powell, Flack, John, Fishman, Robert, Jones, Michael, Adams, Todd, Bajzer, Christopher, Mathur, Anthony, Jain, Ajay, Balawon, Armida, Zongo, Olivier, Bent, Clare, Beckett, David, Lakeman, Nicki, Kennard, Sarah, D’souza, Richard, Statton, Sarah, Wilkes, Lindsay, Anning, Christine, Sayer, Jeremy, Iyer, Sudha Ganesh, Robinson, Nicholas, Sevillano, Annaliza, Ocampo, Madelaine, Gerber, Robert, Faris, Mohamad, Marshall, Andrew John, Sinclair, Janet, Pepper, Hayley, Davies, Justin, Chapman, Neil, Burak, Paula, Carvelli, Paula, Jadhav, Sachin, Quinn, Jane, Rump, Lars Christian, Stegbauer, Johannes, Schimmöller, Lars, Potthoff, Sebastian, Schmid, Claudia, Roeder, Sylvia, Weil, Joachim, Hafer, Lukas, Agdirlioglu, Tolga, Köllner, Tanja, Böhm, Michael, Ewen, Sebastian, Kulenthiran, Saarraaken, Wachter, Angelika, Koch, Christina, Fengler, Karl, Rommel, Karl-Philipp, Trautmann, Kai, Petzold, Martin, Ott, Christian, Schmid, Axel, Uder, Michael, Heinritz, Ulrike, Fröhlich-Endres, Kerstin, Genth-Zotz, Sabine, Kämpfner, Denise, Grawe, Armin, Höhne, Johannes, Kaesberger, Bärbel, von Zur Mühlen, Constantin, Wolf, Dennis, Welzel, Markus, Heinrichs, Gudrun, Trabitzsch, Barbara, Cremer, Antoine, Trillaud, Hervé, Papadopoulos, Panteleimon, Maire, Florent, Gaudissard, Julie, Sapoval, Marc, Livrozet, Marine, Lorthioir, Aurélien, Amar, Laurence, Paquet, Valérie, Pathak, Atul, Honton, Benjamin, Cottin, Marianne, Petit, Frédéric, Lantelme, Pierre, Berge, Constance, Courand, Pierre-Yves, Langevin, Fatou, Delsart, Pascal, Longere, Benjamin, Ledieu, Guillaume, Pontana, François, Sommeville, Coralie, Bertrand, Fabien, Feyz, Lida, Zeijen, Victor, Ruiter, Arno, Huysken, Elisabeth, Blankestijn, Peter, Voskuil, Michiel, Rittersma, Zwaantina, Dolmans, Helma, Kroon, A.A., van Zwam, W.H., Vranken, Jeannique, de Haan., Claudia, Renkin, Jean, Maes, Frédéric, Beauloye, Christophe, Lengelé, Jean-Philippe, Huyberechts, Dominique, Bouvie, Anne, Witkowski, Adam, Januszewicz, Andrzej, Kądziela, Jacek, Prejbisj, Aleksander, Hering, Dagmara, Ciecwierz, Dariusz, Jaguszewski, Milosz, Owczuk, Radoslaw, CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CArdiovasculaire Rénal Transplantation nEurovasculaire [Paris] (DMU CARTE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Saarland University [Saarbrücken], Biotechnologie et signalisation cellulaire (BSC), Université de Strasbourg (UNISTRA)-Institut de recherche de l'Ecole de biotechnologie de Strasbourg (IREBS)-Centre National de la Recherche Scientifique (CNRS), University Hospital of Wales (UHW), University of Exeter, Universitätsklinikum Erlangen [Erlangen], Leipzig University, Queen Mary University of London (QMUL), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Erasmus University Medical Center [Rotterdam] (Erasmus MC), University of Nevada [Reno], Medical University of South Carolina [Charleston] (MUSC), Hôpital Saint-André, Royal Bournemouth Hospital, Université Catholique de Louvain = Catholic University of Louvain (UCL), Cliniques Universitaires Saint-Luc [Bruxelles], Plant Health Institute of Montpellier (UMR PHIM), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Montpellier, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Montpellier (UM), Columbia University Medical Center (CUMC), Columbia University [New York], Danderyds sjukhus = Danderyd University Hospital, University of Vermont [Burlington], Stanford University, Argolyn Bioscience, Inc., and Argolyn Bioscience

Subjects
[SDV]Life Sciences [q-bio]
Abstract

Auteurs : RADIANCE-HTN Investigators; International audience; Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m 2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m 2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of −2.4 [16.6] vs −7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426

Published
2022

34. Hypertension in Patients Treated With In-Center Maintenance Hemodialysis: Current Evidence and Future Opportunities: A Scientific Statement From the American Heart Association.

Author

Bansal, Nisha, Artinian, Nancy T., Bakris, George, Chang, Tara, Cohen, Jordana, Flythe, Jennifer, Lea, Janice, Vongpatanasin, Wanpen, and Chertow, Glenn M.

Abstract

Nearly 500 000 individuals are treated with maintenance hemodialysis for kidney failure in the United States, and roughly half will die of cardiovascular causes. Hypertension, an important and modifiable risk factor for cardiovascular disease, is observed in >80% of patients treated with maintenance hemodialysis. The pathophysiology of hypertension in patients treated with maintenance hemodialysis is multifactorial and differs from that seen in other patient populations. Factors that contribute to hypertension in patients treated with hemodialysis include volume overload, arterial stiffness, enhanced activity of the sympathetic nervous and renin-angiotensin-aldosterone systems, endothelial dysfunction, and use of erythropoietin-stimulating agents. This scientific statement reviews the current evidence on defining, diagnosing, and treating hypertension in patients treated with maintenance hemodialysis and highlights opportunities for future investigation, including studies on blood pressure targets and treatment strategies. [ABSTRACT FROM AUTHOR]

Published
2023
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38. A Web-Based, Provider-Driven Mobile App to Enhance Patient Care Coordination Between Dialysis Facilities and Hospitals: Development and Pilot Implementation Study.

Author

Hoge, Courtney, Hoge, Courtney, Vandenberg, Ann, James, Kyle, Masud, Tahsin, Khakharia, Anjali, Gray, Carol, Jaar, Bernard, Lea, Janice, ODonnell, Christopher, Mutell, Richard, Plantinga, Laura, Hoge, Courtney, Hoge, Courtney, Vandenberg, Ann, James, Kyle, Masud, Tahsin, Khakharia, Anjali, Gray, Carol, Jaar, Bernard, Lea, Janice, ODonnell, Christopher, Mutell, Richard, and Plantinga, Laura

Abstract

BACKGROUND: We piloted a web-based, provider-driven mobile app (DialysisConnect) to fill the communication and care coordination gap between hospitals and dialysis facilities. OBJECTIVE: This study aimed to describe the development and pilot implementation of DialysisConnect. METHODS: DialysisConnect was developed iteratively with focus group and user testing feedback and was made available to 120 potential users at 1 hospital (hospitalists, advanced practice providers [APPs], and care coordinators) and 4 affiliated dialysis facilities (nephrologists, APPs, nurses and nurse managers, social workers, and administrative personnel) before the start of the pilot (November 1, 2020, to May 31, 2021). Midpilot and end-of-pilot web-based surveys of potential users were also conducted. Descriptive statistics were used to describe system use patterns, ratings of multiple satisfaction items (1=not at all; 3=to a great extent), and provider-selected motivators of and barriers to using DialysisConnect. RESULTS: The pilot version of DialysisConnect included clinical information that was automatically uploaded from dialysis facilities, forms for entering critical admission and discharge information, and a direct communication channel. Although physicians comprised most of the potential users of DialysisConnect, APPs and dialysis nurses were the most active users. Activities were unevenly distributed; for example, 1 hospital-based APP recorded most of the admissions (280/309, 90.6%) among patients treated at the pilot dialysis facilities. End-of-pilot ratings of DialysisConnect were generally higher for users versus nonusers (eg, I can see the potential value of DialysisConnect for my work with dialysis patients: mean 2.8, SD 0.4, vs mean 2.3, SD 0.6; P=.02). Providers most commonly selected reduced time and energy spent gathering information as a motivator (11/26, 42%) and a lack of time to use the system as a barrier (8/26, 31%) at the end of the pilot. CONCLUSIONS: This pilot st

Published
2022

39. BP Control and Long-Term Risk of ESRD and Mortality

Author

Ku, Elaine, Gassman, Jennifer, Appel, Lawrence J., Smogorzewski, Miroslaw, Sarnak, Mark J., Glidden, David V., Bakris, George, Gutiérrez, Orlando M., Hebert, Lee A., Ix, Joachim H., Lea, Janice, Lipkowitz, Michael S., Norris, Keith, Ploth, David, Pogue, Velvie A., Rostand, Stephen G., Siew, Edward D., Sika, Mohammed, Tisher, C. Craig, Toto, Robert, Wright, Jackson T., Jr., Wyatt, Christina, and Hsu, Chi-yuan

Published
2017
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40. Clinical Course of SARS-CoV-2 Infection in Adults with ESKD Receiving Outpatient Hemodialysis

Author

Bardossy, Ana Cecilia, primary, Korhonen, Lauren, additional, Schatzman, Sabrina, additional, Gable, Paige, additional, Herzig, Carolyn, additional, Brown, Nicole E., additional, Beshearse, Elizabeth, additional, Varela, Kate, additional, Sabour, Sarah, additional, Lyons, Amanda K., additional, Overton, Rahsaan, additional, Hudson, Matthew, additional, Hernandez-Romieu, Alfonso C., additional, Alvarez, Jorge, additional, Roman, Kaylin, additional, Weng, Mark, additional, Soda, Elizabeth, additional, Patel, Priti R., additional, Grate, Crystal, additional, Dalrymple, Lorien S., additional, Wingard, Rebecca L., additional, Thornburg, Natalie J., additional, Halpin, Alison S. Laufer, additional, Folster, Jennifer M., additional, Tobin-D’Angelo, Melissa, additional, Lea, Janice, additional, Apata, Ibironke, additional, McDonald, L. Clifford, additional, Brown, Allison C., additional, Kutty, Preeta K., additional, and Novosad, Shannon, additional

Published
2021
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41. A Web-Based, Provider-Driven Mobile App to Enhance Patient Care Coordination Between Dialysis Facilities and Hospitals: Development and Pilot Implementation Study (Preprint)

Author

Plantinga, Laura C, primary, Hoge, Courtney, additional, Vandenberg, Ann E, additional, James, Kyle, additional, Masud, Tahsin, additional, Khakharia, Anjali, additional, Gray, Carol, additional, Jaar, Bernard G, additional, Lea, Janice P, additional, O'Donnell, Christopher M, additional, and Mutell, Richard, additional

Published
2021
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43. Predictors of blood pressure response in the SYMPLICITY HTN-3 trial

Author

Kandzari, David E., Bhatt, Deepak L., Brar, Sandeep, Devireddy, Chandan M., Esler, Murray, Fahy, Martin, Flack, John M., Katzen, Barry T., Lea, Janice, Lee, David P., Leon, Martin B., Ma, Adrian, Massaro, Joseph, Mauri, Laura, Oparil, Suzanne, OʼNeill, William W., Patel, Manesh R., Rocha-Singh, Krishna, Sobotka, Paul A., Svetkey, Laura, Townsend, Raymond R., and Bakris, George L.

Published
2015
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45. Absence of SARS-CoV-2 infections among patients with end-stage renal disease following facility-wide testing in four outpatient hemodialysis facilities

Author

Wilson, W. Wyatt, primary, Bardossy, Ana C., additional, Gable, Paige, additional, Herzig, Carolyn, additional, Beshearse, Elizabeth, additional, Gualandi, Nicole, additional, Sabour, Sarah, additional, Brown, Nicole, additional, Brown, Allison C., additional, Kutty, Preeta, additional, Tobin-D'Angelo, Melissa, additional, Lea, Janice P., additional, Apata, Ibironke W., additional, Novosad, Shannon, additional, Hudson, Matthew, additional, Hernandez-Romieu, Alfonso C., additional, Tobolowsky, Farrell, additional, Lyons, Amanda, additional, Gilbert, Sarah, additional, Soda, Elizabeth, additional, Biedron, Caitlin, additional, and Korhonen, Lauren, additional

Published
2021
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46. Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomised, multicentre, single-blind, sham-controlled trial

Author

Azizi, Michel, primary, Sanghvi, Kintur, additional, Saxena, Manish, additional, Gosse, Philippe, additional, Reilly, John P, additional, Levy, Terry, additional, Rump, Lars C, additional, Persu, Alexandre, additional, Basile, Jan, additional, Bloch, Michael J, additional, Daemen, Joost, additional, Lobo, Melvin D, additional, Mahfoud, Felix, additional, Schmieder, Roland E, additional, Sharp, Andrew S P, additional, Weber, Michael A, additional, Sapoval, Marc, additional, Fong, Pete, additional, Pathak, Atul, additional, Lantelme, Pierre, additional, Hsi, David, additional, Bangalore, Sripal, additional, Witkowski, Adam, additional, Weil, Joachim, additional, Kably, Benjamin, additional, Barman, Neil C, additional, Reeve-Stoffer, Helen, additional, Coleman, Leslie, additional, McClure, Candace K, additional, Kirtane, Ajay J, additional, Costello, Josh, additional, Krathan, Courtney, additional, Lewis, Luot, additional, McElvarr, Andrew, additional, Reilly, John, additional, Jenkins, Stephen, additional, Cash, Michael, additional, Williams, Shannon, additional, Jarvis, Maria, additional, Laffer, Cheryl, additional, Gainer, James, additional, Robbins, Mark, additional, Crook, Sherron, additional, Maddel, Sarita, additional, Martin, Scott, additional, Portnay, Edward, additional, Ducey, Maryanne, additional, Rose, Suzanne, additional, DelMastro, Elizabeth, additional, Williams, Stephen, additional, Cabos, Stanley, additional, Rodriguez Alvarez, Carolina, additional, Todoran, Thomas, additional, Powers, Eric, additional, Hodskins, Emily, additional, Paladugu, Vijay, additional, Tecklenburg, Anna, additional, Devireddy, Chandan, additional, Lea, Janice, additional, Wells, Bryan, additional, Fiebach, Amanda, additional, Merlin, Claudia, additional, Rader, Florian, additional, Dohad, Suhail, additional, Kim, Hyun-Min, additional, Rashid, Mohammad, additional, Abraham, Josephine, additional, Owan, Theophilus, additional, Abraham, Anu, additional, Lavasani, Iran, additional, Neilson, Hailey, additional, Calhoun, David, additional, McElderry, Thomas, additional, Maddox, William, additional, Oparil, Suzanne, additional, Kinder, Sheila, additional, Radhakrishnan, Jai, additional, Batres, Candido, additional, Edwards, Suzanne, additional, Garasic, Joseph, additional, Drachman, Doug, additional, Zusman, Randy, additional, Rosenfield, Kenneth, additional, Do, Danny, additional, Khuddus, Matheen, additional, Zentko, Suzanne, additional, O'Meara, James, additional, Barb, Ilie, additional, Foster, Abby, additional, Boyette, Alice, additional, Wang, Yale, additional, Jay, Desmond, additional, Skeik, Nedaa, additional, Schwartz, Robert, additional, Peterson, Rose, additional, Goldman, Jo Anne, additional, Goldman, Jessie, additional, Ledley, Gary, additional, Katof, Nancy, additional, Potluri, Srinivasa, additional, Biedermann, Scott, additional, Ward, Jacquelyn, additional, White, Megan, additional, Fisher, Naomi DL, additional, Mauri, Laura, additional, Sobieszczky, Piotr, additional, Smith, Alex, additional, Aseltine, Laura, additional, Stouffer, Rick, additional, Hinderliter, Alan, additional, Pauley, Eric, additional, Wade, Tyrone, additional, Zidar, David, additional, Shishehbor, Mehdi, additional, Effron, Barry, additional, Costa, Marco, additional, Semenec, Terence, additional, Roongsritong, Chanwit, additional, Nelson, Priscilla, additional, Neumann, Bridget, additional, Cohen, Debbie, additional, Giri, Jay, additional, Neubauer, Robin, additional, Vo, Thu, additional, Chugh, Atul R, additional, Huang, Pei-Hsiu, additional, Jose, Powell, additional, Flack, John, additional, Fishman, Robert, additional, Jones, Michael, additional, Adams, Todd, additional, Bajzer, Christopher, additional, Mathur, Anthony, additional, Jain, Ajay, additional, Balawon, Armida, additional, Zongo, Olivier, additional, Bent, Clare, additional, Beckett, David, additional, Lakeman, Nicki, additional, Kennard, Sarah, additional, Sharp, Andrew, additional, D'Souza, Richard J, additional, Statton, Sarah, additional, Wilkes, Lindsay, additional, Anning, Christine, additional, Sayer, Jeremy, additional, Iyer, Sudha Ganesh, additional, Robinson, Nicholas, additional, Sevillano, Annaliza, additional, Ocampo, Madelaine, additional, Gerber, Robert, additional, Faris, Mohamad, additional, Marshall, Andrew John, additional, Sinclair, Janet, additional, Pepper, Hayley, additional, Davies, Justin, additional, Chapman, Neil, additional, Burak, Paula, additional, Carvelli, Paula, additional, Jadhav, Sachin, additional, Quinn, Jane, additional, Rump, Lars Christian, additional, Stegbauer, Johannes, additional, Schimmöller, Lars, additional, Potthoff, Sebastian, additional, Schmid, Claudia, additional, Roeder, Sylvia, additional, Hafer, Lukas, additional, Agdirlioglu, Tolga, additional, Köllner, Tanja, additional, Böhm, Michael, additional, Ewen, Sebastian, additional, Kulenthiran, Saarraaken, additional, Wachter, Angelika, additional, Koch, Christina, additional, Lurz, Philipp, additional, Fengler, Karl, additional, Rommel, Karl-Philipp, additional, Trautmann, Kai, additional, Petzold, Martin, additional, Ott, Christian, additional, Schmid, Axel, additional, Uder, Michael, additional, Heinritz, Ulrike, additional, Fröhlich-Endres, Kerstin, additional, Genth-Zotz, Sabine, additional, Kämpfner, Denise, additional, Grawe, Armin, additional, Höhne, Johannes, additional, Kaesberger, Bärbel, additional, von zur Mühlen, Constantin, additional, Wolf, Dennis, additional, Welzel, Markus, additional, Heinrichs, Gudrun, additional, Trabitzsch, Barbara, additional, Cremer, Antoine, additional, Trillaud, Hervé, additional, Papadopoulos, Panteleimon, additional, Maire, Florent, additional, Gaudissard, Julie, additional, Azizi, Michel, additional, Cornu, Erika, additional, Fouassier, David, additional, Livrozet, Marine, additional, Lorthioir, Aurélien, additional, Paquet, Valérie, additional, Honton, Benjamin, additional, Cottin, Marianne, additional, Petit, Frédéric, additional, Berge, Constance, additional, Courand, Pierre-Yves, additional, Langevin, Fatou, additional, Delsart, Pascal, additional, Longere, Benjamin, additional, Ledieu, Guillaume, additional, Pontana, François, additional, Sommeville, Coralie, additional, Bertrand, Fabien, additional, Feyz, Lida, additional, Zeijen, Victor, additional, Ruiter, Arno, additional, Huysken, Elisabeth, additional, Blankestijn, Peter, additional, Voskuil, Michiel, additional, Rittersma, Zwaantina, additional, Dolmans, Helma, additional, Kroon, A A, additional, van Zwam, W H, additional, Vranken, Jeannique, additional, de Haan, Claudia, additional, Renkin, Jean, additional, Maes, Frédéric, additional, Beauloye, Christophe, additional, Lengelé, Jean-Philippe, additional, Huyberechts, Dominique, additional, Bouvie, Anne, additional, Januszewicz, Andrzej, additional, Kdziela, Jacek, additional, Prejbisj, Aleksander, additional, Hering, Dagmara, additional, Ciecwierz, Dariusz, additional, Jaguszewski, Milosz J, additional, and Owczuk, Radoslaw, additional

Published
2021
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47. Association of Patient-Reported Difficulty with Adherence with Achievement of Clinical Targets Among Hemodialysis Patients

Author

Snyder,Rachel L, Jaar,Bernard G., Lea,Janice P., and Plantinga,Laura C.

Subjects
Patient Preference and Adherence
Abstract

Rachel L Snyder, 1 Bernard G Jaar, 2–5 Janice P Lea, 6 Laura C Plantinga 1, 6 1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA; 3Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 5Nephrology Center of Maryland, Baltimore, MD, USA; 6Department of Medicine, Emory University, Atlanta, GA, USACorrespondence: Laura C PlantingaDepartment of Medicine, Emory University, 1841 Clifton Road, Wesley Woods Health Center Room 552, Atlanta, GA 30329 Tel +1 404 727 3460Fax +1 404 728 6425Email laura.plantinga@emory.eduBackground: Non-adherence to dialysis recommendations is common and associated with poor outcomes. We used data from a cohort of in-center hemodialysis patients to determine whether patients’ reported difficulties with adherence were associated with achievement of clinical targets for treatment recommendations.Patients and Methods: We included 799 in-center patients receiving hemodialysis from February 2010 to October 2016 at Emory Dialysis (Atlanta, GA, USA). Patient-reported difficulty with adherence (yes vs no) across multiple domains (coming to dialysis, completing dialysis sessions, fluid restrictions, diet restrictions, taking medications) was obtained from baseline social worker assessments. Achievement of clinical targets for coming to dialysis (missing ≥ 3 expected sessions), completing dialysis sessions (shortening > 3 sessions by ≥ 15 min), fluid restrictions (mean interdialytic weight gain ≥ 3 kg), diet restrictions (mean potassium ≥ 5.0 mEq/L, mean phosphate > 5.5 mg/dL), and taking medications (mean phosphate > 5.5 mg/dL) was estimated over the following 12 weeks, using electronic medical record data. Crude agreement was assessed, and multivariable logistic regression was used to estimate the associations between these measures.Results: Agreement between reported difficulty in adherence and failure to achieve clinical targets was generally poor across all domains (percent agreement: 52.9– 65.3%). After adjustment, patients reporting difficulty with fluid restrictions were 62% more likely to have mean interdialytic weight gain ≥ 3 kg than those not reporting difficulty (OR: 1.62, 95% CI: 1.08, 2.43). Patients reporting difficulty with coming to dialysis were 41% more likely to miss ≥ 3 expected dialysis sessions over 12 weeks (OR: 1.41, 95% CI: 0.96, 2.07); however, this association was not statistically significant. There were no significant associations between reported difficulty and failure to achieve clinical targets in other categories.Conclusion: While reported difficulty with only fluid restrictions and coming to dialysis were associated with failure to achieve clinical targets in our study, the general lack of agreement between reported difficulty with adherence and failure to achieve clinical targets highlights a gap that could be explored to develop and target educational interventions aimed at increasing adherence among dialysis patients.Keywords: dialysis, end-stage renal disease, visit adherence, diet, fluid restriction, medications

Published
2020

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