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4. Can Peer Review Be Kinder? Supportive Peer Review: A Re-Commitment to Kindness and a Call to Action

Author

Clase, Catherine M, Dicks, Elizabeth, Holden, Rachel, Sood, Manish M, Levin, Adeera, Kalantar-Zadeh, Kamyar, Moore, Linda W, Bartlett, Susan J, Bello, Aminu K, Bohm, Clara, Bridgewater, Darren, Bouchard, Josee, Burger, Dylan, Carrero, Juan Jesús, Donald, Maoliosa, Elliott, Meghan, Goldenberg, Maya J, Jardine, Meg, Lam, Ngan N, Maddigan, W Joy, Madore, François, Mavrakanas, Thomas A, Molnar, Amber O, Prasad, GV Ramesh, Rigatto, Claudio, Tennankore, Karthik K, Torban, Elena, Trainor, Laurel, White, Christine A, and Hartwig, Sunny

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Good Health and Well Being, humility, kindness, peer review, supportive review, truth, Clinical sciences
Abstract

Peer review aims to select articles for publication and to improve articles before publication. We believe that this process can be infused by kindness without losing rigor. In 2014, the founding editorial team of the Canadian Journal of Kidney Health and Disease (CJKHD) made an explicit commitment to treat authors as we would wish to be treated ourselves. This broader group of authors reaffirms this principle, for which we suggest the terminology "supportive review."

Published
2022

8. Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Bagasha, Peace, Bargman, Joanne M., Bavanandan, Sunita, Beckwith, Hannah, Bennett, Paul N., Bohm, Clara, Brennan, Frank, Burton, James O., Cavanaugh, Kerri L., Chilcot, Joseph, Choi, Peter, Cukor, Daniel, Dember, Laura M., Dong, Jie, Edwards, Dawn, Erickson, Kevin F., Figueiredo, Ana, Finkelstein, Fredric O., Fukagawa, Masafumi, Germain, Michael, Guillano, Franklin B., Hurst, Helen, Iseki, Kunitoshi, Jardine, Meg J., Jauré, Allison, Jha, Vivekanand, Jhamb, Manisha, Kanjanabuch, Talerngsak, Lerma, Edgar, Kam-Tao Li, Philip, Liew, Adrian, Małyszko, Jolanta, Proenca de Moraes, Thyago, Moranne, Olivier, Nam Ng, Marques Shek, Ostermann, Marlies, Perl, Jeffrey, Pigford, Jayne, Pommer, Wolfgang, Richardson, Michelle M., Rivara, Matthew B., Roberts, Glenda V., Sarafidis, Pantelis, Shroff, Rukshana, Slon Roblero, Maria Fernanda, Smyth, Brendan, Søndergaard, Henning, Van Der Veer, Sabine N., Vassalotti, Joseph A., Vervloet, Marc, Vincent, Lloyd, Walker, Rachael, Warren, Madeleine, Wasylynuk, Betty Ann, West, Melissa, Wilkie, Caroline, Mehrotra, Rajnish, Davison, Sara N., Farrington, Ken, Flythe, Jennifer E., Foo, Marjorie, Madero, Magdalena, Morton, Rachael L., Tsukamoto, Yusuke, Unruh, Mark L., Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., and Brown, Edwina A.

Published
2023
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9. An International Survey of Peritoneal Dialysis Exercise Practices and Perceptions

Author

Bennett, Paul N., Bohm, Clara, Yee-Moon Wang, Angela, Kanjanabuch, Talerngsak, Figueiredo, Ana Elizabeth, Harasemiw, Oksana, Brown, Leanne, Gabrys, Iwona, Jegatheesan, Dev, Lambert, Kelly, Lightfoot, Courtney J., MacRae, Jennifer, Scholes-Robertson, Nicole, Stewart, Krista, Tarca, Brett, Verdin, Nancy, Warren, Madeleine, West, Mike, Zimmerman, Deborah, Finderup, Jeannette, Ford, Emilie, Ribeiro, Heitor S., Xu, Qunyan, and Thompson, Stephanie

Published
2023
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12. Cultivating Innovative Pragmatic Cluster-Randomized Registry Trials Embedded in Hemodialysis Care: Workshop Proceedings From 2018

Author

Lee, Elliot J, Patel, Aakil, Acedillo, Rey R, Bachynski, Jovina C, Barrett, Ian, Basile, Erika, Battistella, Marisa, Benjamin, Derek, Berry, David, Blake, Peter G, Chan, Patricia, Bohm, Clara J, Clemens, Kristin K, Cook, Charles, Dember, Laura, Dirk, Jade S, Dixon, Stephanie, Fowler, Elisabeth, Getchell, Leah, Gholami, Nazanine, Goldstein, Cory, Hahn, Emma, Hogeterp, Betty, Huang, Susan, Hughes, Michelle, Jardine, Meg J, Kalatharan, Shasikara, Kilburn, Shane, Lacson, Eduardo, Leonard, Sean, Liberty, Channing, Lindsay, Craig, MacRae, Jennifer M, Manns, Braden J, McCallum, Janice, McIntyre, Christopher W, Molnar, Amber O, Mustafa, Reem A, Nesrallah, Gihad E, Oliver, Matthew J, Pandes, Michael, Pandeya, Sanjay, Parmar, Malvinder S, Rabin, Elijah Z, Riley, Johnathan, Silver, Samuel A, Sontrop, Jessica M, Sood, Manish M, Suri, Rita S, Tangri, Navdeep, Tascona, Daniel J, Thomas, Alison, Wald, Ron, Walsh, Michael, Weijer, Charles, Weir, Matthew A, Vorster, Hans, Zimmerman, Deborah, and Garg, Amit X

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Trials and Supportive Activities, Clinical Research, Comparative Effectiveness Research, Assistive Technology, Kidney Disease, Bioengineering, Good Health and Well Being, chronic kidney disease, cluster randomized, hemodialysis, patient-oriented research, pragmatic, randomized controlled trial, registry-based, workshop, Clinical sciences
Abstract

Hemodialysis is a life-sustaining treatment for persons with kidney failure. However, those on hemodialysis still face a poor quality of life and a short life expectancy. High-quality research evidence from large randomized controlled trials is needed to identify interventions that improve the experiences, outcomes, and health care of persons receiving hemodialysis. With the support of the Canadian Institutes of Health Research and its Strategy for Patient-Oriented Research, the Innovative Clinical Trials in Hemodialysis Centers initiative brought together Canadian and international kidney researchers, patients, health care providers, and health administrators to participate in a workshop held in Toronto, Canada, on June 2 and 3, 2018. The workshop served to increase knowledge and awareness about the conduct of innovative, pragmatic, cluster-randomized registry trials embedded into routine hemodialysis care and provided an opportunity to discuss and build support for new trial ideas. The workshop content included structured presentations, facilitated group discussions, and expert panel feedback. Partnerships and promising trial ideas borne out of the workshop will continue to be developed to support the implementation of future large-scale trials.

Published
2019

16. Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care

Author

Bennett, Paul N., Kohzuki, Masahiro, Bohm, Clara, Roshanravan, Baback, Bakker, Stephan J.L., Viana, João L., MacRae, Jennifer M., Wilkinson, Thomas J., Wilund, Kenneth R., Van Craenenbroeck, Amaryllis H., Sakkas, Giorgos K., Mustata, Stefan, Fowler, Kevin, McDonald, Jamie, Aleamañy, Geovana Martin, Anding, Kirsten, Avin, Keith G., Escobar, Gabriela Leal, Gabrys, Iwona, Goth, Jill, Isnard, Myriam, Jhamb, Manisha, Kim, Jun Chul, Li, John Wing, Lightfoot, Courtney J., McAdams-DeMarco, Mara, Manfredini, Fabio, Meade, Anthony, Molsted, Stig, Parker, Kristen, Seguri-Orti, Eva, Smith, Alice C., Verdin, Nancy, Zheng, Jing, Zimmerman, Deb, and Thompson, Stephanie

Published
2022
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27. Effect of Intradialytic Exercise on Cardiovascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis

Author

Verrelli, Davide, primary, Sharma, Ajaya, additional, Alexiuk, Jamie, additional, Tays, Quinn, additional, Rossum, Krista, additional, Sharma, Monica, additional, Ford, Emilie, additional, Iansavichene, Alla, additional, Al-Jaishi, Ahmed A., additional, Whitlock, Reid, additional, McIntyre, Christopher W., additional, Garg, Amit X., additional, and Bohm, Clara, additional

Published
2024
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32. Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Mehrotra, Rajnish, primary, Davison, Sara N., additional, Farrington, Ken, additional, Flythe, Jennifer E., additional, Foo, Marjorie, additional, Madero, Magdalena, additional, Morton, Rachael L., additional, Tsukamoto, Yusuke, additional, Unruh, Mark L., additional, Cheung, Michael, additional, Jadoul, Michel, additional, Winkelmayer, Wolfgang C., additional, Brown, Edwina A., additional, Bagasha, Peace, additional, Bargman, Joanne M., additional, Bavanandan, Sunita, additional, Beckwith, Hannah, additional, Bennett, Paul N., additional, Bohm, Clara, additional, Brennan, Frank, additional, Burton, James O., additional, Cavanaugh, Kerri L., additional, Chilcot, Joseph, additional, Choi, Peter, additional, Cukor, Daniel, additional, Dember, Laura M., additional, Dong, Jie, additional, Edwards, Dawn, additional, Erickson, Kevin F., additional, Figueiredo, Ana, additional, Finkelstein, Fredric O., additional, Fukagawa, Masafumi, additional, Germain, Michael, additional, Guillano, Franklin B., additional, Hurst, Helen, additional, Iseki, Kunitoshi, additional, Jardine, Meg J., additional, Jauré, Allison, additional, Jha, Vivekanand, additional, Jhamb, Manisha, additional, Kanjanabuch, Talerngsak, additional, Lerma, Edgar, additional, Kam-Tao Li, Philip, additional, Liew, Adrian, additional, Małyszko, Jolanta, additional, Proenca de Moraes, Thyago, additional, Moranne, Olivier, additional, Nam Ng, Marques Shek, additional, Ostermann, Marlies, additional, Perl, Jeffrey, additional, Pigford, Jayne, additional, Pommer, Wolfgang, additional, Richardson, Michelle M., additional, Rivara, Matthew B., additional, Roberts, Glenda V., additional, Sarafidis, Pantelis, additional, Shroff, Rukshana, additional, Slon Roblero, Maria Fernanda, additional, Smyth, Brendan, additional, Søndergaard, Henning, additional, Van Der Veer, Sabine N., additional, Vassalotti, Joseph A., additional, Vervloet, Marc, additional, Vincent, Lloyd, additional, Walker, Rachael, additional, Warren, Madeleine, additional, Wasylynuk, Betty Ann, additional, West, Melissa, additional, and Wilkie, Caroline, additional

Published
2023
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36. Development of an algorithm to predict appendicular lean mass (ALM) from regional spine and hip DXA scans

Author

Leslie, William (Internal Medicine), Lix, Lisa (Community Health Sciences), Tangri, Navdeep, Bohm, Clara, Rossum, Krista, Leslie, William (Internal Medicine), Lix, Lisa (Community Health Sciences), Tangri, Navdeep, Bohm, Clara, and Rossum, Krista

Abstract

Background: Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Sarcopenia is common in older individuals and negatively impacts quality of life. It is associated with several adverse health outcomes, including but not limited to falls, reduced mobility, and increased mortality. All current operational definitions of sarcopenia include a measurement of muscle mass, most often Dual-energy X-ray Absorptiometry (DXA)-derived appendicular lean mass (ALM). ALM can only be derived from whole-body DXA scans. However, whole-body DXA scans are performed less commonly than hip and spine DXA scans as part of clinical care. The primary objective of our study was to develop an algorithm to predict ALM from regional spine and hip DXA scan. The exploratory objective of this study was to determine if self-reported history of falls is associated with sarcopenia, as determined using predicted ALM. Methods: We performed a retrospective cross-sectional study using a subset of patients from the Manitoba BMD clinical database who had whole-body DXA scans and hip and spine DXA scans at the same visit. We developed the algorithm using backward stepwise multiple linear regression and report the proportion of variation explained (i.e., R2), adjusted for the covariates age, sex, height, weight, spine and hip fat fraction, spine and hip tissue thickness. We internally validated the algorithm using the bootstrap method. Mean bootstrap parameter estimates were used as the final equation. We evaluated the relationship between sarcopenia, defined as low predicted-ALM/height2, and self-reported falls using logistic regression; odds ratios (OR), area under the curve (AUC) and 95% confidence intervals (CI) are reported. Results: There were 678 patients with both whole-body and hip and spine DXA scans included in our dataset. Mean age was 52.6 (standard deviation [SD] 21.0) and 77.0% identified as female. Mean ALM was 18.0 kg (SD 5.0 kg

Published
2023

37. The impact of the COVID-19 pandemic on home dialysis modality use in Canada

Author

Nickel, Nathan (Community Health Sciences), Tennankore, Karthik (Dalhousie University), Bohm, Clara, Rigatto, Claudio, Verrelli, Davide, Nickel, Nathan (Community Health Sciences), Tennankore, Karthik (Dalhousie University), Bohm, Clara, Rigatto, Claudio, and Verrelli, Davide

Abstract

Background: During the COVID-19 pandemic, nephrology societies recommended that individuals receiving facility-based hemodialysis transition to home modalities where possible. We aimed to understand if more people transitioned from facility-based hemodialysis to home dialysis modalities in Canada during the COVID-19 pandemic compared to historical trends. We also compared home dialysis failure (transition to facility-based hemodialysis) rates, reasons for failure on home dialysis, and risk factors for failure on home dialysis. Methods: Using administrative data from the Canadian Organ Replacement Registry (CORR), we performed an interrupted time-series analysis comparing monthly trends in transition to and failures on home dialysis during the pre-pandemic period (Jan. 1, 2016 – Dec. 31, 2019) to the pandemic period (Apr. 1, 2020 – Sept. 30, 2021). All individuals who spent any time on hemodialysis during the study period were included in the study cohort. Transitions and failures were each defined as moves of 30 days or greater. Logistic regression models were used to examine predictors of home dialysis failures between time periods. Results: 31,596 and 22,607 individuals were prevalent on facility-based hemodialysis during the pre-pandemic and pandemic periods, respectively. Transitions to home dialysis increased during the pandemic (trend change = 0.00006, p=0.03). Home dialysis failures within our cohort increased (trend change = 0.000357, p=0.045) but facility-based initiations did not change during the pandemic as compared to pre-pandemic. In our cohort, there were more home dialysis failures due to peritonitis (9.2% vs 7.3%; p = 0.0423) and resource-related reasons (5.8% vs 2.7%; p <0.0001), and fewer failures due to dialysis recipient/family burnout (4.3% vs 5.9%; p=0.0307) during the pandemic period. Conclusion: Transitions to home dialysis increased in response to COVID-19 related risks. Whether the increase in home dialysis failures was attributable to exc

Published
2023

38. Illness experiences and settler colonialism: an ethnography with Indigenous Peoples receiving in-centre hemodialysis in Winnipeg, Manitoba

Author

Anderson, Marcia (Community Health Sciences), McPhail, Deborah (Community Health Sciences), Lorway, Robert, Bohm, Clara, Ferreira da Silva, Priscila, Anderson, Marcia (Community Health Sciences), McPhail, Deborah (Community Health Sciences), Lorway, Robert, Bohm, Clara, and Ferreira da Silva, Priscila

Abstract

In 2015, the Truth and Reconciliation Commission (TRC) set a national agenda, calling for institutions to develop concrete plans to advance the health and socioeconomic status of Indigenous peoples in Canada. Indigenous peoples experience a variety of health disparities, including alarming rates of end-stage kidney disease, also known as kidney failure. In Canada, most people with kidney failure start in-centre (hospital-based) hemodialysis. Manitoba has the highest prevalence and incidence of kidney failure in Canada, and Indigenous people are disproportionately represented. This qualitative ethnographic study employed Indigenous methodologies, including a conversational approach with people living with end-stage kidney disease. I conducted 11 in-depth individual interviews—six with people undergoing in-centre hemodialysis, three with caregivers, and two with healthcare providers working in renal health. Drawing upon critical anti-colonial and social determinants of health frameworks, colonization is reconceptualized as a present structure rather than a past event. This perspective brings into view how institutional practices continue to produce health inequities. Specifically, this study pursued a multi-sited approach to examine the interplay between the social determinants of health and people’s personal journeys amid a sense of dislocation. I followed the trajectories of people who were displaced from their communities and forced to relocate to Winnipeg for hemodialysis. As people navigated abrupt life changes and rebuilt their lives amid crisis, I portray their experiences of grief and disconnection from kinship networks as well as their diverse conceptualizations of health and wellbeing. I also portray their experiences of discrimination and racism in hemodialysis units, emergency departments, specialized care, and while seeking health and social services, such as housing. These experiences demonstrate the urgency for mandatory cultural safety training for tho

Published
2023

41. Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis

Author

Cho, Thomas Hyunwoo, primary, Ng, Patrick C. K., additional, Lefebvre, Melissa J., additional, Desjarlais, Arlene, additional, McCann, Dennis, additional, Waldvogel, Blair, additional, Tonelli, Marcello, additional, Garg, Amit X., additional, Wilson, JoAnne, additional, Beaulieu, Monica, additional, Marin, Judith, additional, Orsulak, Cali, additional, Talson, Melanie, additional, Sharma, Monica, additional, Feldberg, Jordanne, additional, Bohm, Clara, additional, and Battistella, Marisa, additional

Published
2023
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42. Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review

Author

Cowan, Andrea C., primary, Clemens, Kristin K., additional, Sontrop, Jessica M., additional, Dixon, Stephanie N., additional, Killin, Lauren, additional, Anderson, Sierra, additional, Acedillo, Rey R., additional, Bagga, Amit, additional, Bohm, Clara, additional, Brown, Pierre Antoine, additional, Cote, Brenden, additional, Dev, Varun, additional, Harris, Claire, additional, Hiremath, Swapnil, additional, Kiaii, Mercedeh, additional, Lacson, Eduardo, additional, Molnar, Amber O., additional, Oliver, Matthew J., additional, Parmar, Malvinder S., additional, McRae, Jennifer M., additional, Nathoo, Bharat, additional, Quinn, Kathleen, additional, Shah, Nikhil, additional, Silver, Samuel A., additional, Tascona, Daniel J., additional, Thompson, Stephanie, additional, Ting, Robert H., additional, Tonelli, Marcello, additional, Vorster, Hans, additional, Wadehra, Davinder B., additional, Wald, Ron, additional, Wolf, Myles, additional, and Garg, Amit X., additional

Published
2023
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44. sj-docx-2-cjk-10.1177_20543581221150676 – Supplemental material for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis

Author

Cho, Thomas Hyunwoo, Ng, Patrick C. K., Lefebvre, Melissa J., Desjarlais, Arlene, McCann, Dennis, Waldvogel, Blair, Tonelli, Marcello, Garg, Amit X., Wilson, JoAnne, Beaulieu, Monica, Marin, Judith, Orsulak, Cali, Talson, Melanie, Sharma, Monica, Feldberg, Jordanne, Bohm, Clara, and Battistella, Marisa

Subjects
Medicine
Abstract

Supplemental material, sj-docx-2-cjk-10.1177_20543581221150676 for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis by Thomas Hyunwoo Cho, Patrick C. K. Ng, Melissa J. Lefebvre, Arlene Desjarlais, Dennis McCann, Blair Waldvogel, Marcello Tonelli, Amit X. Garg, JoAnne Wilson, Monica Beaulieu, Judith Marin, Cali Orsulak, Melanie Talson, Monica Sharma, Jordanne Feldberg, Clara Bohm and Marisa Battistella in Canadian Journal of Kidney Health and Disease

Published
2023
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45. sj-docx-1-cjk-10.1177_20543581221150676 – Supplemental material for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis

Author

Cho, Thomas Hyunwoo, Ng, Patrick C. K., Lefebvre, Melissa J., Desjarlais, Arlene, McCann, Dennis, Waldvogel, Blair, Tonelli, Marcello, Garg, Amit X., Wilson, JoAnne, Beaulieu, Monica, Marin, Judith, Orsulak, Cali, Talson, Melanie, Sharma, Monica, Feldberg, Jordanne, Bohm, Clara, and Battistella, Marisa

Subjects
Medicine
Abstract

Supplemental material, sj-docx-1-cjk-10.1177_20543581221150676 for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis by Thomas Hyunwoo Cho, Patrick C. K. Ng, Melissa J. Lefebvre, Arlene Desjarlais, Dennis McCann, Blair Waldvogel, Marcello Tonelli, Amit X. Garg, JoAnne Wilson, Monica Beaulieu, Judith Marin, Cali Orsulak, Melanie Talson, Monica Sharma, Jordanne Feldberg, Clara Bohm and Marisa Battistella in Canadian Journal of Kidney Health and Disease

Published
2023
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46. sj-docx-1-cjk-10.1177_20543581231162218 – Supplemental material for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study

Author

Whitlock, Reid H., Nour-Mohammadi, Mohammad, Curtis, Sarah, Komenda, Paul, Bohm, Clara, Collister, David, Tangri, Navdeep, and Rigatto, Claudio

Subjects
Medicine
Abstract

Supplemental material, sj-docx-1-cjk-10.1177_20543581231162218 for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study by Reid H. Whitlock, Mohammad Nour-Mohammadi, Sarah Curtis, Paul Komenda, Clara Bohm, David Collister, Navdeep Tangri and Claudio Rigatto in Canadian Journal of Kidney Health and Disease

Published
2023
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47. sj-docx-1-cjk-10.1177_20543581231154183 – Supplemental material for Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review

Author

Cowan, Andrea C., Clemens, Kristin K., Sontrop, Jessica M., Dixon, Stephanie N., Killin, Lauren, Anderson, Sierra, Acedillo, Rey R., Bagga, Amit, Bohm, Clara, Brown, Pierre Antoine, Cote, Brenden, Dev, Varun, Harris, Claire, Hiremath, Swapnil, Kiaii, Mercedeh, Lacson, Eduardo, Molnar, Amber O., Oliver, Matthew J., Parmar, Malvinder S., McRae, Jennifer M., Nathoo, Bharat, Quinn, Kathleen, Shah, Nikhil, Silver, Samuel A., Tascona, Daniel J., Thompson, Stephanie, Ting, Robert H., Tonelli, Marcello, Vorster, Hans, Wadehra, Davinder B., Wald, Ron, Wolf, Myles, and Garg, Amit X.

Subjects
Medicine
Abstract

Supplemental material, sj-docx-1-cjk-10.1177_20543581231154183 for Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review by Andrea C. Cowan, Kristin K. Clemens, Jessica M. Sontrop, Stephanie N. Dixon, Lauren Killin, Sierra Anderson, Rey R. Acedillo, Amit Bagga, Clara Bohm, Pierre Antoine Brown, Brenden Cote, Varun Dev, Claire Harris, Swapnil Hiremath, Mercedeh Kiaii, Eduardo Lacson Jr, Amber O. Molnar, Matthew J. Oliver, Malvinder S. Parmar, Jennifer M. McRae, Bharat Nathoo, Kathleen Quinn, Nikhil Shah, Samuel A. Silver, Daniel J. Tascona, Stephanie Thompson, Robert H. Ting, Marcello Tonelli, Hans Vorster, Davinder B. Wadehra, Ron Wald, Myles Wolf and Amit X. Garg in Canadian Journal of Kidney Health and Disease

Published
2023
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49. Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

Author

Bennett, Paul N., Bohm, Clara, Harasemiw, Oksana, Brown, Leanne, Gabrys, Iwona, Jegatheesan, Dev, Johnson, David W., Lambert, Kelly, Lightfoot, Courtney J., MacRae, Jennifer, Meade, Anthony, Parker, Kristen, Scholes-Robertson, Nicole, Stewart, Krista, Tarca, Brett, Verdin, Nancy, Wang, Angela Yee Moon, Warren, Madeleine, West, Mike, Zimmerman, Deborah, Li, Philip Kam Tao, Thompson, Stephanie, Bennett, Paul N., Bohm, Clara, Harasemiw, Oksana, Brown, Leanne, Gabrys, Iwona, Jegatheesan, Dev, Johnson, David W., Lambert, Kelly, Lightfoot, Courtney J., MacRae, Jennifer, Meade, Anthony, Parker, Kristen, Scholes-Robertson, Nicole, Stewart, Krista, Tarca, Brett, Verdin, Nancy, Wang, Angela Yee Moon, Warren, Madeleine, West, Mike, Zimmerman, Deborah, Li, Philip Kam Tao, and Thompson, Stephanie

Abstract

Life participation requiring physical activity and physical function is a key patient-reported outcome for people receiving peritoneal dialysis (PD). Clinician guidance is required from multidisciplinary sources regarding exercise and activity advice to address the specific needs of this group. From August 2020 through to June 2021, the Global Renal Exercise Network and the International Society for Peritoneal Dialysis reviewed the published literature and international clinical experience to develop a set of clinical practice points. A set of questions relevant to physical activity and exercise were developed from the perspective of a person receiving PD and were the basis for the practice point development. The GRADE framework was used to evaluate the quality of evidence and to guide clinical practice points. The review of the literature found sparse quality evidence, and thus the clinical practice points are generally based on the expert consensus of people receiving PD, PD exercise expert clinicians and experienced PD exercise researchers. Clinical practice points address timing of exercise and activity (post-catheter insertion, peritoneal space empty or full), the uptake of specific activities (work, sex, swimming, core exercise), potential adverse outcomes related to activity and exercise (exit site care, perspiration, cardiovascular compromise, fatigue, intra-abdominal pressure), the effect of exercise and activity on conditions of interest (mental health, obesity, frailty, low fitness) and exercise nutrition.

Published
2022

50. Metabolic acidosis is undertreated and underdiagnosed: a retrospective cohort study.

Author

Whitlock, Reid H, Ferguson, Thomas W, Komenda, Paul, Rigatto, Claudio, Collister, David, Bohm, Clara, Reaven, Nancy L, Funk, Susan E, and Tangri, Navdeep

Subjects
ACIDOSIS, ELECTRONIC health records, COHORT analysis, CHRONIC kidney failure, SODIUM bicarbonate
Abstract

Background Guidelines recommend treatment of metabolic acidosis (MA) in patients with chronic kidney disease (CKD), but the diagnosis and treatment rates in real-world settings are unknown. We investigated the frequency of MA treatment and diagnosis in patients with CKD. Methods In this retrospective cohort study, we examined administrative health data from two US databases [Optum's de-identified Integrated Claims + Clinical Electronic Health Record Database (US EMR cohort; 1 January 2007 to 30 June 2019) and Symphony Health Solutions IDV® (US claims cohort; 1 May 2016 to 30 April 2019)] and population-level databases from Manitoba, Canada (1 April 2006 to 31 March 2018). Patients who met laboratory criteria indicative of CKD and chronic MA were included: two consecutive estimated glomerular filtration results <60 mL/min/1.73 m2 and two serum bicarbonate results 12 to <22 mEq/L over 28–365 days. Outcomes included treatment of MA (defined as a prescription for oral sodium bicarbonate) and a diagnosis of MA (defined using administrative records). Outcomes were assessed over a 3-year period (1 year pre-index, 2 years post-index). Results A total of 96 184 patients were included: US EMR, 6179; Manitoba, 3223; US Claims, 86 782. Sodium bicarbonate treatment was prescribed for 17.6%, 8.7% and 15.3% of patients, and a diagnosis was found for 44.7%, 20.9% and 20.9% of patients, for the US EMR, Manitoba and US Claims cohorts, respectively. Conclusions This analysis of 96 184 patients with laboratory-confirmed MA from three independent cohorts of patients with CKD and MA highlights an important diagnosis and treatment gap for this disease-modifying complication. [ABSTRACT FROM AUTHOR]

Published
2023
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