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1. The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Published
2023
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3. Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study

Author

Mark, P.B., Carrero, J.J., Matsushita, K., Sang, Y., Ballew, S.H., Grams, M.E., Coresh, J., Surapaneni, A., Brunskill, N.J., Chalmers, J., Chan, L., Chang, A.R., Chinnadurai, R., Chodick, G., Cirillo, M., Zeeuw, D. de, Evans, M., Garg, A.X., Gutierrez, O.M., Heerspink, H.J.L., Heine, G.H., Herrington, W.G., Ishigami, J., Kronenberg, F., Lee, J.Y., Levin, A., Major, R.W., Marks, A., Nadkarni, G.N., Naimark, D.M.J., Nowak, C., Rahman, M., Sabanayagam, C., Sarnak, M., Sawhney, S., Schneider, M.P., Shalev, V., Shin, J.I., Siddiqui, M.K., Stempniewicz, N., Sumida, K., Valdivielso, J.M., Brand, J. van den, Yee-Moon Wang, A, Wheeler, D.C., Zhang, L., Visseren, F.L.J., Stengel, B., Mark, P.B., Carrero, J.J., Matsushita, K., Sang, Y., Ballew, S.H., Grams, M.E., Coresh, J., Surapaneni, A., Brunskill, N.J., Chalmers, J., Chan, L., Chang, A.R., Chinnadurai, R., Chodick, G., Cirillo, M., Zeeuw, D. de, Evans, M., Garg, A.X., Gutierrez, O.M., Heerspink, H.J.L., Heine, G.H., Herrington, W.G., Ishigami, J., Kronenberg, F., Lee, J.Y., Levin, A., Major, R.W., Marks, A., Nadkarni, G.N., Naimark, D.M.J., Nowak, C., Rahman, M., Sabanayagam, C., Sarnak, M., Sawhney, S., Schneider, M.P., Shalev, V., Shin, J.I., Siddiqui, M.K., Stempniewicz, N., Sumida, K., Valdivielso, J.M., Brand, J. van den, Yee-Moon Wang, A, Wheeler, D.C., Zhang, L., Visseren, F.L.J., and Stengel, B.

Abstract

Item does not contain fulltext, AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT). METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence. CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

Published
2023

4. Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis

Author

Grams, M.E., Coresh, J., Matsushita, K., Ballew, S.H., Sang, Y., Surapaneni, A., Pinho, N. Alencar de, Anderson, A., Appel, L.J., Ärnlöv, J., Azizi, F., Bansal, N., Bell, S., Bilo, H.J.G., Brunskill, N.J., Carrero, J.J., Chadban, S., Chalmers, J., Chen, J., Ciemins, E., Cirillo, M., Ebert, N., Evans, M., Ferreiro, Alejandro, Fu, E.L., Fukagawa, M., Green, J.A., Gutierrez, O.M., Herrington, W.G., Hwang, S.J., Inker, L.A., Iseki, K., Jafar, T., Jassal, S.K., Jha, V., Kadota, A., Katz, R., Köttgen, A., Konta, T., Kronenberg, F., Lee, B.J., Lees, J., Levin, A., Looker, H.C., Major, R., Cohen, C. Melzer, Mieno, M., Miyazaki, M., Moranne, O., Muraki, I., Naimark, D., Nitsch, D., Oh, W., Pena, M., Purnell, T.S., Sabanayagam, C., Satoh, M., Sawhney, S., Schaeffner, E., Schöttker, B., Shen, J.I., Shlipak, M.G., Sinha, S., Stengel, B., Sumida, K., Tonelli, M., Valdivielso, J.M., Zuilen, A.D. van, Visseren, F.L.J., Wang, A.Y., Wen, C.P., Wheeler, D.C., Yatsuya, H., Yamagata, K., Yang, J.W., Young, A., Zhang, Haitao, Zhang, L., Wetzels, J.F.M., Levey, A.S., Gansevoort, R.T., Grams, M.E., Coresh, J., Matsushita, K., Ballew, S.H., Sang, Y., Surapaneni, A., Pinho, N. Alencar de, Anderson, A., Appel, L.J., Ärnlöv, J., Azizi, F., Bansal, N., Bell, S., Bilo, H.J.G., Brunskill, N.J., Carrero, J.J., Chadban, S., Chalmers, J., Chen, J., Ciemins, E., Cirillo, M., Ebert, N., Evans, M., Ferreiro, Alejandro, Fu, E.L., Fukagawa, M., Green, J.A., Gutierrez, O.M., Herrington, W.G., Hwang, S.J., Inker, L.A., Iseki, K., Jafar, T., Jassal, S.K., Jha, V., Kadota, A., Katz, R., Köttgen, A., Konta, T., Kronenberg, F., Lee, B.J., Lees, J., Levin, A., Looker, H.C., Major, R., Cohen, C. Melzer, Mieno, M., Miyazaki, M., Moranne, O., Muraki, I., Naimark, D., Nitsch, D., Oh, W., Pena, M., Purnell, T.S., Sabanayagam, C., Satoh, M., Sawhney, S., Schaeffner, E., Schöttker, B., Shen, J.I., Shlipak, M.G., Sinha, S., Stengel, B., Sumida, K., Tonelli, M., Valdivielso, J.M., Zuilen, A.D. van, Visseren, F.L.J., Wang, A.Y., Wen, C.P., Wheeler, D.C., Yatsuya, H., Yamagata, K., Yang, J.W., Young, A., Zhang, Haitao, Zhang, L., Wetzels, J.F.M., Levey, A.S., and Gansevoort, R.T.

Abstract

Item does not contain fulltext, IMPORTANCE: Chronic kidney disease (low estimated glomerular filtration rate [eGFR] or albuminuria) affects approximately 14% of adults in the US. OBJECTIVE: To evaluate associations of lower eGFR based on creatinine alone, lower eGFR based on creatinine combined with cystatin C, and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes. DESIGN, SETTING, AND PARTICIPANTS: Individual-participant data meta-analysis of 27 503 140 individuals from 114 global cohorts (eGFR based on creatinine alone) and 720 736 individuals from 20 cohorts (eGFR based on creatinine and cystatin C) and 9 067 753 individuals from 114 cohorts (albuminuria) from 1980 to 2021. EXPOSURES: The Chronic Kidney Disease Epidemiology Collaboration 2021 equations for eGFR based on creatinine alone and eGFR based on creatinine and cystatin C; and albuminuria estimated as urine albumin to creatinine ratio (UACR). MAIN OUTCOMES AND MEASURES: The risk of kidney failure requiring replacement therapy, all-cause mortality, cardiovascular mortality, acute kidney injury, any hospitalization, coronary heart disease, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The analyses were performed within each cohort and summarized with random-effects meta-analyses. RESULTS: Within the population using eGFR based on creatinine alone (mean age, 54 years [SD, 17 years]; 51% were women; mean follow-up time, 4.8 years [SD, 3.3 years]), the mean eGFR was 90 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 11 mg/g (IQR, 8-16 mg/g). Within the population using eGFR based on creatinine and cystatin C (mean age, 59 years [SD, 12 years]; 53% were women; mean follow-up time, 10.8 years [SD, 4.1 years]), the mean eGFR was 88 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 9 mg/g (IQR, 6-18 mg/g). Lower eGFR (whether based on creatinine alone or based on creatinine and cystatin C) and higher UACR were each significantly associ

Published
2023

5. Cost-effectiveness of Simvastatin plus Ezetimibe for Cardiovascular Prevention in CKD: Results of the Study of Heart and Renal Protection (SHARP)

Author

Collins, R., Baigent, C., Landray, M.J., Bray, C., Chen, Y., Baxter, A., Young, A., Hill, M., Knott, C., Cass, A., Feldt-Rasmussen, B., Fellström, B., Grobbee, D.E., Grönhagen-Riska, C., Haas, M., Holdaas, H., Hooi, L.S., Jiang, L., Kasiske, B., Krairittichai, U., Levin, A., Massy, Z.A., Tesar, V., Walker, R., Wanner, C., Wheeler, D.C., Wiecek, A., Dasgupta, T., Herrington, W., Lewis, D., Mafham, M., Majoni, W., Reith, C., Emberson, J., Parish, S., Simpson, D., Strony, J., Musliner, T., Agodoa, L., Armitage, J., Chen, Z., Craig, J., de Zeeuw, D., Gaziano, J.M., Grimm, R., Krane, V., Neal, B., Ophascharoensuk, V., Pedersen, T., Sleight, P., Tobert, J., Tomson, C., Mihaylova, Borislava, Schlackow, Iryna, Herrington, William, Lozano-Kühne, Jingky, Kent, Seamus, Emberson, Jonathan, Reith, Christina, Haynes, Richard, Cass, Alan, Craig, Jonathan, Gray, Alastair, Collins, Rory, Landray, Martin J., and Baigent, Colin

Published
2016
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6. Effects of Sacubitril/Valsartan Versus Irbesartan in Patients With Chronic Kidney Disease: A Randomized Double-Blind Trial

Author

Haynes, Richard, Judge, Parminder K., Staplin, Natalie, Herrington, William G., Storey, Benjamin C., Bethel, Angelyn, Bowman, Louise, Brunskill, Nigel, Cockwell, Paul, Hill, Michael, Kalra, Philip A., McMurray, John J.V., Taal, Maarten, Wheeler, David C., Landray, Martin J., Baigent, Colin, Haynes, R., Judge, P.K., Staplin, N., Herrington, W.G., Storey, B.C., Bethel, A., Bowman, L., Brunskill, N., Cockwell, P., Hill, M., Kalra, P.A., McMurray, J.J., Taal, M., Wheeler, D.C., Landray, M.J., Baigent, C., Baigent, C., Haynes, R., Landray, M.J., Dayanandan, R., Baxter, A., Staplin, N., Bethel, A., Bowman, L., Brunskill, N., Cockwell, P., Herrington, W.G., Hill, M., Judge, P.K., Kalra, P.A., Knott, C., McMurray, J.J.V., Murphy, K., Taal, M., Wheeler, D.C., Wheatley, K., Emberson, J., Tomson, C., Roderick, P., Clark, L., Annand, J., Marks, A., Rose, H., Taal, M., Brear, T., Havill, L., McKinnell, J., Melbourne, S., Shardlow, A., Smith, J., Stone, C., Rowe, P., Connor, A., Wooding, J., Taylor, J., Bough, L., Purse, K., Wignall, S., Winter-Goodwin, B., Brunskill, N., Bailey, B., Barratt, J., Bielecka, E., McCartney, M., Hutchison, A., Asari, A., Waring, D., Sajith, R., Walton, H., Mikhail, A., Hilldrup, I., Latif, F., Shrivastava, R., Nicholas, J., Byrne, T., Sandhu, K.S., Tan, B.K., Ward, J., Whistance-Smith, D., Khwaja, A., Jackson, Y., Kawar, B., Middle, J., Sorrell, J., Byrne, C., Brand, S., McHaffie, E., Haynes, R., Crosbie, S., Judge, P.K., Lafferty, K., Ruse, S., Sharples, E., Storey, B.C., Sampson, A., Kirk, A., Lewis, R., Vinall, L., Watkins, L., Williams, F., Cockwell, P., Anderson, N., Dutton, M., Ferro, C., Fifer, L., Smith, S., Stringer, S., Bhandary, N., Alchi, B., Foxton, J., Jones, L., D’Souza, R., Harrison, D., Heddon, S., Wheeler, D.C., Caplin, B., Damian, E., Sobande, T., Davies, S., Edwards, C., Matthews, C., Plaza, M., Reddy, S., Kalra, P.A., Chiu, D., Haydock, L., Kershaw, M., Wilson, C., Vassallo, D., Methven, S., Bowles, J., Collins, E., Dawson, S., Power, A., Kardasz, S., Laven, C., Wroe, C., Eardley, K., Donaldson, D., Tonks, L., Ayub, W., Evans, G., Hewins, S., Fraser, D., Bagshawe, J., Foxwell, D., Williams, A., Border, D., Birch, S., Griffiths, L., Jones, C., McCullough, K., Molyneux, R., and Richardson, D.

Published
2018
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7. Additional file 2 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 2

Published
2023
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8. Additional file 1 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 1

Published
2023
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9. Additional file 5 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 5

Published
2023
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10. Additional file 6 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 6

Published
2023
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11. Additional file 3 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 3

Published
2023
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12. Additional file 4 of The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

Author

Walklin, C. G, Young, Hannah M.L, Asghari, E, Bhandari, S, Billany, R. E, Bishop, N, Bramham, K, Briggs, J, Burton, J. O., Campbell, J, Castle, E. M, Chilcot, J, Cooper, N, Deelchand, V, Graham-Brown, M. P.M, Hamilton, A, Jesky, M, Kalra, P. A, Koufaki, P, McCafferty, K, Nixon, A. C, Noble, H, Saynor, Z. L., Sothinathan, C, Taal, M. W, Tollitt, J, Wheeler, D.C, Wilkinson, T. J, Macdonald, J.H, and Greenwood, S. A

Abstract

Supplementary Material 4

Published
2023
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13. POS-255 EFFECT OF DAPAGLIFLOZIN ON BLOOD PRESSURE IN PATIENTS WITH CKD: A PRE-SPECIFIED ANALYSIS FROM DAPA-CKD

Author

Provenzano, M., primary, Toto, R.D., additional, Vart, P., additional, Umanath, K., additional, Luis Górriz, J., additional, Mark, P.B., additional, Mann, J.F.E., additional, Chertow, G.M., additional, McMurray, J.J.V., additional, Correa-Rotter, R., additional, Rossing, P., additional, Langkilde, A.M., additional, Stefánsson, B.V., additional, Wheeler, D.C., additional, and Lambers Heerspink, H., additional

Published
2022
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14. POS-282 ASSOCIATION BETWEEN PRIMARY CARE CODING OF CHRONIC KIDNEY DISEASE (CKD) AND SUBSEQUENT HOSPITALISATIONS AND DEATH: A COHORT ANALYSIS USING NATIONAL AUDIT DATA

Author

CLEARY, F., primary, Kim, L., additional, Wheeler, D.C., additional, Prieto-Merino, D., additional, Steenkamp, R., additional, Fluck, R., additional, Adlam, D., additional, Denaxas, S., additional, Griffith, K., additional, Loud, F., additional, Hull, S., additional, Caplin, B., additional, and Nitsch, D., additional

Published
2022
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15. POS-305 HOSPITALIZATIONS AND LENGTH OF STAY IN PATIENTS WITH CKD WITH AND WITHOUT HYPERKALEMIA: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT

Author

James, G., primary, Carrero, J.J., additional, Khezrian, M., additional, Fishbane, S., additional, Wittbrodt, E., additional, Kanda, E., additional, Chen, H., additional, Kashihara, N., additional, Järbrink, K., additional, Lam, C.S.P., additional, Pollock, C., additional, Lainscak, M., additional, Stenvinkel, P., additional, Wheeler, D.C., additional, and Pecoits-Filho, R., additional

Published
2022
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16. POS-202 DAPAGLIFLOZIN IN PATIENTS WITH CHRONIC KIDNEY DISEASE TREATED WITH MINERALOCORTICOID RECEPTOR ANTAGONISTS: PRE-SPECIFIED ANALYSIS OF THE DAPA-CKD TRIAL

Author

Provenzano, M., primary, Jongs, N., additional, Stefánsson, B.V., additional, Chertow, G.M., additional, Langkilde, A.M., additional, McMurray, J.J., additional, Correa-Rotter, R., additional, Rossing, P., additional, Sjöström, C.D., additional, Toto, R.D., additional, Wheeler, D.C., additional, and Lambers Heerspink, H., additional

Published
2022
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17. Survival on four-times-per-week compared with three times a week haemodialysis in high ultrafiltration patients : an observational study

Author

Fotheringham, J., Latimer, N., Froissart, M., Kronenberg, F., Stenvinkel, P., Floege, J., Eckardt, K.-U., and Wheeler, D.C.

Abstract

Background\ud \ud The harm caused by the long interdialytic interval in three-times-per-week haemodialysis regimens (3×WHD) may relate to fluid accumulation and associated high ultrafiltration rate (UFR). Four-times-per-week haemodialysis (4×WHD) may offer a solution, but its impact on mortality, hospitalization and vascular access complications is unknown.\ud \ud \ud \ud Methods\ud \ud From the AROii cohort of incident in-centre haemodialysis patients, 3×WHD patients with a UFR >10 mL/kg/h were identified. The hazard for the outcomes of mortality, hospitalization and vascular access complications in those who switched to 4×WHD compared with staying on 3×WHD was estimated using a marginal structural Cox proportional hazards model. Adjustment included baseline patient and treatment characteristics with inverse probability weighting used to adjust for time-varying UFR and cardiovascular comorbidities.\ud \ud \ud \ud Results\ud \ud From 10 637 European 3×WHD patients, 3842 (36%) exceeded a UFR >10 mL/kg/h. Of these, 288 (7.5%) started 4×WHD and at baseline were more comorbid. Event rates while receiving 4×WHD compared with 3×WHD were 12.6 compared with 10.8 per 100 patient years for mortality, 0.96 compared with 0.65 per year for hospitalization and 14.7 compared with 8.0 per 100 patient years for vascular access complications. Compared with 3×WHD, the unadjusted hazard ratio (HR) for mortality on 4×WHD was 1.05 [95% confidence interval (CI) 0.78–1.42]. Following adjustment for baseline demographics, time-varying treatment probability and censoring risks, this HR was 0.73 (95% CI 0.50–1.05; P = 0.095). Despite these adjustments on 4×WHD, the HR for hospitalization remained elevated and vascular access complications were similar to 3×WHD.\ud \ud \ud \ud Conclusions\ud \ud This observational study was not able to demonstrate a mortality benefit in patients switched to 4×WHD. To demonstrate the true benefits of 4×WHD requires a large, well-designed clinical trial. Our data may help in the design of such a study.

Published
2021

18. POS-328 THE BURDEN OF HYPERKALEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT

Author

JAMES, G., primary, Carrero, J.J., additional, Kumar, S., additional, Fishbane, S., additional, Wittbrodt, E., additional, Kanda, E., additional, Hedman, K., additional, Kashihara, N., additional, Kosiborod, M., additional, Lainscak, M., additional, Lam, C., additional, Pollock, C., additional, Stenvinkel, P., additional, Wheeler, D.C., additional, and Pecoits-Filho, R., additional

Published
2021
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19. POS-329 TREATMENT PATTERNS IN CHRONIC KIDNEY DISEASE PATIENTS WITH HYPERKALEMIA: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT

Author

JAMES, G., primary, Carrero, J.J., additional, Kumar, S., additional, Fishbane, S., additional, Wittbrodt, E., additional, Kanda, E., additional, Hedman, K., additional, Kashihara, N., additional, Kosiborod, M., additional, Lainscak, M., additional, Lam, C., additional, Pollock, C., additional, Stenvinkel, P., additional, Wheeler, D.C., additional, and Pecoits-Filho, R., additional

Published
2021
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20. POS-264 PATIENT PALATABILITY AND PREFERENCE STUDY OF 3 POTASSIUM BINDERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND HYPERKALAEMIA: RATIONALE AND DESIGN OF THE APPETIZE STUDY

Author

JAMES, G., primary, Søndergaard, H., additional, Hedman, K., additional, Karlsson, N., additional, Wittbrodt, E., additional, Sabir, I., additional, Kim, J., additional, Allgren, R., additional, Stjernlöf, G., additional, Någård, M., additional, Chung, H.L., additional, Morris, J., additional, and Wheeler, D.C., additional

Published
2021
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21. POS-832 DAPAGLIFLOZIN IN IgA NEPHROPATHY: FINDINGS FROM THE DAPA-CKD TRIAL

Author

Lambers Heerspink, H., primary, Toto, R.D., additional, Jongs, N., additional, Vart, P., additional, Chertow, G.M., additional, Hou, F.F., additional, McMurray, J.J.V., additional, Pecoits-Filho, R., additional, Correa-Rotter, R., additional, Rossing, P., additional, Sjöström, C.D., additional, Stefánsson, B.V., additional, Umanath, K., additional, Langkilde, A.M., additional, and Wheeler, D.C., additional

Published
2021
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22. POS-503 EVALUATING CHRONIC KIDNEY DISEASE PROGRESSION: A REPORT FROM THE DISCOVER CKD RETROSPECTIVE COHORT

Author

ABDUL SULTAN, A., primary, Heerspink, H., additional, Arnold, M., additional, Pollock, C., additional, Garcia Sanchez, J.J., additional, Carrero, J.J., additional, Pecoits-Filho, R., additional, Lam, C., additional, Kashihara, N., additional, Kanda, E., additional, Kosiborod, M., additional, Fishbane, S., additional, Lainscak, M., additional, Stenvinkel, P., additional, and Wheeler, D.C., additional

Published
2021
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23. POS-831 THE EFFECT OF DAPAGLIFLOZIN IN PATIENTS WITH eGFR <30 mL/min/1.73m2: FINDINGS FROM THE DAPA-CKD TRIAL

Author

Chertow, G.M., primary, Vart, P., additional, Jongs, N., additional, Toto, R.D., additional, Gorriz, J.L., additional, Hou, F.F., additional, McMurray, J.J.V., additional, Correa-Rotter, R., additional, Rossing, P., additional, Sjöström, C.D., additional, Stefánsson, B.V., additional, Langkilde, A.M., additional, Wheeler, D.C., additional, and Lambers Heerspink, H., additional

Published
2021
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24. POS-270 STRUCTURAL AND FUNCTIONAL CARDIOVASCULAR DISEASE IN CHILDREN AND YOUNG ADULTS WITH CKD AND ON DIALYSIS

Author

LALAYIANNIS, A., primary, Ferro, C.J., additional, Wheeler, D.C., additional, Duncan, N.D., additional, Popoola, J., additional, Askiti, V., additional, Mitsioni, A., additional, Kaur, A., additional, Sinha, M.D., additional, McGuirk, S.P., additional, Mortensen, K.H., additional, Milford, D.V., additional, and Shroff, R., additional

Published
2021
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25. Clinical Practice Guides ESC 2019 guide on diabetes, prediabetes and cardiovascular disease, in collaboration with the European Association for the Study of Diabetes (EASD)

Author

Cosentino, F., Grant, P.J., Aboyans, V., Bailey, C.J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D.E., Hansen, T.B., Huikuri, H.V., Johansson, I., Juni, P., Lettino, M., Marx, N., Mellbin, L.G., Ostgren, C.J., Rocca, B., Roffi, M., Sattar, N., Seferovic, P.M., Sousa-Uva, M., Valensi, P., Wheeler, D.C., Grp Trabajo Diabet Prediabet Enfer, and European Assoc Study Diabet EASD

Published
2020

26. KDIGO Controversies Conference on onco-nephrology: kidney disease in hematological malignancies and the burden of cancer after kidney transplantation

Author

Małyszko, J. Bamias, A. Danesh, F.R. Dębska-Ślizień, A. Gallieni, M. Gertz, M.A. Kielstein, J.T. Tesarova, P. Wong, G. Cheung, M. Wheeler, D.C. Winkelmayer, W.C. Porta, C. Abu-Alfa, A.K. Amer, H. Beutel, G. Chapman, J. Chen, X. Chudek, J. Cosmai, L. Danesi, R. De Stefano, F. Iseki, K. Jaimes, E.A. Jhaveri, K.D. Jurczyszyn, A. Kazancioğlu, R. Kitchlu, A. Kollmannsberger, C. Lahoti, A. Li, Y. Macía, M. Matsubara, T. Mitropoulos, D. Noiri, E. Perazella, M.A. Ronco, P. Rosner, M.H. Soler Romeo, M.J. Sprangers, B. Stadler, W.M. Stevens, P.E. Tesař, V. Torres da Costa e Silva, V. Vesole, D.H. Vijayan, A. Viklický, O. Workeneh, B.T. Yanagita, M. Zakharova, E. Conference Participants

Abstract

The bidirectional relationship between cancer and chronic kidney disease (CKD) is complex. Patients with cancer, particularly those with hematological malignancies such as multiple myeloma and lymphoma, are at increased risk of developing acute kidney injury and CKD. On the other hand, emerging evidence from large observational registry analyses have consistently shown that cancer risk is increased by at least 2- to 3-fold in kidney transplant recipients, and the observed increased risk occurs not only in those who have received kidney transplants but also in those on dialysis and with mild- to moderate-stage CKD. The interactions between cancer and CKD have raised major therapeutic and clinical challenges in the management of these patients. Given the magnitude of the problem and uncertainties, and current controversies within the existing evidence, Kidney Disease: Improving Global Outcomes (KDIGO) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology to identify key management issues in nephrology relevant to patients with malignancy. This report covers the discussed controversies in kidney disease in hematological malignancies, as well as cancer after kidney transplantation. An overview of future research priorities is also discussed. © 2020 Kidney Disease: Improving Global Outcomes (KDIGO)

Published
2020

27. KDIGO Controversies Conference on onco-nephrology: understanding kidney impairment and solid-organ malignancies, and managing kidney cancer

Author

Porta, C. Bamias, A. Danesh, F.R. Dębska-Ślizień, A. Gallieni, M. Gertz, M.A. Kielstein, J.T. Tesarova, P. Wong, G. Cheung, M. Wheeler, D.C. Winkelmayer, W.C. Małyszko, J. Abu-Alfa, A.K. Amer, H. Beutel, G. Chapman, J. Chen, X. Chudek, J. Cosmai, L. Danesi, R. De Stefano, F. Iseki, K. Jaimes, E.A. Jhaveri, K.D. Jurczyszyn, A. Kazancioğlu, R. Kitchlu, A. Kollmannsberger, C. Lahoti, A. Li, Y. Macía, M. Matsubara, T. Mitropoulos, D. Noiri, E. Perazella, M.A. Ronco, P. Rosner, M.H. Soler Romeo, M.J. Sprangers, B. Stadler, W.M. Stevens, P.E. ladimír Tesař Torres da Costa e Silva, V. Vesole, D.H. Vijayan, A. Viklický, O. Workeneh, B.T. Yanagita, M. Zakharova, E.

Abstract

The association between kidney disease and cancer is multifaceted and complex. Persons with chronic kidney disease (CKD) have an increased incidence of cancer, and both cancer and cancer treatments can cause impaired kidney function. Renal issues in the setting of malignancy can worsen patient outcomes and diminish the adequacy of anticancer treatments. In addition, the oncology treatment landscape is changing rapidly, and data on tolerability of novel therapies in patients with CKD are often lacking. Caring for oncology patients has become more specialized and interdisciplinary, currently requiring collaboration among specialists in nephrology, medical oncology, critical care, clinical pharmacology/pharmacy, and palliative care, in addition to surgeons and urologists. To identify key management issues in nephrology relevant to patients with malignancy, KDIGO (Kidney Disease: Improving Global Outcomes) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology in December 2018. This report covers issues related to kidney impairment and solid organ malignancies as well as management and treatment of kidney cancer. Knowledge gaps, areas of controversy, and research priorities are described. © 2020 Kidney Disease:Improving Global Outcomes (KDIGO)

Published
2020

30. SAT-156 RENAL, CARDIOVASCULAR, AND SAFETY OUTCOMES OF CANAGLIFLOZIN ACCORDING TO BASELINE ALBUMINURIA: A CREDENCE SECONDARY ANALYSIS

Author

Jardine, M., primary, Zhou, Z., additional, Heerspink, H.J.L., additional, Li, Q., additional, Agarwal, R., additional, Bakris, G., additional, Charytan, D.M., additional, Oh, R., additional, Pollock, C., additional, Wheeler, D.C., additional, Zeeuw, D.D., additional, Zhang, H., additional, Zinman, B., additional, Mahaffey, K.W., additional, and Perkovic, V., additional

Published
2020
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31. Blood pressure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference

Author

Cheung, A.K., Chang, T.I., Cushman, W.C., Furth, S.L., Ix, J.H., Pecoits-Filho, R., Perkovic, V., Sarnak, M.J., Tobe, S.W., Tomson, C.R.V., Cheung, M., Wheeler, D.C., Winkelmayer, W.C., and Mann, J.F.E.

Subjects
Cardiovascular and Metabolic Diseases
Abstract

In September 2017, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference titled Blood Pressure in Chronic Kidney Disease (CKD). The purpose of the meeting was to consider which recommendations from the 2012 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD should be reevaluated based on new evidence from clinical trials. Participants included a multidisciplinary panel of clinical and scientific experts. Discussions focused on the optimal means for measuring blood pressure (BP) as well as managing BP in CKD patients. Consistent with the 2012 Guideline, the conference did not address BP management in patients on maintenance dialysis.

Published
2019

33. Management and treatment of glomerular diseases (part 1): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Floege, J., Barbour, S.J., Cattran, D.C., Hogan, J.J., Nachman, P.H., Tang, S.C.W., Wetzels, J.F.M., Cheung, M., Wheeler, D.C., Winkelmayer, W.C., Rovin, B.H., Floege, J., Barbour, S.J., Cattran, D.C., Hogan, J.J., Nachman, P.H., Tang, S.C.W., Wetzels, J.F.M., Cheung, M., Wheeler, D.C., Winkelmayer, W.C., and Rovin, B.H.

Abstract

Contains fulltext : 202673.pdf (publisher's version ) (Open Access), The Kidney Disease: Improving Global Outcomes (KDIGO) initiative organized a Controversies Conference on glomerular diseases in November 2017. The conference focused on the 2012 KDIGO guideline with the aim of identifying new insights into nomenclature, pathogenesis, diagnostic work-up, and, in particular, therapy of glomerular diseases since the guideline's publication. It was the consensus of the group that most guideline recommendations, in particular those dealing with therapy, will need to be revisited by the guideline-updating Work Group. This report covers general management of glomerular disease, IgA nephropathy, and membranous nephropathy.

Published
2019

34. Management and treatment of glomerular diseases (part 2): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Rovin, B.H., Caster, D.J., Cattran, D.C., Gibson, K.L., Hogan, J.J., Moeller, M.J., Roccatello, D., Cheung, M., Wheeler, D.C., Wetzels, J.F.M., Winkelmayer, W.C., Floege, J., Rovin, B.H., Caster, D.J., Cattran, D.C., Gibson, K.L., Hogan, J.J., Moeller, M.J., Roccatello, D., Cheung, M., Wheeler, D.C., Wetzels, J.F.M., Winkelmayer, W.C., and Floege, J.

Abstract

Contains fulltext : 203024.pdf (publisher's version ) (Open Access), In November 2017, the Kidney Disease: Improving Global Outcomes (KDIGO) initiative brought a diverse panel of experts in glomerular diseases together to discuss the 2012 KDIGO glomerulonephritis guideline in the context of new developments and insights that had occurred over the years since its publication. During this KDIGO Controversies Conference on Glomerular Diseases, the group examined data on disease pathogenesis, biomarkers, and treatments to identify areas of consensus and areas of controversy. This report summarizes the discussions on primary podocytopathies, lupus nephritis, anti-neutrophil cytoplasmic antibody-associated nephritis, complement-mediated kidney diseases, and monoclonal gammopathies of renal significance.

Published
2019

36. Cost-effectiveness of lipid lowering with statins and ezetimibe in chronic kidney disease

Author

Schlackow, Iryna, primary, Kent, Seamus, additional, Herrington, William, additional, Emberson, Jonathan, additional, Haynes, Richard, additional, Reith, Christina, additional, Collins, Rory, additional, Landray, Martin J., additional, Gray, Alastair, additional, Baigent, Colin, additional, Mihaylova, Borislava, additional, Collins, R., additional, Baigent, C., additional, Landray, M.J., additional, Bray, C., additional, Chen, Y., additional, Baxter, A., additional, Young, A., additional, Hill, M., additional, Knott, C., additional, Cass, A., additional, Feldt-Rasmussen, B., additional, Fellström, B., additional, Grobbee, D.E., additional, Grönhagen-Riska, C., additional, Haas, M., additional, Holdaas, H., additional, Hooi, L.S., additional, Jiang, L., additional, Kasiske, B., additional, Krairittichai, U., additional, Levin, A., additional, Massy, Z.A., additional, Tesar, V., additional, Walker, R., additional, Wanner, C., additional, Wheeler, D.C., additional, Wiecek, A., additional, Dasgupta, T., additional, Herrington, W., additional, Lewis, D., additional, Mafham, M., additional, Majoni, W., additional, Reith, C., additional, Emberson, J., additional, Parish, S., additional, Simpson, D., additional, Strony, J., additional, Musliner, T., additional, Agodoa, L., additional, Armitage, J., additional, Chen, Z., additional, Craig, J., additional, de Zeeuw, D., additional, Gaziano, J.M., additional, Grimm, R., additional, Krane, V., additional, Neal, B., additional, Ophascharoensuk, V., additional, Pedersen, T., additional, Sleight, P., additional, Tobert, J., additional, and Tomson, C., additional

Published
2019
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37. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis

Author

Kovesdy, C.P., Matsushita, K., Sang, Y., Brunskill, N.J., Carrero, J.J., Chodick, G., Hasegawa, T., Heerspink, H.L., Hirayama, A., Landman, G.W., Levin, A., Nitsch, D., Wheeler, D.C., Coresh, J., Hallan, S.I., Wetzels, J.F.M., Shalev, V., Grams, M.E., Kovesdy, C.P., Matsushita, K., Sang, Y., Brunskill, N.J., Carrero, J.J., Chodick, G., Hasegawa, T., Heerspink, H.L., Hirayama, A., Landman, G.W., Levin, A., Nitsch, D., Wheeler, D.C., Coresh, J., Hallan, S.I., Wetzels, J.F.M., Shalev, V., and Grams, M.E.

Abstract

Item does not contain fulltext, Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 +/- 16 years, average eGFR was 83 +/- 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 +/- 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts. Conclusions: Outpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria.

Published
2018

38. Scope and Consistency of Outcomes Reported in Randomized Trials Conducted in Adults Receiving Hemodialysis: A Systematic Review.

Author

Ju A., Kerr P.G., McDonald S.P., Craig J.C., Sautenet B., Tong A., Williams G., Hemmelgarn B.R., Manns B., Wheeler D.C., Tugwell P., van Biesen W., Winkelmayer W.C., Crowe S., Harris T., Evangelidis N., Hawley C.M., Pollock C., Johnson D.W., Polkinghorne K.R., Howard K., Gallagher M.P., Ju A., Kerr P.G., McDonald S.P., Craig J.C., Sautenet B., Tong A., Williams G., Hemmelgarn B.R., Manns B., Wheeler D.C., Tugwell P., van Biesen W., Winkelmayer W.C., Crowe S., Harris T., Evangelidis N., Hawley C.M., Pollock C., Johnson D.W., Polkinghorne K.R., Howard K., and Gallagher M.P.

Abstract

Background: Clinical trials are most informative for evidence-based decision making when they consistently measure and report outcomes of relevance to stakeholders. We aimed to assess the scope and consistency of outcomes reported in trials for hemodialysis. Study Design: Systematic review. Setting & Population: Adults requiring maintenance hemodialysis enrolled in clinical trials. Selection Criteria: All Cochrane systematic reviews of interventions published by August 29, 2016, and the trials published and registered in ClinicalTrials.gov since January 2011. Intervention(s): Any hemodialysis-related interventions. Outcome(s): Frequency and characteristics of the reported outcome domains and measures. Result(s): From the 362 trials, we extracted and classified 10,713 outcome measures (a median of 21 [IQR, 10-39] per trial) into 81 different outcome domains, of which 42 (52%) were surrogate; 25 (31%), clinical; and 14 (17%), patient reported. The number of outcome measures reported significantly changed over time. The 5 most commonly reported domains were all surrogates: phosphate (125 [35%] trials), dialysis adequacy (120 [33%]), anemia (115 [32%]), inflammatory markers (114 [31%]), and calcium (109 [30%]). Mortality, cardiovascular diseases, and quality of life were reported very infrequently (73 [20%], 44 [12%], and 32 [9%], respectively). Limitation(s): For feasibility, we included a sampling frame that included only trials identified in Cochrane systematic reviews or ClinicalTrials.gov. Conclusion(s): Outcomes reported in clinical trials involving adults receiving hemodialysis are focused on surrogate outcomes, rather than clinical and patient-centered outcomes. There is also extreme multiplicity and heterogeneity at every level: domain, measure, metric, and time point. Estimates of the comparative effectiveness of available interventions are unreliable and improvements over time have been inconsistent.Copyright © 2018 National Kidney Foundation, Inc.

Published
2018

39. Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease

Author

Verberne, W.R. (Wouter R.), Das-Gupta, Z. (Zofia), Allegretti, A.S. (Andrew S.), Bart, H.A.J. (Hans A.J.), Biesen, W. (Wim) van, García-García, G. (Guillermo), Gibbons, E. (Elizabeth), Parra, E. (Eduardo), Hemmelder, M.H. (Marc), Jager, K.J. (Kitty), Ketteler, M. (Markus), Roberts, C. (Charlotte), Al Rohani, M. (Muhamed), Salt, M.J. (Matthew J.), Stopper, A. (Andrea), Terkivatan, T. (Türkan), Tuttle, K.R. (Katherine R.), Yang, C.-W. (Chih-Wei), Wheeler, D.C. (David C.), Bos, W.J.W. (Willem Jan), Verberne, W.R. (Wouter R.), Das-Gupta, Z. (Zofia), Allegretti, A.S. (Andrew S.), Bart, H.A.J. (Hans A.J.), Biesen, W. (Wim) van, García-García, G. (Guillermo), Gibbons, E. (Elizabeth), Parra, E. (Eduardo), Hemmelder, M.H. (Marc), Jager, K.J. (Kitty), Ketteler, M. (Markus), Roberts, C. (Charlotte), Al Rohani, M. (Muhamed), Salt, M.J. (Matthew J.), Stopper, A. (Andrea), Terkivatan, T. (Türkan), Tuttle, K.R. (Katherine R.), Yang, C.-W. (Chih-Wei), Wheeler, D.C. (David C.), and Bos, W.J.W. (Willem Jan)

Abstract

Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use. The considered outcomes and patient-reported outcome measures were generated from systematic literature reviews. Feedback was sought from patients and health professionals. Patients with very high-risk CKD (stages G3a/A3 and G3b/A2-G5, including dialysis, kidney transplantation, and conservative care) were selected as the target population. Using an online modified Delphi process, outcomes important to all patients were selected, such as survival and hospitalization, and to treatment-specific subgroups, such as vascular access survival and kidney allograft survival. Patient-reported outcome measures were included to capture domains of health-related quality of life, which were rated as the most important outcomes by patients. Demographic and clinical variables were identified to be used as case-mix adjusters. Use of these consensus recommendations could enable institutions to monitor, compare, and improve the quality of their CKD care.

Published
2018
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40. Supplementary Material for: An Epidemiological Study of Hemodialysis Patients Based on the European Fresenius Medical Care Hemodialysis Network: Results of the ARO Study

Author

A.L.M., De Francisco, Kim, J., Anker, S.D., Belozeroff, V., Canaud, B., Chazot, C., Drüeke, T.B., Eckardt, K.-U., Floege, J., Kronenberg, F., Macdougall, I.C., Marcelli, D., Molemans, B., Passlick-Deetjen, J., Schernthaner, G., Stenvinkel, P., Wheeler, D.C., Fouqueray, B., and Aljama, P.

Abstract

Background/Aims: ARO, an observational study of hemodialysis (HD) patients in Europe, aims to enhance our understanding of patient characteristics and practice patterns to improve patient outcome. Methods: HD patients (n = 8,963) from 134 Fresenius Medical Care facilities treated between 2005 and 2006 were randomly selected from 9 European countries (Czech Republic, France, Hungary, Italy, Poland, Portugal, Spain, Slovak Republic and Slovenia) and Turkey. Information was captured on demographics, comorbidities, medications, laboratory and dialysis parameters, and outcome. Results: Patients were followed for 1.4 ± 0.7 years. Wide variation by country was observed for age, sex and diabetes as a cause of chronic kidney disease. Cardiovascular disease was present in 73% of patients. Dialysis parameters were homogeneous across countries. Arteriovenous fistulas were frequently used (73%). More incident patients had hemoglobin Conclusion: ARO revealed differences in HD practice patterns and patient characteristics in the 10 participating countries. Future ARO studies will fill gaps in the knowledge about the care of European HD patients.

Published
2017
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41. Supplementary Material for: Acute Stroke Thrombolysis in End-Stage Renal Disease: A National Survey of Nephrologist Opinion

Author

Power, A., Fogarty, D., and Wheeler, D.C.

Abstract

Background/Aims: Systemic thrombolysis for acute ischaemic stroke is the standard of care in the UK. In the absence of trial data on the safety and efficacy of this treatment in patients with end-stage renal disease, we captured the views of UK nephrologists to highlight health care policy and research objectives. Methods: Consultant nephrologists participated in an internet-based questionnaire. Respondents were asked about their involvement in thrombolysis decisions, safety concerns in dialysis patients, views on stroke rehabilitation and opinions on antiplatelet and warfarin use for stroke prevention. Results: 122/433 (28%) clinicians responded. 75% wanted involvement in thrombolysis decisions although just 10% gave input in practice. 64% expressed a high degree of concern (≥7/10) regarding intracranial bleeding risk in haemodialysis (HD). Overall risks of intra- and extracranial bleeding were rated lower in peritoneal dialysis (PD; p < 0.001). 85% felt the HD schedule impacted negatively on rehabilitation, whereas 63% felt this was the case in the context of PD (p = 0.001). More clinicians favoured warfarin for stroke prevention in PD patients with atrial fibrillation in comparison with HD patients (79 vs. 66%, p = 0.04). Conclusion: The majority of nephrologists want involvement in thrombolysis decisions relevant to their patients. Concerns about bleeding risks with thrombolysis are high and we identify a vital need to improve access to stroke rehabilitation in the UK, especially in HD patients.

Published
2017
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42. Impact of CKD on Household Income

Author

Morton, Rachael L., primary, Schlackow, Iryna, additional, Gray, Alastair, additional, Emberson, Jonathan, additional, Herrington, William, additional, Staplin, Natalie, additional, Reith, Christina, additional, Howard, Kirsten, additional, Landray, Martin J., additional, Cass, Alan, additional, Baigent, Colin, additional, Mihaylova, Borislava, additional, Collins, R., additional, Baigent, C., additional, Landray, M.J., additional, Bray, C., additional, Chen, Y., additional, Baxter, A., additional, Young, A., additional, Hill, M., additional, Knott, C., additional, Cass, A., additional, Feldt-Rasmussen, B., additional, Fellström, B., additional, Grobbee, D.E., additional, Grönhagen-Riska, C., additional, Haas, M., additional, Holdaas, H., additional, Hooi, L.S., additional, Jiang, L., additional, Kasiske, B., additional, Krairittichai, U., additional, Levin, A., additional, Massy, Z.A., additional, Tesar, V., additional, Walker, R., additional, Wanner, C., additional, Wheeler, D.C., additional, Wiecek, A., additional, Dasgupta, T., additional, Herrington, W., additional, Lewis, D., additional, Mafham, M., additional, Majoni, W., additional, Reith, C., additional, Emberson, J., additional, Parish, S., additional, Simpson, D., additional, Strony, J., additional, Musliner, T., additional, Agodoa, L., additional, Armitage, J., additional, Chen, Z., additional, Craig, J., additional, de Zeeuw, D., additional, Gaziano, J.M., additional, Grimm, R., additional, Krane, V., additional, Neal, B., additional, Ophascharoensuk, V., additional, Pedersen, T., additional, Sleight, P., additional, Tobert, J., additional, and Tomson, C., additional

Published
2018
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43. Developing a Set of Core Outcomes for Trials in Hemodialysis: An International Delphi Survey.

Author

Howell M., McDonald S.P., Howard K., Craig J.C., Polkinghorne K.R., Evangelidis N., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W.C., Sautenet B., O'Donoghue D., Tam-Tham H., Youssouf S., Mandayam S., Ju A., Kerr P.G., Hawley C., Pollock C., Harris D.C., Johnson D.W., Rifkin D.E., Tentori F., Agar J., Gallagher M., Howell M., McDonald S.P., Howard K., Craig J.C., Polkinghorne K.R., Evangelidis N., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W.C., Sautenet B., O'Donoghue D., Tam-Tham H., Youssouf S., Mandayam S., Ju A., Kerr P.G., Hawley C., Pollock C., Harris D.C., Johnson D.W., Rifkin D.E., Tentori F., Agar J., and Gallagher M.

Abstract

Background Survival and quality of life for patients on hemodialysis therapy remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. The aim of this project was to generate a consensus-based prioritized list of core outcomes for trials in hemodialysis. Study Design In a Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale in round 1 and then re-rated outcomes in rounds 2 and 3 after reviewing other respondents' scores. For each outcome, the median, mean, and proportion rating as 7 to 9 (critically important) were calculated. Setting & Participants 1,181 participants (202 [17%] patients/caregivers, 979 health professionals) from 73 countries completed round 1, with 838 (71%) completing round 3. Outcomes & Measurements Outcomes included in the potential core outcome set met the following criteria for both patients/caregivers and health professionals: median score >= 8, mean score >= 7.5, proportion rating the outcome as critically important >= 75%, and median score in the forced ranking question < 10. Results Patients/caregivers rated 4 outcomes higher than health professionals: ability to travel, dialysis-free time, dialysis adequacy, and washed out after dialysis (mean differences of 0.9, 0.5, 0.3, and 0.2, respectively). Health professionals gave a higher rating for mortality, hospitalization, decrease in blood pressure, vascular access complications, depression, cardiovascular disease, target weight, infection, and potassium (mean differences of 1.0, 1.0, 1.0, 0.9, 0.9, 0.8, 0.7, 0.4, and 0.4, respectively). Limitations The Delphi survey was conducted online in English and excludes participants without access to a computer and internet connection. Conclusions Patients/caregivers gave higher priority to lifestyle-related outcomes than health professionals. The prioritized outcomes for both groups were vascular access problems, dialysis

Published
2017

44. Combining Decision Rules from Classification Tree Models and Expert Assessment to Estimate Occupational Exposure to Diesel Exhaust for a Case-Control Study

Author

Friesen, M.C., Wheeler, D.C., Vermeulen, R., Locke, S.J., Zaebst, D.D., Koutros, S., Pronk, A., Colt, J.S., Baris, D., Karagas, M.R., Malats, N., Schwenn, M., Johnson, A., Armenti, K.R., Rothman, N., Stewart, P.A., Kogevinas, M., and Silverman, D.T.

Subjects
Exposure assessment methodology, RAPID - Risk Analysis for Products in Development, Biomedical Innovation, Case-control, Occupational exposure, Statistical learning, Life, ELSS - Earth, Life and Social Sciences, Biology, Biomedical engineering, Diesel exhausts, Healthy Living, Industrial hygiene, Probability
Abstract

Objectives: To efficiently and reproducibly assess occupational diesel exhaust exposure in a Spanish case-control study, we examined the utility of applying decision rules that had been extracted from expert estimates and questionnaire response patterns using classification tree (CT) models from a similar US study. Methods: First, previously extracted CT decision rules were used to obtain initial ordinal (0-3) estimates of the probability, intensity, and frequency of occupational exposure to diesel exhaust for the 10 182 jobs reported in a Spanish case-control study of bladder cancer. Second, two experts reviewed the CT estimates for 350 jobs randomly selected from strata based on each CT rule's agreement with the expert ratings in the original study [agreement rate, from 0 (no agreement) to 1 (perfect agreement)]. Their agreement with each other and with the CT estimates was calculated using weighted kappa (κw) and guided our choice of jobs for subsequent expert review. Third, an expert review comprised all jobs with lower confidence (low-to-moderate agreement rates or discordant assignments, n = 931) and a subset of jobs with a moderate to high CT probability rating and with moderately high agreement rates (n = 511). Logistic regression was used to examine the likelihood that an expert provided a different estimate than the CT estimate based on the CT rule agreement rates, the CT ordinal rating, and the availability of a module with diesel-related questions. Results: Agreement between estimates made by two experts and between estimates made by each of the experts and the CT estimates was very high for jobs with estimates that were determined by rules with high CT agreement rates (κw: 0.81-0.90). For jobs with estimates based on rules with lower agreement rates, moderate agreement was observed between the two experts (κw: 0.42-0.67) and poor-to-moderate agreement was observed between the experts and the CT estimates (κw: 0.09-0.57). In total, the expert review of 1442 jobs changed 156 probability estimates, 128 intensity estimates, and 614 frequency estimates. The expert was more likely to provide a different estimate when the CT rule agreement rate was

Published
2016

45. Using hierarchical cluster models to systematically identify groups of jobs with similar occupational questionnaire response patterns to assist rule-based expert exposure assessment in population-based studies

Author

Friesen, M.C., Shortreed, S.M., Wheeler, D.C., Burstyn, I., Vermeulen, R., Pronk, A., Colt, J.S., Baris, D., Karagas, M.R., Schwenn, M., Johnson, A., Armenti, K.R., Silverman, D.T., and Yu, K.

Subjects
Data reduction, Information dissemination, Work and Employment, RAPID - Risk Analysis for Products in Development, Case-control study, Surveys, Occupational exposure, Hierarchical clusters, Hierarchical systems, Cluster analysis, Life, Intraclass correlation coefficients, Exposure assessment, Probability estimate, ELSS - Earth, Life and Social Sciences, Workplace, Diesel exhausts, Hierarchical clustering methods, Healthy Living, Probability, Reduction
Abstract

Objectives: Rule-based expert exposure assessment based on questionnaire response patterns in population-based studies improves the transparency of the decisions. The number of unique response patterns, however, can be nearly equal to the number of jobs. An expert may reduce the number of patterns that need assessment using expert opinion, but each expert may identify different patterns of responses that identify an exposure scenario. Here, hierarchical clustering methods are proposed as a systematic data reduction step to reproducibly identify similar questionnaire response patterns prior to obtaining expert estimates. As a proof-of-concept, we used hierarchical clustering methods to identify groups of jobs (clusters) with similar responses to diesel exhaust-related questions and then evaluated whether the jobs within a cluster had similar (previously assessed) estimates of occupational diesel exhaust exposure. Methods: Using the New England Bladder Cancer Study as a case study, we applied hierarchical cluster models to the diesel-related variables extracted from the occupational history and job- and industry-specific questionnaires (modules). Cluster models were separately developed for two subsets: (i) 5395 jobs with ≥1 variable extracted from the occupational history indicating a potential diesel exposure scenario, but without a module with diesel-related questions; and (ii) 5929 jobs with both occupational history and module responses to diesel-relevant questions. For each subset, we varied the numbers of clusters extracted from the cluster tree developed for each model from 100 to 1000 groups of jobs. Using previously made estimates of the probability (ordinal), intensity (μg m-3 respirable elemental carbon), and frequency (hours per week) of occupational exposure to diesel exhaust, we examined the similarity of the exposure estimates for jobs within the same cluster in two ways. First, the clusters' homogeneity (defined as >75% with the same estimate) was examined compared to a dichotomized probability estimate (

Published
2015

46. Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Chapman, A.B., Devuyst, O., Eckardt, K.U., Gansevoort, R.T., Harris, T., Horie, S., Kasiske, B.L., Odland, D., Pei, Y., Perrone, R.D., Pirson, Y., Schrier, R.W., Torra, R., Torres, V.E., Watnick, T., Wheeler, D.C., Drenth, J.P., University of Zurich, and Torres, Vicente E

Subjects
medicine.medical_specialty, Pathology, diagnosis, PREIMPLANTATION GENETIC DIAGNOSIS, medicine.medical_treatment, Autosomal dominant polycystic kidney disease, Renal function, 610 Medicine & health, Disease, Article, End stage renal disease, 10052 Institute of Physiology, Quality of life (healthcare), LEFT-VENTRICULAR MASS, QUALITY-OF-LIFE, LIVER-DISEASE, CYST INFECTION, medicine, Polycystic kidney disease, Renal replacement therapy, patient support, Intensive care medicine, ADPKD, end-stage renal disease, polycystic kidney disease, 2727 Nephrology, business.industry, RENAL REPLACEMENT THERAPY, INDIVIDUAL PATIENT DATA, medicine.disease, LONG-ACTING SOMATOSTATIN, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, 10076 Center for Integrative Human Physiology, 570 Life sciences, biology, FOLLOW-UP, business, UNRUPTURED INTRACRANIAL ANEURYSMS, management, Kidney disease
Abstract

Item does not contain fulltext Autosomal-dominant polycystic kidney disease (ADPKD) affects up to 12 million individuals and is the fourth most common cause for renal replacement therapy worldwide. There have been many recent advances in the understanding of its molecular genetics and biology, and in the diagnosis and management of its manifestations. Yet, diagnosis, evaluation, prevention, and treatment vary widely and there are no broadly accepted practice guidelines. Barriers to translation of basic science breakthroughs to clinical care exist, with considerable heterogeneity across countries. The Kidney Disease: Improving Global Outcomes Controversies Conference on ADPKD brought together a panel of multidisciplinary clinical expertise and engaged patients to identify areas of consensus, gaps in knowledge, and research and health-care priorities related to diagnosis; monitoring of kidney disease progression; management of hypertension, renal function decline and complications; end-stage renal disease; extrarenal complications; and practical integrated patient support. These are summarized in this review.

Published
2015

47. Patient and Caregiver Priorities for Outcomes in Hemodialysis: An International Nominal Group Technique Study.

Author

Winkelmayer W.C., Tong A., van Biesen W., Johnson D.W., Evangelidis N., Howard K., Urquhart-Secord R., Craig J.C., Hemmelgarn B., Tam-Tham H., Manns B., Howell M., Polkinghorne K.R., Kerr P.G., Harris D.C., Thompson S., Schick-Makaroff K., Wheeler D.C., Winkelmayer W.C., Tong A., van Biesen W., Johnson D.W., Evangelidis N., Howard K., Urquhart-Secord R., Craig J.C., Hemmelgarn B., Tam-Tham H., Manns B., Howell M., Polkinghorne K.R., Kerr P.G., Harris D.C., Thompson S., Schick-Makaroff K., and Wheeler D.C.

Abstract

Background In the context of clinical research, investigators have historically selected the outcomes that they consider to be important, but these are often discordant with patients' priorities. Efforts to define and report patient-centered outcomes are gaining momentum, though little work has been done in nephrology. We aimed to identify patient and caregiver priorities for outcomes in hemodialysis. Study Design Nominal group technique. Setting & Participants Patients on hemodialysis therapy and their caregivers were purposively sampled from 4 dialysis units in Australia (Sydney and Melbourne) and 7 dialysis units in Canada (Calgary). Methodology Identification and ranking of outcomes. Analytical Approach Mean rank score (of 10) for top 10 outcomes and thematic analysis. Results 82 participants (58 patients, 24 caregivers) aged 24 to 87 (mean, 58.4) years in 12 nominal groups identified 68 outcomes. The 10 top-ranked outcomes were fatigue/energy (mean rank score, 4.5), survival (defined by patients as resilience and coping; 3.7), ability to travel (3.6), dialysis-free time (3.3), impact on family (3.2), ability to work (2.5), sleep (2.3), anxiety/stress (2.1), decrease in blood pressure (2.0), and lack of appetite/taste (1.9). Mortality ranked only 14th and was not regarded as the complement of survival. Caregivers ranked mortality, anxiety, and depression higher than patients, whereas patients ranked ability to work higher. Four themes underpinned their rankings: living well, ability to control outcomes, tangible and experiential relevance, and severity and intrusiveness. Limitations Only English-speaking participants were eligible. Conclusions Although trials in hemodialysis have typically focused on outcomes such as death, adverse events, and biological markers, patients tend to prioritize outcomes that are more relevant to their daily living and well-being. Researchers need to consider interventions that are likely to improve these outcomes and measure and rep

Published
2016

48. Cost-effectiveness of Simvastatin plus Ezetimibe for Cardiovascular Prevention in CKD: Results of the Study of Heart and Renal Protection (SHARP)

Author

Mihaylova, Borislava, primary, Schlackow, Iryna, additional, Herrington, William, additional, Lozano-Kühne, Jingky, additional, Kent, Seamus, additional, Emberson, Jonathan, additional, Reith, Christina, additional, Haynes, Richard, additional, Cass, Alan, additional, Craig, Jonathan, additional, Gray, Alastair, additional, Collins, Rory, additional, Landray, Martin J., additional, Baigent, Colin, additional, Collins, R., additional, Baigent, C., additional, Landray, M.J., additional, Bray, C., additional, Chen, Y., additional, Baxter, A., additional, Young, A., additional, Hill, M., additional, Knott, C., additional, Cass, A., additional, Feldt-Rasmussen, B., additional, Fellström, B., additional, Grobbee, D.E., additional, Grönhagen-Riska, C., additional, Haas, M., additional, Holdaas, H., additional, Hooi, L.S., additional, Jiang, L., additional, Kasiske, B., additional, Krairittichai, U., additional, Levin, A., additional, Massy, Z.A., additional, Tesar, V., additional, Walker, R., additional, Wanner, C., additional, Wheeler, D.C., additional, Wiecek, A., additional, Dasgupta, T., additional, Herrington, W., additional, Lewis, D., additional, Mafham, M., additional, Majoni, W., additional, Reith, C., additional, Emberson, J., additional, Parish, S., additional, Simpson, D., additional, Strony, J., additional, Musliner, T., additional, Agodoa, L., additional, Armitage, J., additional, Chen, Z., additional, Craig, J., additional, de Zeeuw, D., additional, Gaziano, J.M., additional, Grimm, R., additional, Krane, V., additional, Neal, B., additional, Ophascharoensuk, V., additional, Pedersen, T., additional, Sleight, P., additional, Tobert, J., additional, and Tomson, C., additional

Published
2016
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49. Standardised outcomes in nephrology - Haemodialysis (SONG-HD): Study protocol for establishing a core outcome set in haemodialysis.

Author

Gallagher M.P., Johnson D.W., McDonald S.P., Urquhart-Secord R., Craig J.C., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Winkelmayer W.C., van Biesen W., Crowe S., Kerr P.G., Polkinghorne K.R., Howard K., Pollock C., Hawley C.M., Gallagher M.P., Johnson D.W., McDonald S.P., Urquhart-Secord R., Craig J.C., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Winkelmayer W.C., van Biesen W., Crowe S., Kerr P.G., Polkinghorne K.R., Howard K., Pollock C., and Hawley C.M.

Abstract

Background: Chronic kidney disease is a significant contributor to mortality and morbidity worldwide, and the number of people who require dialysis or transplantation continues to increase. People on dialysis are 15 times more likely to die than the general population. Dialysis is also costly, intrusive, and time-consuming and imposes an enormous burden on patients and their families. This escalating problem has spurred a proliferation of trials in dialysis, yet health and quality of life remain poor. The reasons for this are complex and varied but are attributable in part to problems in the design and reporting of studies, particularly outcome selection. Problems related to outcomes include use of unvalidated surrogates, outcomes of little or no relevance to patients, highly variable outcome selection limiting comparability across studies, and bias in reporting outcomes. The aim of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) study is to establish a core outcome set for haemodialysis trials, to improve the quality of reporting, and the relevance of trials conducted in people on haemodialysis. Methods/design: SONG-HD is a five-phase project that includes the following: a systematic review to identify outcomes that have been reported in haemodialysis systematic reviews and trials; nominal group technique with patients and caregivers to identify, rank, and describe reasons for their choices; qualitative stakeholder interviews with patients, caregivers, clinicians, researchers, and policy makers to elicit individual values and perspectives on outcomes for haemodialysis trials; a three-round Delphi survey with stakeholder groups to distil and generate a prioritised list of core outcomes; and a consensus workshop to establish a core outcome set for haemodialysis trials. Discussion(s): Establishing a core outcome set to be consistently measured and reported in haemodialysis trials will improve the integrity, transparency, usability, and contribution of

Published
2015

50. Scope and consistency of outcomes reported in randomised trials of haemodialysis.

Author

Urquhart-Secord R., Mcdonald S.P., Gallagher M.P., Craig J.C., Williams G.J., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Winkelmayer W.C., Van Biesen W., Kerr P.G., Polkinghorne K.R., Howard K., Pollock C., Hawley C.M., Johnson D.W., Urquhart-Secord R., Mcdonald S.P., Gallagher M.P., Craig J.C., Williams G.J., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Winkelmayer W.C., Van Biesen W., Kerr P.G., Polkinghorne K.R., Howard K., Pollock C., Hawley C.M., and Johnson D.W.

Abstract

Aim: We aimed to assess the scope and consistency of outcome selection and reporting in trials included in systematic reviews of interventions for patients on haemodialysis. Background(s): Inconsistent outcome selection and reporting in clinical trials may limit their capacity to inform evidence-based decision making and the ability to combine findings in systematic reviews. Method(s): The Cochrane Database of Systematic Reviews was searched from 1999 to January 2015 for published systematic reviews of interventions for patients on chronic haemodialysis. The description and frequency of outcomes reported within the source randomised controlled trials were assessed. Result(s): The 18 systematic reviews included 282 trials that reported over 518 outcomes. There was considerable heterogeneity among the outcomes reported. Across all trials, 320 outcomes occurred only once, and 198 outcomes were identified twice. The five most common outcome domains were mortality (50 trials, 18%), blood pressure (46 trials, 16%), calcium (44 trials, 16%), parathyroid hormone (41 trials, 15%) and quality of life (39 trials [14%]). There was considerable variation in how the domains were measured, the time at which they were measured, and the units and threshold changes that defined an outcome. For example, blood pressure was reported as pre-dialysis, post-dialysis, maximum, difference in pre and post dialysis, ambulatory, resting, rise, and time to restore. Conclusion(s): A wide array of outcomes are reported in trials of interventions in haemodialysis, with large heterogeneity in timing of measurements, units of measure, and threshold changes that define an outcome. This highlights the need for a well-defined set of standardised core outcomes to improve the comparability of trial findings in meta-analysis and to provide greater confidence around treatment decisions for patients undergoing haemodialysis.

Published
2015

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