Cover Stories

Warfarin Therapy Effective and Safe in Older Adults with Reduced Kidney Function

Approximately 10% to 15% of adults worldwide are affected by chronic kidney disease (CKD), defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. In the patient population with CKD, the leading cause of death is cardiovascular disease, and the risk for stroke is four to 10 times greater than that in the general population. The incidence and prevalence of ... Read More »

Quality of Life Affected by More than Renal Function in Patients with ADPKD

Recent studies have suggested that quality of life among patients with chronic kidney disease (CKD) depends on factors such as anemia and cardiovascular disease in addition to kidney function. In autosomal dominant polycystic kidney disease (ADPKD), anemia and cardiovascular disease are less frequent than in other kidney diseases, a possible indicator that other disease-specific factors may contribute to impairment of ... Read More »

Shared Risk Factors of Preeclampsia and End-Stage Renal Disease

Approximately 8% of pregnancies are complicated by hypertension, a complication that can lead to significant maternal morbidity and mortality. Previous studies have documented some long-term effects on maternal health of hypertensive pregnancies, especially the risk for cardiovascular disease. Several large registry-based studies have also shown associations between pregnancy hypertension and the development of kidney disease, including end-stage renal disease (ESRD). ... Read More »

Using a Dynamic Model to Predict Progression of CKD to Kidney Failure

The worldwide incidence and prevalence of chronic kidney disease (CKD) is increasing; recent estimates indicate that 24 million Americans have CKD and are at risk for comorbidities and complications such as cardiovascular disease, anemia, bone mineral metabolism abnormalities, and progression to kidney failure. Patients with end-stage renal disease require treatment with dialysis or kidney transplantation. Due to the varied complications ... Read More »

Undocumented Immigrants with No Access to Scheduled Hemodialysis

It is estimated that 11.3 million undocumented immigrants live and work in the United States, representing a low-income population excluded from public benefits such as federally funded Medicaid and insurance provisions of the Affordable Care Act. Healthcare for individuals in that population is largely limited to safety-net provisions designed to protect the uninsured, including community health centers, public clinics, and ... Read More »

Risk of Chronic Kidney Disease with Use of PPIs without Intervening AKI

According to the National Health and Nutrition Examination Survey, 7.8% of adults in the United States had a prescription proton pump inhibitor (PPI) in the previous 30 days. Studies have shown an association between use of PPIs and an increase in risk for adverse health outcomes, including acute kidney injury (AKI), incident chronic kidney disease (CKD), progression of CKD, and ... Read More »

Better HRQoL with Frequent Hemodialysis versus Conventional Hemodialysis

In the effort to make healthcare and health policies more patient-centered, awareness of the ways a treatment affects patient-reported outcomes has gained importance. Among patients with end-stage renal disease (ESRD), health-related quality of life (HRQoL) is of great importance, and information regarding how choice of dialysis modality will affect their HRQoL is a high priority for patients. Worldwide, more than ... Read More »

Frailty in Dialysis Patients and Increased Hospitalization and Mortality

According to the United States Renal Data System, 44.5% of patients with end-stage renal disease (ESRD) who receive maintenance dialysis are ≥65 years of age. In addition, the prevalence of ESRD patients on dialysis is increasing rapidly among older age groups. In a nationwide ESRD patient registry in Korea, the mean age of these patients increased from 55.2 years in ... Read More »

Temporal Trends in Intensive Procedures at End of Life in Dialysis Patients

The percentage of Medicare spending for treatments for beneficiaries approaching the end of life is disproportionately high; in 2011 Medicare spent approximately $170 billion (28% of the agency’s total budget) in care for beneficiaries in their last 6 months of life. The spending reflects intensive inpatient-oriented patterns of care aimed at treating underlying disease and prolonging survival. Despite recent efforts ... Read More »

Mortality in Patients Initiating Dialysis Therapy Varies by Indications

More than 115,000 patients with chronic kidney failure initiate dialysis therapy in the United States each year. For those patients, the transition period is a vulnerable time. The annual rates of mortality from chronic kidney disease (CKD) stage 5 through the first year of maintenance dialysis therapy are more than 20%. According to Matthew B. Rivara, MD, and colleagues, clinician ... Read More »