Cover Stories

Associated Costs Lower for Endovascular AVF Creation

Arteriovenous fistula (AVF) is the preferred access type, offering longer access survival, lower risk of mortality, and reductions in rate of infection. AVF also requires fewer interventions following successful maturation and use. Recent studies have suggested that maturation and maintenance of function may require two or more additional procedures following the initial AVF creation. Additional procedures notwithstanding, a proportion of ... Read More »

Initial Dialysis Session Duration Associated with Patient Outcomes

Following expansion of Medicare coverage to patients with end-stage renal disease (ESRD) 40 years ago, the average number of hours per hemodialysis session has decreased from 6 hours in 1973 to 3.5 to 4 hours in 2010. The decline is explained in part by the improved efficiency of dialyzers; however, there are few data on the clinical consequences of shorter ... Read More »

Recovery Times in Hemodiafiltration and High-Flux Hemodialysis

Both duration and quality of life are adversely affected by the presence of end-stage renal disease (ESRD); worldwide, approximately 1.9 million people receive renal replacement therapy. Intermittent renal replacement therapy is essential for many patients with ESRD. In the developed world, extracorporeal treatments for ESRD such as hemodialysis and hemodiafiltration are more prevalent than peritoneal dialysis. While observational data have ... Read More »

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 »