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  • 1
    Online Resource
    Online Resource
    Age- and Race-Specific Changes in End Stage Kidney Disease Incidence over Four Decades
    Ovid Technologies (Wolters Kluwer Health) ; 2024
    In:  Journal of the American Society of Nephrology
    Details
    In: Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health)
    Abstract: Substantial changes in End Stage Kidney Disease (ESKD) incidence over four decades among Black and White Americans of different ages have been incompletely explored. Methods: We analyzed United States Renal Data System data from 1980-2019 to determine ESKD incidence trends among Black and White adolescent (13-17 years), adult (18-64 years), and older adult (≥65) populations. We used the National Cancer Institute Joinpoint Regression Program to estimate Annual Percent Change in ESKD incidence and to define points in time where a statistically significant change in Annual Percent Change slope occurred for each group. Results: ESKD incidence rose after 1980 for all groups, although the trends differed (p 〈 .001). Growth in incidence slowed for most by 1993 and by 2006 the Annual Percent Change in ESKD incidence had declined for all groups except White adults, for whom rates continued to rise (p 〈 0.05). By 2019 ESKD incidence among Black and White adolescents nearly returned to 1980 levels, but no other group achieved that degree of improvement. Nonetheless, the ESKD incidence among Black Americans exceeds that of White patients in every age group. Conclusions: Distinct patterns in ESKD incidence among patients of different age, sex, and racial groups are shown. These findings could reflect changes in dialysis acceptance rates, access to preventive healthcare, incidence of diabetes mellitus, implementation of evidence-based guidelines for treatment of chronic kidney disease, or other unrecognized factors. There may be population-specific opportunities to change the growth of the US ESKD population and address current racial disparities.
    Type of Medium: Online Resource
    ISSN: 1046-6673 , 1533-3450
    URL: Article
    DOI: 10.1681/ASN.0000000000000310
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 2029124-3
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  • 2
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    Concomitant Use of Gabapentinoids with Opioids Is Associated with Increased Mortality and Morbidity among Dialysis Patients
    S. Karger AG ; 2020
    In:  American Journal of Nephrology Vol. 51, No. 6 ( 2020), p. 424-432
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 51, No. 6 ( 2020), p. 424-432
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The opioid epidemic is a public health emergency and appropriate medication prescription for pain remains challenging. Physicians have increasingly prescribed gabapentinoids for pain despite limited evidence supporting their use. We determined the prevalence of concomitant gabapentinoid and opioid prescriptions and evaluated their associations with outcomes among dialysis patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We used the United States Renal Data System to identify patients treated with dialysis with Part A, B, and D coverage for all of 2010. Patients were grouped into 4 categories of drugs exposure status in 2010: (1) no prescriptions of either an opioid or gabapentinoid, (2) ≥1 prescription of an opioid and no prescriptions of gabapentinoids, (3) no prescriptions of an opioid and ≥1 prescription of gabapenbtinoids, (4) ≥1 prescription of both an opioid and gabapentinoid. Outcomes included 2-year all-cause death, dialysis discontinuation, and hospitalizations assessed in 2011 and 2012. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The study population included 153,758 dialysis patients. Concomitant prescription of an opioid and gabapentin (15%) was more common than concomitant prescription of an opioid and pregabalin (4%). In adjusted analyses, concomitant prescription of an opioid and gabapentin compared to no prescription of either was associated with increased risk of death (hazard ratio [HR] 1.16, 95% CI 1.12–1.19), dialysis discontinuation (HR 1.14, 95% CI 1.03–1.27), and hospitalization (HR 1.33, 95% CI 1.31–1.36). Concomitant prescription of an opioid and pregabalin compared to no prescription of either was associated with increased mortality (HR 1.22, 95% CI 1.16–1.28) and hospitalization (HR 1.37, 95% CI 1.33–1.41), but not dialysis discontinuation (HR 1.13, 95% CI 0.95–1.35). Prescription of opioids and gabepentinoids compared to only being prescribed opioids was associated with higher risk of hospitalizations, but not mortality, or dialysis discontinuation. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Concomitant prescription of opioids and gabapentinoids among US dialysis patients is common, and both drugs have independent effects on outcomes. Future research should prospectively investigate the potential harms of such drugs and identify safer alternatives for treatment of pain in end-stage renal disease patients.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000507725
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1468523-1
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  • 3
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    Racial/Ethnic Disparities in Atrial Fibrillation Treatment and Outcomes among Dialysis Patients in the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of the American Society of Nephrology Vol. 31, No. 3 ( 2020-3), p. 637-649
    Details
    In: Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 3 ( 2020-3), p. 637-649
    Abstract: Reduced likelihood of anticoagulant use among patients on hemodialysis with ESKD and atrial fibrillation may contribute to higher stroke rates, especially among racial/ethnic minority patients. In a retrospective cohort study, the authors identified patients with ESKD who initiated hemodialysis, determined which patients subsequently developed atrial fibrillation, and followed them for 1 year for all-cause stroke and other outcomes. Compared with white patients, racial/ethnic minority patients were more likely to experience stroke but less likely to fill a warfarin prescription. Additional analysis suggested that achieving warfarin distribution equal to that for white patients would prevent 7%, 10%, and 12% of excess strokes among black, Hispanic, and Asian patients, respectively. Identifying and addressing barriers to maximizing appropriate anticoagulation treatment may help reduce disparities in stroke among patients on hemodialysis with atrial fibrillation. Background Because stroke prevention is a major goal in the management of ESKD hemodialysis patients with atrial fibrillation, investigating racial/ethnic disparities in stroke among such patients is important to those who could benefit from strategies to maximize preventive measures. Methods We used the United States Renal Data System to identify ESKD patients who initiated hemodialysis from 2006 to 2013 and then identified those with a subsequent atrial fibrillation diagnosis and Medicare Part A/B/D. Patients were followed for 1 year for all-cause stroke, mortality, prescription medications, and cardiovascular disease procedures. The survival mediational g-formula quantified the percentage of excess strokes attributable to lower use of atrial fibrillation treatments by race/ethnicity. Results The study included 56,587 ESKD hemodialysis patients with atrial fibrillation. Black, white, Hispanic, and Asian patients accounted for 19%, 69%, 8%, and 3% of the population, respectively. Compared with white patients, black, Hispanic, or Asian patients were more likely to experience stroke (13%, 15%, and 16%, respectively) but less likely to fill a warfarin prescription (10%, 17%, and 28%, respectively). Warfarin prescription was associated with decreased stroke rates. Analyses suggested that equalizing the warfarin distribution to that in the white population would prevent 7%, 10%, and 12% of excess strokes among black, Hispanic, and Asian patients, respectively. We found no racial/ethnic disparities in all-cause mortality or use of cardiovascular disease procedures. Conclusions Racial/ethnic disparities in all-cause stroke among hemodialysis patients with atrial fibrillation are partially mediated by lower use of anticoagulants among black, Hispanic, and Asian patients. The reasons for these disparities are unknown, but strategies to maximize stroke prevention in minority hemodialysis populations should be further investigated.
    Type of Medium: Online Resource
    ISSN: 1046-6673 , 1533-3450
    URL: Article
    DOI: 10.1681/ASN.2019050543
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2029124-3
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  • 4
    Online Resource
    Online Resource
    Transplantation Mediates Much of the Racial Disparity in Survival from Childhood-Onset Kidney Failure
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American Society of Nephrology Vol. 33, No. 7 ( 2022-07), p. 1265-1275
    Details
    In: Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 7 ( 2022-07), p. 1265-1275
    Abstract: Differences in survival between Black and White patients with childhood-onset kidney failure are recognized, but the impact of lifelong racial disparities in kidney transplantation on survival is not well characterized. In a 30-year observational cohort study of 28,337 children that extends into young adulthood, Black patients had a 45% higher risk of death, a 31% lower rate of first transplant, and a 39% lower rate of second transplant. Black patients had fewer living donor transplants than White patients. Children and young adults are likely to require more than one transplant during their lifetime, yet even after their first transplant Black patients received 11% fewer total lifetime transplants than White patients. Transplants failed earlier for Black patients after the first and second transplant. These combined disparities resulted in Black patients spending 24% less time being treated for kidney failure with a transplant than White patients. We estimate that 35% of excess deaths in Black patients with ESKD beginning in childhood would be prevented if their time with a transplant was the same as among White patients. Increasing kidney transplant rates and improving allograft survival for Black children and young adults has the potential to help close the survival gap. Background The role of kidney transplantation in differential survival in Black and White patients with childhood-onset kidney failure is unexplored. Methods We analyzed 30-year cohort data of children beginning RRT before 18 years of age between January 1980 and December 2017 ( n =28,337) in the US Renal Data System. Cox regression identified transplant factors associated with survival by race. The survival mediational g-formula estimated the excess mortality among Black patients that could be eliminated if an intervention equalized their time with a transplant to that of White patients. Results Black children comprised 24% of the cohort and their crude 30-year survival was 39% compared with 57% for White children (log rank P 〈 0.001). Black children had 45% higher risk of death (adjusted hazard ratio [aHR], 1.45; 95% confidence interval [95% CI] , 1.36 to 1.54), 31% lower incidence of first transplant (aHR, 0.69; 95% CI, 0.67 to 0.72), and 39% lower incidence of second transplant (aHR, 0.61; 95% CI, 0.57 to 0.65). Children and young adults are likely to require multiple transplants, yet even after their first transplant, Black patients had 11% fewer total transplants (adjusted incidence rate ratio [aIRR], 0.89; 95% CI, 0.86 to 0.92). In Black patients, grafts failed earlier after first and second transplants. Overall, Black patients spent 24% less of their RRT time with a transplant than did White patients (aIRR, 0.76; 95% CI, 0.74 to 0.78). Transplantation compared with dialysis strongly protected against death (aHR, 0.28; 95% CI, 0.16 to 0.48) by time-varying analysis. Mediation analyses estimated that equalizing transplant duration could prevent 35% ( P 〈 0.001) of excess deaths in Black patients. Conclusions Equalizing time with a functioning transplant for Black patients may equalize survival of childhood-onset ESKD with White patients.
    Type of Medium: Online Resource
    ISSN: 1046-6673 , 1533-3450
    URL: Article
    DOI: 10.1681/ASN.2021071020
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2029124-3
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  • 5
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    Epidemiology of Infantile Ureteropelvic Junction Obstruction in the US
    Elsevier BV ; 2024
    In:  Urology Vol. 183 ( 2024-01), p. 185-191
    Details
    In: Urology, Elsevier BV, Vol. 183 ( 2024-01), p. 185-191
    Type of Medium: Online Resource
    ISSN: 0090-4295
    URL: Article
    DOI: 10.1016/j.urology.2023.09.024
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2011025-X
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  • 6
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    GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide
    Springer Science and Business Media LLC ; 2023
    In:  Clinical Research in Cardiology Vol. 112, No. 6 ( 2023-06), p. 759-771
    Details
    In: Clinical Research in Cardiology, Springer Science and Business Media LLC, Vol. 112, No. 6 ( 2023-06), p. 759-771
    Type of Medium: Online Resource
    ISSN: 1861-0684 , 1861-0692
    URL: Article
    DOI: 10.1007/s00392-022-02079-y
    RVK:
    XA 37040
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2218331-0
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  • 7
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    Factors Associated with Persistence of Severe Asthma from Late Adolescence to Early Adulthood
    American Thoracic Society ; 2021
    In:  American Journal of Respiratory and Critical Care Medicine Vol. 204, No. 7 ( 2021-10-01), p. 776-787
    Details
    In: American Journal of Respiratory and Critical Care Medicine, American Thoracic Society, Vol. 204, No. 7 ( 2021-10-01), p. 776-787
    Type of Medium: Online Resource
    ISSN: 1073-449X , 1535-4970
    URL: Article
    DOI: 10.1164/rccm.202010-3763OC
    RVK:
    XA 21200
    Language: English
    Publisher: American Thoracic Society
    Publication Date: 2021
    detail.hit.zdb_id: 1468352-0
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  • 8
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    Personalized diagnosis in suspected myocardial infarction
    Springer Science and Business Media LLC ; 2023
    In:  Clinical Research in Cardiology Vol. 112, No. 9 ( 2023-09), p. 1288-1301
    Details
    In: Clinical Research in Cardiology, Springer Science and Business Media LLC, Vol. 112, No. 9 ( 2023-09), p. 1288-1301
    Abstract: In suspected myocardial infarction (MI), guidelines recommend using high-sensitivity cardiac troponin (hs-cTn)-based approaches. These require fixed assay-specific thresholds and timepoints, without directly integrating clinical information. Using machine-learning techniques including hs-cTn and clinical routine variables, we aimed to build a digital tool to directly estimate the individual probability of MI, allowing for numerous hs-cTn assays. Methods In 2,575 patients presenting to the emergency department with suspected MI, two ensembles of machine-learning models using single or serial concentrations of six different hs-cTn assays were derived to estimate the individual MI probability (ARTEMIS model). Discriminative performance of the models was assessed using area under the receiver operating characteristic curve (AUC) and logLoss. Model performance was validated in an external cohort with 1688 patients and tested for global generalizability in 13 international cohorts with 23,411 patients. Results Eleven routinely available variables including age, sex, cardiovascular risk factors, electrocardiography, and hs-cTn were included in the ARTEMIS models. In the validation and generalization cohorts, excellent discriminative performance was confirmed, superior to hs-cTn only. For the serial hs-cTn measurement model, AUC ranged from 0.92 to 0.98. Good calibration was observed. Using a single hs-cTn measurement, the ARTEMIS model allowed direct rule-out of MI with very high and similar safety but up to tripled efficiency compared to the guideline-recommended strategy. Conclusion We developed and validated diagnostic models to accurately estimate the individual probability of MI, which allow for variable hs-cTn use and flexible timing of resampling. Their digital application may provide rapid, safe and efficient personalized patient care. Trial Registration numbers Data of following cohorts were used for this project: BACC ( www.clinicaltrials.gov ; NCT02355457), stenoCardia ( www.clinicaltrials.gov ; NCT03227159), ADAPT-BSN ( www.australianclinicaltrials.gov.au ; ACTRN12611001069943), IMPACT ( www.australianclinicaltrials.gov.au , ACTRN12611000206921), ADAPT-RCT ( www.anzctr.org.au ; ANZCTR12610000766011), EDACS-RCT ( www.anzctr.org.au ; ANZCTR12613000745741); DROP-ACS ( https://www.umin.ac.jp , UMIN000030668); High-STEACS ( www.clinicaltrials.gov ; NCT01852123), LUND ( www.clinicaltrials.gov ; NCT05484544), RAPID-CPU ( www.clinicaltrials.gov ; NCT03111862), ROMI ( www.clinicaltrials.gov ; NCT01994577), SAMIE ( https://anzctr.org.au ; ACTRN12621000053820), SEIGE and SAFETY ( www.clinicaltrials.gov ; NCT04772157), STOP-CP ( www.clinicaltrials.gov ; NCT02984436), UTROPIA ( www.clinicaltrials.gov ; NCT02060760). Graphical Abstract
    Type of Medium: Online Resource
    ISSN: 1861-0684 , 1861-0692
    URL: Article
    DOI: 10.1007/s00392-023-02206-3
    RVK:
    XA 37040
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2218331-0
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  • 9
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    Synthesis, crystallization and Hirshfeld surface analysis of transition metal carboxylate pentapyridines
    Royal Society of Chemistry (RSC) ; 2022
    In:  CrystEngComm Vol. 24, No. 1 ( 2022), p. 57-69
    Details
    In: CrystEngComm, Royal Society of Chemistry (RSC), Vol. 24, No. 1 ( 2022), p. 57-69
    Abstract: A new compound 2,6-bis(1,1-di(pyridin-2-yl)ethyl)isonicotinic acid (Py5Me 2 COOH) was successfully synthesised and metalated with nickel, cobalt and copper to give the corresponding complexes [Co(Py5Me 2 COO − )(OH − )] 1+ (1), [Ni(Py5Me 2 COO − )(H 2 O)] 1+ (2) and [Cu 4 (Py5Me 2 COO − ) 2 (H 2 O) 4 (OH − ) 2 ] 4+ (3). The complexes were characterized through HD-MS, FT-IR and UV-vis spectroscopic methods. Crystals suitable for single X-ray diffraction were successfully grown and reveals complex 1 and 2 maintain the conventional distorted octahedral configuration. Complex 3 resulted in the formation of a square pyramidal tetra-copper di-ligand structure. Hirshfeld surfaces mapped with d norm and shape index functions were used to give further information on interaction types within the crystal. Analysis of the 2D fingerprint plots shows the dominant interactions within the crystal packing to be H⋯H and O⋯H contacts, with complex 1 forming a three-dimensional hydrogen bonded polymer. Crystal packing in complex 3 is strongly influenced by fluorine interactions; (H⋯F) and the packing structure of complex 2 is shaped by π based interactions. The orientation of these contacts reveals the structure directing effects of the carboxylate, with the weaker aromatic interactions arranging to give priority to the stronger and more directional hydrogen bonds.
    Type of Medium: Online Resource
    ISSN: 1466-8033
    URL: Article
    DOI: 10.1039/D1CE01248G
    Language: English
    Publisher: Royal Society of Chemistry (RSC)
    Publication Date: 2022
    detail.hit.zdb_id: 2025075-7
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  • 10
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    Baseline Features and Reasons for Nonparticipation in the Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) Study, a Colorectal Cancer Screening Trial
    American Medical Association (AMA) ; 2023
    In:  JAMA Network Open Vol. 6, No. 7 ( 2023-07-11), p. e2321730-
    Details
    In: JAMA Network Open, American Medical Association (AMA), Vol. 6, No. 7 ( 2023-07-11), p. e2321730-
    Abstract: The Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy. Objective To (1) describe study participant characteristics and (2) examine who declined participation because of a preference for colonoscopy or stool testing (ie, fecal occult blood test [FOBT]/FIT) and assess that preference’s association with geographic and temporal factors. Design, Setting, and Participants This cross-sectional study within CONFIRM, which completed enrollment through 46 Department of Veterans Affairs medical centers between May 22, 2012, and December 1, 2017, with follow-up planned through 2028, comprised veterans aged 50 to 75 years with an average CRC risk and due for screening. Data were analyzed between March 7 and December 5, 2022. Exposure Case report forms were used to capture enrolled participant data and reasons for declining participation among otherwise eligible individuals. Main Outcomes and Measures Descriptive statistics were used to characterize the cohort overall and by intervention. Among individuals declining participation, logistic regression was used to compare preference for FOBT/FIT or colonoscopy by recruitment region and year. Results A total of 50 126 participants were recruited (mean [SD] age, 59.1 [6.9] years; 46 618 [93.0%] male and 3508 [7.0%] female). The cohort was racially and ethnically diverse, with 748 (1.5%) identifying as Asian, 12 021 (24.0%) as Black, 415 (0.8%) as Native American or Alaska Native, 34 629 (69.1%) as White, and 1877 (3.7%) as other race, including multiracial; and 5734 (11.4%) as having Hispanic ethnicity. Of the 11 109 eligible individuals who declined participation (18.0%), 4824 (43.4%) declined due to a stated preference for a specific screening test, with FOBT/FIT being the most preferred method (2820 [58.5%]) vs colonoscopy (1958 [40.6%] ; P   & amp;lt; .001) or other screening tests (46 [1.0%] P   & amp;lt; .001). Preference for FOBT/FIT was strongest in the West (963 of 1472 [65.4%]) and modest elsewhere, ranging from 199 of 371 (53.6%) in the Northeast to 884 of 1543 (57.3%) in the Midwest ( P  = .001). Adjusting for region, the preference for FOBT/FIT increased by 19% per recruitment year (odds ratio, 1.19; 95% CI, 1.14-1.25). Conclusions and Relevance In this cross-sectional analysis of veterans choosing nonenrollment in the CONFIRM study, those who declined participation more often preferred FOBT or FIT over colonoscopy. This preference increased over time and was strongest in the western US and may provide insight into trends in CRC screening preferences.
    Type of Medium: Online Resource
    ISSN: 2574-3805
    URL: Article
    DOI: 10.1001/jamanetworkopen.2023.21730
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
    detail.hit.zdb_id: 2931249-8
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