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Golper TA, Twardowski ZJ, Warady BA, Lewy JE, Gotch FA, Firanek C, Eknoyan G. Dose and Adequacy in Peritoneal Dialysis Dose and Adequacya. Perit Dial Int 2020. [DOI: 10.1177/089686089701703s11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Thomas A. Golper
- University of Arkansas for Medical Sciences, Little Rock, Arkansas,
| | - Zbylut J. Twardowski
- University of Missouri, Harry S. Truman Veterans Administration Hospital, Dalton Research Center, Columbia, Missouri
| | - Bradley A. Warady
- University of Missouri, Kansas City School of Medicine, Kansas City, Missouri,
| | - John E. Lewy
- Tulane University School of Medicine, New Orleans
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2
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Chan C, Combes G, Davies S, Finkelstein F, Firanek C, Gomez R, Jager KJ, George VJ, Johnson DW, Lambie M, Madero M, Masakane I, McDonald S, Misra M, Mitra S, Moraes T, Nadeau-Fredette AC, Mukhopadhyay P, Perl J, Pisoni R, Robinson B, Ryu DR, Saran R, Sloand J, Sukul N, Tong A, Szeto CC, Van Biesen W. Transition Between Different Renal Replacement Modalities: Gaps in Knowledge and Care-The Integrated Research Initiative. Perit Dial Int 2019; 39:4-12. [PMID: 30692232 DOI: 10.3747/pdi.2017.00242] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/06/2018] [Indexed: 12/27/2022] Open
Abstract
Patients with end-stage kidney disease (ESKD) have different options to replace the function of their failing kidneys. The "integrated care" model considers treatment pathways rather than individual renal replacement therapy (RRT) techniques. In such a paradigm, the optimal strategy to plan and enact transitions between the different modalities is very relevant, but so far, only limited data on transitions have been published. Perspectives of patients, caregivers, and health professionals on the process of transitioning are even less well documented. Available literature suggests that poor coordination causes significant morbidity and mortality.This review briefly provides the background, development, and scope of the INTErnational Group Research Assessing Transition Effects in Dialysis (INTEGRATED) initiative. We summarize the literature on the transition between different RRT modalities. Further, we present an international research plan to quantify the epidemiology and to assess the qualitative aspects of transition between different modalities.
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Affiliation(s)
| | - Christopher Chan
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Gill Combes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Simon Davies
- Institute for Applied Clinical Sciences, Keele University, Keele, UK, and Department of Nephrology, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | | | | | | | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, The Netherlands
| | | | | | - Mark Lambie
- Institute for Applied Clinical Sciences, Keele University, Keele, UK, and Department of Nephrology, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | | | - Ikuto Masakane
- Department of Nephrology, Yabuki Hospital, Yamagata, Japan
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia, and University of Adelaide, Adelaide, Australia
| | - Madhukar Misra
- Department of Medicine, Division of Nephrology, University of Missouri, Columbia, MO, USA
| | - Sandip Mitra
- Nephrology Department, Central Manchester University Hospital NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Thyago Moraes
- Nephrology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | | | - Jeff Perl
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Ronald Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Rajiv Saran
- Division of Nephrology, Department of Medicine & Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - James Sloand
- Renal Division, Baxter Healthcare Corporation, Deerfield, IL, USA
| | - Nidhi Sukul
- Nephrology Department, University of Michigan, Ann Arbor, MI, USA
| | - Allison Tong
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Cheuk-Chun Szeto
- Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Firanek C, Penny M, Kudelka T, Sloand J. FP508TEMPORAL EVOLUTION IN THE SELECTION OF APD CYCLER-EMBEDDED REMOTE PATIENT MANAGEMENT FLAG ALERTS BY HEALTH CARE PRACTITIONERS (HCPS): LESSONS TO ACCELERATE THE RPM LEARNING CURVE? Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Catherine Firanek
- Global Medical Affairs, Baxter Healthcare Corporation, Deerfield, IL, United States
| | - Mark Penny
- Information Technology, Baxter Healthcare Limited, Norfolk, United Kingdom
| | - Timothy Kudelka
- Global Medical Affairs, Baxter Healthcare Corporation, Deerfield, IL, United States
| | - James Sloand
- Global Medical Affairs, Baxter Healthcare Corporation, Deerfield, IL, United States
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Wallace EL, Rosner MH, Alscher MD, Schmitt CP, Jain A, Tentori F, Firanek C, Rheuban KS, Florez-Arango J, Jha V, Foo M, de Blok K, Marshall MR, Sanabria M, Kudelka T, Sloand JA. Remote Patient Management for Home Dialysis Patients. Kidney Int Rep 2017; 2:1009-1017. [PMID: 29634048 PMCID: PMC5733746 DOI: 10.1016/j.ekir.2017.07.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/09/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022] Open
Abstract
Remote patient management (RPM) offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.
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Affiliation(s)
- Eric L. Wallace
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mitchell H. Rosner
- Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Mark Dominik Alscher
- Department of Internal Medicine and Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Claus Peter Schmitt
- Center for Pediatric and Adolescent Medicine, Division of Pediatric Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Arsh Jain
- Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada, Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Francesca Tentori
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Karen S. Rheuban
- Department of Center for Telehealth, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Jose Florez-Arango
- Department of Biomedical Informatics, Texas A & M University, College Station, Texas, USA
- Universidad de Pontificia Bolivariana a Escuela de Ciencias de la Salud, Medellin, Columbia
| | - Vivekanand Jha
- George Institute for Global Health, Syndey, New South Wales, Australia
| | - Marjorie Foo
- Department of Renal Medicine, Duke−National University of Singapore Graduate Medical School, Singapore
| | - Koen de Blok
- Department of Nephrology and Dialysis, Flevo Hospital, Almere, Flevoland, Netherlands
| | - Mark R. Marshall
- Baxter Healthcare (Asia) Pte Ltd, Singapore
- Counties Manukau Health, Auckland, New Zealand
| | - Mauricio Sanabria
- Baxter Healthcare Inc, Deerfield, Illinois, USA
- Renal Therapy Services, Bogota, Colombia
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Firanek C, Salas M, Drummond R, Wiebenson D, Gellens M, Sloand J. MP557DISCREPANCY BETWEEN PRESCRIBED AND ACTUAL APD PRESCRIPTION DELIVERY: IDENTIFICATION USING CYCLER REMOTE MANAGEMENT TECHNOLOGY. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx176.mp557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Firanek C, Szpara E, Polanco P, Davis I, Sloand J. Comparison of Disinfection Procedures on the Catheter Adapter-Transfer Set Junction. Perit Dial Int 2016; 36:225-7. [PMID: 27006440 DOI: 10.3747/pdi.2014.00319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Peritonitis is a significant complication of peritoneal dialysis (PD), contributing to mortality and technique failure. Suboptimal disinfection and/or a loose connection at the catheter adapter-transfer set junction are forms of touch contamination that can compromise the integrity of the sterile fluid path and lead to peritonitis. Proper use of the right disinfectants for connections at the PD catheter adapter-transfer set interface can help eliminate bacteria at surface interfaces, secure connections, and prevent bacteria from entering into the sterile fluid pathway. Three studies were conducted to assess the antibacterial effects of various disinfecting agents and procedures, and ensuing security of the catheter adapter-transfer set junction. An open-soak disinfection procedure with 10% povidone iodine improves disinfection and tightness/security of catheter adapter-transfer set connection.
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Affiliation(s)
- Catherine Firanek
- Renal Division, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA
| | - Edward Szpara
- Research and Development, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA
| | - Patricia Polanco
- Research and Development, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA
| | - Ira Davis
- Global Medical Affairs, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA
| | - James Sloand
- Global Medical Affairs, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA
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Firanek C, Main C, Rutherford P. FP586HEALTH CARE PROFESSIONALS’ AND PATIENTS’ PERCEPTIONS OF AN APD CYCLER DEVELOPMENT WITH REMOTE MONITORING: AN OPPORTUNITY TO IMPROVE STANDARD OF CARE? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv180.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Affiliation(s)
- Catherine Firanek
- Baxter Healthcare Corporation, Renal Division, McGaw Park, Illinois, USA
| | - Steven Guest
- Baxter Healthcare Corporation, Renal Division, McGaw Park, Illinois, USA
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Mendelssohn DC, Mujais SK, Soroka SD, Brouillette J, Takano T, Barre PE, Mittal BV, Singh A, Firanek C, Story K, Finkelstein FO. A prospective evaluation of renal replacement therapy modality eligibility. Nephrol Dial Transplant 2008; 24:555-61. [DOI: 10.1093/ndt/gfn484] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Finkelstein FO, Story K, Firanek C, Mendelssohn D, Barre P, Takano T, Soroka S, Mujais S. Health-related quality of life and hemoglobin levels in chronic kidney disease patients. Clin J Am Soc Nephrol 2008; 4:33-8. [PMID: 18987300 DOI: 10.2215/cjn.00630208] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The relationship between quality of life (QofL) and anemia has been the subject of recent debates; it has been suggested that the QofL changes associated with the treatment of anemia of chronic kidney disease (CKD) or ESRD patients should not be used in making decisions to treat anemia in CKD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This study examines the relationship between Kidney Disease Quality of Life (KDQofL) questionnaire domains and hemoglobin (Hgb) levels in 1200 patients with stage 3, 4, and 5 CKD followed in seven centers. QofL measures were compared in a stepwise fashion for hemoglobin levels of <11, 11 to <12, 12 to <13, and > or =13. ANOVA was used to examine the relationship between QofL scores and Hgb level, age, CKD stage, and albumin level; a history of diabetes, congestive heart failure, or myocardial infarction; use of erythropoetic-stimulating agents (ESA); and the interaction of hemoglobin level and ESA. RESULTS The results demonstrate that with increasing Hgb levels there is a statistically significant increase in all four physical domains, the energy/vitality domain, and the physical composite score of the SF-36, and the general health score on the kidney disease component of the questionnaire. The most dramatic improvements in these various domains occurred between the <11 and the 11 to 12 group. CONCLUSIONS Higher Hgb levels are associated with improved QofL domains of the KDQofL questionnaire. These findings have implications for the care of CKD patients in terms of the initiation of and the Hgb target of ESA therapy.
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Finkelstein FO, Story K, Firanek C, Barre P, Takano T, Soroka S, Mujais S, Rodd K, Mendelssohn D. Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies. Kidney Int 2008; 74:1178-84. [PMID: 18668024 DOI: 10.1038/ki.2008.376] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The need to educate patients in order to enable them to participate in making appropriate choices for all therapeutic options in end stage renal disease would seem obvious yet there are many barriers to providing such information. We measured 'perceived knowledge' of the therapeutic options for end stage renal disease in a cohort of patients with chronic kidney disease in established treatment programs. A self administered questionnaire was given to 676 patients with stage 3-5 chronic kidney disease as part of the CRIOS study designed to identify trends in practice patterns and outcomes over a 4 year period. The median patient age was 66, about three-fourths were Caucasian and almost half were diabetic. When patients were asked to rate their level of knowledge, about one-third reported limited or no understanding of their chronic kidney disease and no awareness regarding their treatment options. A significant and substantial number of patients indicated they had no familiarity with transplant, hemodialysis, and continuous ambulatory or automated peritoneal dialysis. Perceived knowledge improved with the progression of kidney disease and frequency of nephrology visits; however, only about half of patients with 4 or more nephrology appointments in the prior year reported knowing of hemodialysis, continuous ambulatory peritoneal dialysis or transplant. Age, gender and disease had no impact on levels of patient knowledge, but African-Americans reported having significantly less understanding than Asians or Caucasians. These findings suggest that the lack of perception concerning the treatment options chronic kidney and end stage renal disease reflects, in part, problems with the education of patients by nephrologists and not a lack of referral of these patients to nephrologists for care. The discrepancy of perceived knowledge between African-Americans and other races needs special attention.
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Abstract
In this report, the outcome, diagnosis, management, and complications of pregnancy in dialysis patients are discussed. The advantages and disadvantages to the use of peritoneal dialysis and hemodialysis and the changes in dialysis regimen used in pregnant women are addressed. Maternal complications, particularly hypertension and anemia, are reviewed. This report looks at the approach to the management of anemia and calcium/phosphorus metabolism in the setting of limited information. The report also discusses pregnancy outcome for the mother and fetus, including the problem of prematurity and fetal loss. Special considerations in women with lupus and diabetes are noted. Pregnancy in dialysis patients remains a high-risk undertaking for both the patient and the infant. There are large gaps in our knowledge base regarding the effect of the abnormalities associated with renal failure on pregnancy. The survival of the infant and the safety of the mother depend on close cooperation among all the specialities involved, including nurses, doctors, nutritionists, and social workers from nephrology, perinatology, and neonatology.
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Affiliation(s)
- S Hou
- Rush Medical College; and Circle Medical Management, Chicago, IL, USA
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13
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Golper TA, Twardowski ZJ, Warady BA, Lewy JE, Gotch FA, Firanek C, Eknoyan G. Dose and adequacy. Perit Dial Int 1997; 17 Suppl 3:S40-1. [PMID: 9304658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- T A Golper
- University of Arkansas for Medical Sciences, Little Rock, USA
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