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Lin MY, Chiu YW, Lin YH, Kang Y, Wu PH, Chen JH, Luh H, Hwang SJ. Kidney Health and Care: Current Status, Challenges, and Developments. J Pers Med 2023; 13:jpm13050702. [PMID: 37240872 DOI: 10.3390/jpm13050702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
The concept of chronic kidney disease (CKD) originated in the 2000s, and an estimated 850 million patients are currently suffering from health threats from different degrees of CKD. However, it is unclear whether the existing CKD care systems are optimal for improving patient prognosis and outcomes, so this review summarizes the burden, existing care models, effectiveness, challenges, and developments of CKD care. Even under the general care principles, there are still significant gaps in our understanding of the causes of CKD, prevention or care resources, and care burdens between countries worldwide. Receiving care from multidisciplinary teams rather than only a nephrologist shows potential profits in comprehensive and preferable outcomes. In addition, we propose a novel CKD care structure that combines modern technologies, biosensors, longitudinal data visualization, machine learning algorithms, and mobile care. The novel care structure could simultaneously change the care process, significantly reduce human contact, and make the vulnerable population less likely to be exposed to infectious diseases such as COVID-19. The information offered should be beneficial, allowing us to rethink future CKD care models and applications to reach the goals of health equality and sustainability.
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Affiliation(s)
- Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yu-Hsuan Lin
- Taiwan Instrument Research Institute, National Applied Research Laboratories, Hsinchu 300, Taiwan
| | - Yihuang Kang
- Department of Information and Management, National Sun Yat-Sen University, Kaohsiung 804, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ping-Hsun Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jeng-Huei Chen
- Department of Mathematical Sciences, National Chengchi University, Taipei 116, Taiwan
| | - Hsing Luh
- Department of Mathematical Sciences, National Chengchi University, Taipei 116, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County 350, Taiwan
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Wan TT, Matthews S, Luh H, Zeng Y, Wang Z, Yang L. A Proposed Multi-Criteria Optimization Approach to Enhance Clinical Outcomes Evaluation for Diabetes Care: A Commentary. Health Serv Res Manag Epidemiol 2022; 9:23333928221089125. [PMID: 35372638 PMCID: PMC8966128 DOI: 10.1177/23333928221089125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/30/2022] Open
Abstract
There are several challenges in diabetes care management including optimizing the currently used therapies, educating patients on selfmanagement, and improving patient lifestyle and systematic healthcare barriers. The purpose of performing a systems approach to implementation science aided by artificial intelligence techniques in diabetes care is two-fold: 1) to explicate the systems approach to formulate predictive analytics that will simultaneously consider multiple input and output variables to generate an ideal decision-making solution for an optimal outcome; and 2) to incorporate contextual and ecological variations in practicing diabetes care coupled with specific health educational interventions as exogenous variables in prediction. A similar taxonomy of modeling approaches proposed by Brennon et al (2006) is formulated to examining the determinants of diabetes care outcomes in program evaluation. The discipline-free methods used in implementation science research, applied to efficiency and quality-of-care analysis are presented. Finally, we illustrate a logically formulated predictive analytics with efficiency and quality criteria included for evaluation of behavioralchange intervention programs, with the time effect included, in diabetes care and research.
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Affiliation(s)
- Thomas T.H. Wan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan and University of Central Florida, Orlando, FL, USA
| | - Sarah Matthews
- Health Communication Consultants, Inc., Orlando, FL, USA
| | - Hsing Luh
- College of Sciences, National Chengchi University, Taipei, Taiwan
| | - Yong Zeng
- Institute for Information Systems Engineering, Concordia University, Montreal, Canada
| | - Zhibo Wang
- College of Engineering and Computer Science, University of Central Florida, Orlando, Florida, USA
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, University of Calgary, Alberta, Canada
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Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) are 1 of the major factors in young adults needing renal replacement therapy, but there is little extensive assessment of their incidence and risk factors. This study aimed to evaluate trends in the incidence of and risk factors for CAKUT among all births in Taiwan.This population-based case-control study design was conducted using the Taiwan national births registry, which contains detailed information about maternal health and characteristics of newborns, supplied by health professionals. Of 1,603,794 newborns registered between 2004 and 2014, 668 infants were reported to have CAKUT. Newborns without congenital anomalies were matched with CAKUT cases by birth year, month, and Apgar score in a ratio of 5:1. Odds ratio (OR) and 95% confidence interval (CI) for developing CAKUT were calculated using a conditional multivariate logistic regression model.The incidence of CAKUT was approximately 4.2 per 10,000 births. The adjusted ORs for CAKUT in newborns associated with maternal age of 20 to 29 (OR, 2.18; 95% CI, 1.11-4.28), or 30 to 39 (OR, 2.29; 95% CI, 1.17-4.51), maternal gestational diabetes (OR, 2.22, 95% CI, 1.06-4.67), maternal thalassemia/hemochromatosis (OR, 2.67; 95% CI, 1.35-5.27), polyhydramnios or oligohydramnios (OR, 9.16; 95% CI, 5.46-15.37), birth parity >1 (OR, 0.27; 95% CI, 0.15-0.50), having a gestational age <37 weeks (OR, 1.48; 95% CI, 1.23-1.78), and being a boy (OR, 1.83; 95% CI, 1.53-2.19). Infants of mother with gestational diabetes were more likely to have congenital anomalies, small gestational age (<37 weeks) and low birth weight.CAKUT are associated with several maternal health risk factors. As Taiwan has the highest prevalence and incidence rates of end-stage renal disease in the world, these findings strongly support the need to develop professional guidelines for prenatal counseling and management of women at risk of adverse birth outcomes, to prevent kidney disease progression and reduce complications.
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Affiliation(s)
- You-Lin Tain
- From the Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (Y-LT); Department of Mathematical Sciences, Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan (HL); Children's Hospital of China Medical University, Taichung, Taiwan (C-YL); Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (C-NH); and School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan (C-NH)
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Cheng LJ, Chen JH, Lin MY, Chen LC, Lao CH, Luh H, Hwang SJ. A competing risk analysis of sequential complication development in Asian type 2 diabetes mellitus patients. Sci Rep 2015; 5:15687. [PMID: 26507664 PMCID: PMC4623532 DOI: 10.1038/srep15687] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 09/23/2015] [Indexed: 01/05/2023] Open
Abstract
This retrospective cohort study investigated the progression risk of sequential complication in Asian type 2 diabetes (T2D) patients using the Taiwan Pay-for-Performance Diabetes Registry and claim data from November 2003 to February 2009. 226,310 adult T2D patients without complication were followed from diagnosis to complications, including myocardial infarction (MI), other ischemic heart disease (IHD), congestive heart failure (CHF), stroke, chronic kidney disease (CKD), retinopathy, amputation, death or to the end of study. Cumulative incidences (CIs) of first and second complications were analyzed in 30 and 4 years using the cumulative incidence competing risk method. IHD (29.8%), CKD (24.5%) and stroke (16.0%) are the most common first complications. The further development of T2D complications depends on a patient’s existing complication profiles. Patients who initially developed cardiovascular complications had a higher risk (9.2% to 24.4%) of developing IHD or CKD, respectively. All-cause mortality was the most likely consequence for patients with a prior MI (12.0%), so as stroke in patients with a prior MI (10.8%) or IHD (8.9%). Patients with CKD had higher risk of developing IHD (16.3%), stroke (8.9%) and all-cause mortality (8.7%) than end-stage renal disease (4.0%). Following an amputation, patients had a considerable risk of all-cause mortality (42.1%).
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Affiliation(s)
- Li-Jen Cheng
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jeng-Huei Chen
- Department of Mathematical Sciences, National Chengchi University, Taipei, Taiwan
| | - Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,National Applied Research Laboratories, Instrument Technology Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chia Chen
- Division for Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, UK.,Graduate Institute of Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Huan Lao
- Waikato Clinical School, The University of Auckland, Hamilton, New Zealand
| | - Hsing Luh
- Department of Mathematical Sciences, National Chengchi University, Taipei, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faulty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Population Sciences, National Health Research Institute, Miaoli, Taiwan
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Cheng HS, Hsu CM, Chen MY, Luh H. The Effect of Perchloric Acid on the Mössbauer Parameters of tin-119 in Frozen Solutions. J CHIN CHEM SOC-TAIP 2013. [DOI: 10.1002/jccs.198700027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hsu CM, Cheng HS, Luh H, Chen MY. Mössbauer Spectroscopic Studies of Bromostannate(II) Complexes in Frozen Aqueous Solutions. J CHIN CHEM SOC-TAIP 2013. [DOI: 10.1002/jccs.198400029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lu TH, Lin YJ, Luh H, Liao FL, Chung CS. A linear cyclic oximate-bridged tetracopper(II) complex. Acta Crystallogr C 2001; 57:1398-9. [PMID: 11740095 DOI: 10.1107/s0108270101016456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2001] [Accepted: 10/03/2001] [Indexed: 02/22/2023] Open
Abstract
The crystal structure of the title complex, tetrakis[mu-6-amino-3-methyl-4-azahex-3-en-2-one oximato(1-)-kappa4N,N',N":O]tetracopper(II) tetraperchlorate 0.6-hydrate, [Cu4(C6H12N3O)4](ClO4)4*0.6H2O, shows the cation to be an oximate-bridged tetramer composed of four 6-amino-3-methyl-4-azahex-3-en-2-one oxime ligands and four copper(II) ions and to have crystallographically imposed 4 symmetry. Each Cu(II) atom is four-coordinated by the three N atoms of one oxime ligand and by the O atom of another oxime ligand in a distorted square-planar geometry.
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Affiliation(s)
- T H Lu
- Department of Physics, National Tsing Hua University, Hsinchu, Taiwan 300.
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Tahirov TH, Lu TH, Luh H, Lai CY, Chung CS. [3,9-Dimethyl-4,8-diaza-3,8-undecadiene-2,10-dione dioximato(1–)](thiocyanato)copper(II) and [3,6,6,9-Tetramethyl-4,8-diaza-3,8-undecadiene-2,10-dione dioximato(1–)](isothiocyanato)copper(II). Acta Crystallogr C 1995. [DOI: 10.1107/s0108270194012898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lu TH, Tahirov TH, Luh H, Chung CS. Structures of Cu(II) complexes with deprotonated oximes. Acta Crystallogr A 1993. [DOI: 10.1107/s010876737809412x] [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: 11/11/2022] Open
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Lu TH, Tseng F, Luh H, Chung CS. Structure of a nickel(II) complex of the deprotonated anion of 3,6,6,9-tetramethyl-4,8-diaza-3,8-undecadiene-2,10-dione dioxime. Acta Crystallogr C 1993. [DOI: 10.1107/s0108270192009880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Tahirov TH, Lu TH, Luh H, Chung CS. Structure of [3,10-dimethyl-4,9-diaza-3,9-dodecadiene-2,11-dione dioximato(1–)](isothiocyanato)copper(II). Acta Crystallogr C 1993. [DOI: 10.1107/s0108270192011089] [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: 11/10/2022] Open
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Zakin JL, Wu R, Luh H, Mayhan KG. Generalized correlations for molecular weight and concentration dependence of zero-shear viscosity of high polymer solutions. ACTA ACUST UNITED AC 1976. [DOI: 10.1002/pol.1976.180140209] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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