On improving outcomes and quality of dialysis care, and more

Eknoyan, Garabed; Agodoa, Lawrence Y.

doi:10.1053/ajkd.2002.32720

Cited by 22 publications

(4 citation statements)

References 1 publication

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“…Building on this initial effort, the National Kidney Foundation (NKF) launched its Dialysis Outcomes Quality initiative (DOQI) in 1995. The first four sets of guidelines developed were hemodialysis adequacy, peritoneal dialysis adequacy, vascular access, and anemia that were published in the fall of 1997 [26]. The implementation of these guidelines, including the development of federal or insurer-sponsored clinical performance measures, has been instrumental in changing practice patterns and their impact on favorably affecting the quality of care delivered to dialysis patients in the United States has been documented [27].…”

Section: Closing the Gap: Guidelinesmentioning

confidence: 99%

The burden of kidney disease: Improving global outcomes

Eknoyan¹,

Lameire²,

Barsoum³

et al. 2004

Kidney International

Self Cite

430

286

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Chronic kidney disease (CKD) is a worldwide public health problem. There is an increasing incidence and prevalence of patients with kidney failure requiring replacement therapy, with poor outcomes and high cost. There is an even higher prevalence of patients in earlier stages of CKD, with adverse outcomes such as kidney failure, cardiovascular disease, and premature death. Patients at earlier stages of CKD can be detected through laboratory testing and their treatment is effective in slowing the progression to kidney failure and reducing cardiovascular events. The science and evidence-based care of these patients are universal and independent of their geographic location. There is a clear need to develop a uniform and global public health approach to the worldwide epidemic of CKD. It is to this end that a new initiative "Kidney Disease: Improving Global Outcomes" has been established. Its stated mission is "Improve the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration and integration of initiatives to develop and implement clinical practice guidelines."

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Section: Closing the Gap: Guidelinesmentioning

confidence: 99%

The burden of kidney disease: Improving global outcomes

Eknoyan¹,

Lameire²,

Barsoum³

et al. 2004

Kidney International

Self Cite

430

286

View full text Add to dashboard Cite

show abstract

“…Decreasing GFR is widely accepted as a hallmark of diabetic nephropathy, where an inverse relationship exists between GFR and the progressive stages of diabetic nephropathy [38]. A region on chromosome 2q35-37 was highlighted in a cohort of Mexican-American diabetes patients as an area with the strongest GFR linkage [39].…”

Section: Irs Proteins and Diabetic Nephropathymentioning

confidence: 99%

IRS proteins and diabetic complications

2016

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IRS proteins are cellular adaptor molecules that mediate many of the key metabolic actions of insulin. When tyrosine is phosphorylated by the activated insulin receptor, IRS proteins recruit downstream effectors, such as phosphoinositide 3-kinase and mitogen-activated protein kinase, in order to elicit cellular responses such as glucose uptake, lipid metabolism and cell proliferation. There are two main IRS proteins in humans (IRS1 and IRS2), both of which are widely expressed. Given their central role in the insulin signalling pathway, it is not surprising that male mice lacking Irs1 or Irs2 present with elevated blood glucose or type 2 diabetes, respectively. For reasons yet to be identified, female Irs2 −/− mice do not develop type 2 diabetes. A number of organs are affected by complications of diabetes; macrovascular complications include stroke and coronary artery disease, while nephropathy, neuropathy and retinopathy fall into the category of microvascular complications. Given the serious consequences of these complications on patient morbidity and mortality, it is essential to identify the molecular pathogenesis underlying diabetic complications, with a view to improving therapeutic intervention and patient outcomes. A number of recently published papers have converged on the hypothesis that the loss of insulin signalling and IRS proteins is instrumental to the development and/or progression of diabetic complications. This review will summarise some highlights from the published work in which this hypothesis is discussed.

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“…Emphasis in recent years has been on demonstrating dose–outcome relationships with survival as the outcome. Studies in ESRD population have suggested that urea removal is important for medium‐term survival (months to years) (5,9); long‐term survival (years to decades) may depend more on the removal of middle‐sized molecules (e.g., ß 2 microglobulin) (9–11).…”

Section: The Concept Of Dosementioning

confidence: 99%

Assessing and Delivering Dialysis Dose in Acute Kidney Injury

Granado

Mehta

2011

Seminars in Dialysis

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Assessing and delivering dialysis dose in acute kidney injury (AKI) has emerged as an important issue in the management of critically ill patients. There is ongoing debate on how dose of dialysis should be expressed and measured. Most studies have focused on clearance of small molecules (blood urea nitrogen) as a marker of delivered dose and for establishing dose-outcome relationships. Recent evidence has shown that other markers may also be important to consider, as acid-base balance and fluid overload have emerged as important factors contributing to outcomes. In this review, we provide an evaluation of current approaches to prescribing and delivering dialysis dose in AKI, identify gaps in practice and propose an integrated approach to optimize dose delivery in dialysis with a goal to improve outcomes.

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On improving outcomes and quality of dialysis care, and more

Cited by 22 publications

References 1 publication

The burden of kidney disease: Improving global outcomes

The burden of kidney disease: Improving global outcomes

IRS proteins and diabetic complications

Assessing and Delivering Dialysis Dose in Acute Kidney Injury

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