Slowing the progression of chronic renal failure: Economic benefits and patients' perspectives

Trivedi, Hariprasad; Pang, Michael M. H.; Campbell, Anne; Saab, Paulette

doi:10.1053/ajkd.2002.31990

Cited by 123 publications

(73 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CKD is a strong predictor of future hospitalization, cardiovascular events, and death as well as considerable health care costs (1)(2)(3)(4). AKI is also recognized as a potent predictor of long-term morbidity and mortality, although the mechanism underlying this association remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Association between AKI, Recovery of Renal Function, and Long-Term Outcomes after Hospital Discharge

Pannu

James

Hemmelgarn

et al. 2013

Clinical Journal of the American Society of Nephrology

258

188

View full text Add to dashboard Cite

SummaryBackground and objectives This study aimed to determine if recovery of kidney function after AKI modifies the association between AKI during hospitalization and adverse outcomes after discharge.Design, setting, participants, & measurements The effect of renal recovery after AKI was evaluated in a population-based cohort study (n=190,714) with participants identified from a provincial claims registry in Alberta, Canada, between November 1, 2002 and December 31, 2007. AKI was identified by a two-fold increase between prehospital and peak in-hospital serum creatinine (SCr). Recovery was assessed using SCr drawn closest to 90 days after the AKI event. All-cause mortality and a combined renal outcome of sustained doubling of SCr or progression to kidney failure were evaluated.Results Overall, 3.7% of the participants (n=7014) had AKI, 62.7% of whom (n=4400) survived 90 days. In the 3231 patients in whom recovery could be assessed over a median follow-up of 34 months, 30.8% (n=1268) of AKI survivors died and 2.1% (n=85) progressed to kidney failure. Participants who did not recover kidney function had a higher risk for mortality and adverse renal outcomes when AKI participants who recovered to within 25% of baseline SCr were used as the reference group (adjusted mortality hazard ratio (HR), 1.26; 95% confidence interval, 1.10, 1.43) (adjusted renal outcomes HR, 4.13; 95% confidence interval, 3.38, 5.04). Mortality HR was notably higher when participants failed to recover within 55% of baseline.Conclusions Renal recovery after AKI is associated with a lower risk of death or adverse renal outcomes after hospital discharge.

show abstract

Section: Introductionmentioning

confidence: 99%

Association between AKI, Recovery of Renal Function, and Long-Term Outcomes after Hospital Discharge

Pannu

James

Hemmelgarn

et al. 2013

Clinical Journal of the American Society of Nephrology

258

188

View full text Add to dashboard Cite

show abstract

“…An increasing body of literature supports the economic value of early detection and treatment of chronic renal disease (22,23). Most of these analyses have revolved around reductions in the economic costs of ESRD.…”

mentioning

confidence: 99%

Prevention of the Development and Progression of Renal Disease

Hostetter

2003

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Na atenção primária, a DRC é pouco detectada por clínicos gerais 14,17 . O impacto do diagnóstico precoce da DRC é grande, pois propicia: a diminuição da mortalidade de causa cardiovascular; a redução do custo do tratamento, tanto por retardar a progressão da DRC como por postergar o início da TRS; a melhora da qualidade de vida dos pacientes; o encaminhamento no tempo certo para o nefrologista 12,13,24 , o que permite o acesso a medicamentos de alto custo para o controle dos estados mórbidos associados à DRC, por exemplo, anemia e distúrbio mineral ósseo, como também possibilita o início eletivo da TRS por meio da confecção de acesso vascular (fístula), e não de acesso provisório por cateter, o que diminui drasticamente a mortalidade durante o primeiro ano de TRS 25,26 . Portanto, o problema de saúde pública do diagnóstico tardio da DRC deve ser enfrentado com o envolvimento do maior número de pessoas da comunidade, além dos profissionais da área de saúde.…”

Section: ▄ Resultadosunclassified

Aplicação do questionário SCORED para rastreamento da doença renal crônica entre pacientes hipertensos e diabéticos

Santos

Neto

2016

Cad. saúde colet.

View full text Add to dashboard Cite

Fonte de financiamento: nenhuma. Conflito de interesses: nada a declarar. ResumoIntrodução: O questionário SCORED foi desenvolvido para predizer a probabilidade de um indivíduo apresentar doença renal crônica (DRC). O estudo teve por objetivo avaliar o desempenho do SCORED entre hipertensos e diabéticos cadastrados na unidade-sede da Estratégia Saúde da Família (ESF), na cidade de Meruoca, no Estado do Ceará. Métodos: A amostra foi formada por 221 participantes. A taxa de filtração glomerular de <60 mL/min foi utilizada como padrão-ouro para o diagnóstico da DRC. Foram calculadas as propriedades de acurácia, sensibilidade, especificidade e likelihood ratios positivo e negativo do instrumento SCORED para o diagnóstico da DRC. Resultados: Os resultados do desempenho do SCORED foram os seguintes: a pontuação gerada pelo SCORED foi preditora independente da presença de DRC (OR=1,261; IC95%=1,108-1,597; p=0,049); o questionário apresentou sensibilidade de 97% e especificidade de 23% em diagnosticar DRC, com likelihood ratio positivo de 1,25 e negativo de 0,13, além de acurácia de 47%. Alta sensibilidade e baixo likelihood ratio negativo habilitam o SCORED como instrumento de rastreamento de DRC entre hipertensos e diabéticos. Conclusão: A utilização desse questionário tem o potencial de incrementar o diagnóstico precoce da DRC entre pacientes cadastrados na ESF, além de sua aplicabilidade na população geral e em campanhas educacionais. Palavras-chave: insuficiência renal crônica; programas de rastreamento; assistência primária à saúde; diabetes mellitus; hipertensão. Abstract Introduction: A questionnaire named SCORED was developed in order to predict the probability of an individual chances of having chronic kidney disease (CKD). We aimed to evaluate the performance of SCORED among hypertensives and diabetics registered with the Family Health Strategy (FHE) program in the city of Meruoca, Ceará, Brazil. Methods: 221 participants formed the sample. Glomerular filtration rate <60 mL/min was used as gold standard for CKD diagnosis. We calculated accuracy, sensitivity, specificity and positive and negative likelihood ratios of the SCORED tool for the diagnosis of CKD. Results: Results of SCORED performance were the following: the score generated was an independent predictor of CKD (OR=1.261; CI 95%=1.108-1.597; p=0.049); the questionnaire had 97% sensitivity and 23% specificity in diagnosing CKD, with positive likelihood ratio of 1.25 and negative of 0.13, and accuracy of 47%. High sensitivity and low negative likelihood ratio enables SCORED to be used as a screening tool for CKD among hypertensive and diabetic people. Conclusion: The use of this questionnaire has the potential to increase early diagnosis of CKD among patients registered with the FHE, besides its applicability to the general population and in educational campaigns.

show abstract

Slowing the progression of chronic renal failure: Economic benefits and patients' perspectives

Cited by 123 publications

References 34 publications

Association between AKI, Recovery of Renal Function, and Long-Term Outcomes after Hospital Discharge

Association between AKI, Recovery of Renal Function, and Long-Term Outcomes after Hospital Discharge

Prevention of the Development and Progression of Renal Disease

Aplicação do questionário SCORED para rastreamento da doença renal crônica entre pacientes hipertensos e diabéticos

Contact Info

Product

Resources

About