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2. Hypernatremia in Hyperglycemia: Clinical Features and Relationship to Fractional Changes in Body Water and Monovalent Cations during Its Development

Author

Wagner, Brent, Ing, Todd S, Roumelioti, Maria-Eleni, Sam, Ramin, Argyropoulos, Christos P, Lew, Susie Q, Unruh, Mark L, Dorin, Richard I, Degnan, James H, and Tzamaloukas, Antonios H

Subjects
Medical Physiology, Biomedical and Clinical Sciences, Cardiovascular, hyperglycemia, hypernatremia, osmotic diuresis, sodium in fluids lost, potassium in fluids lost, Clinical Sciences, Biomedical and clinical sciences
Abstract

In hyperglycemia, the serum sodium concentration ([Na]S) receives influences from (a) the fluid exit from the intracellular compartment and thirst, which cause [Na]S decreases; (b) osmotic diuresis with sums of the urinary sodium plus potassium concentration lower than the baseline euglycemic [Na]S, which results in a [Na]S increase; and (c), in some cases, gains or losses of fluid, sodium, and potassium through the gastrointestinal tract, the respiratory tract, and the skin. Hyperglycemic patients with hypernatremia have large deficits of body water and usually hypovolemia and develop severe clinical manifestations and significant mortality. To assist with the correction of both the severe dehydration and the hypovolemia, we developed formulas computing the fractional losses of the body water and monovalent cations in hyperglycemia. The formulas estimate varying losses between patients with the same serum glucose concentration ([Glu]S) and [Na]S but with different sums of monovalent cation concentrations in the lost fluids. Among subjects with the same [Glu]S and [Na]S, those with higher monovalent cation concentrations in the fluids lost have higher fractional losses of body water. The sum of the monovalent cation concentrations in the lost fluids should be considered when computing the volume and composition of the fluid replacement for hyperglycemic syndromes.

Published
2024

6. Matrix Metalloproteinase-2 and CKD Progression: The Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Appel, Lawrence J., Cohen, Debbie, Dember, Laura, Go, Alan S., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Baudier, Robin L., Orlandi, Paula F., Yang, Wei, Chen, Hsiang-Yu, Bansal, Nisha, Blackston, J. Walker, Chen, Jing, Deo, Rajat, Dobre, Mirela, He, Hua, He, Jiang, Ricardo, Ana C., Shafi, Tariq, Srivastava, Anand, Xie, Dawei, Susztak, Katalin, Feldman, Harold I., and Anderson, Amanda H.

Published
2024
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7. Neighborhood Socioeconomic Status and Cardiovascular Events in Adults With CKD: The CRIC Study

Author

Chen, Jing, Cohen, Debbie L., Dember, Laura M., Anderson, Amada H., Go, Alan S., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Aronov, Avi G., Saunders, Milda R., Hsu, Jesse Y., Sha, Daohang, Daviglus, Martha, Fischer, Michael J., Appel, Lawrence J., Sondheimer, James, He, Jiang, Rincon-Choles, Hernan, Horwitz, Edward J., Kelly, Tanika N., Ricardo, Ana C., and Lash, James P.

Published
2024
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8. Adherence to Plant-Based Diets and Risk of CKD Progression and All-Cause Mortality: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Chen, Jing, Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Amir, Saira, Kim, Hyunju, Hu, Emily A., Ricardo, Ana C., Mills, Katherine T., He, Jiang, Fischer, Michael J., Pradhan, Nishigandha, Tan, Thida C., Navaneethan, Sankar D., Dobre, Mirela, Anderson, Cheryl A.M., Appel, Lawrence J., and Rebholz, Casey M.

Published
2024
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9. Depressive Symptoms, Antidepressants, and Clinical Outcomes in Chronic Kidney Disease: Findings from the CRIC Study

Author

Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Hernandez, Rosalba, Xie, Dawei, Wang, Xue, Jordan, Neil, Ricardo, Ana C., Anderson, Amanda H., Diamantidis, Clarissa J., Kusek, John W., Yaffe, Kristine, Lash, James P., and Fischer, Michael J.

Published
2024
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11. Frailty and Cardiovascular Outcomes in Adults With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Chen, Jing, Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Hannan, Mary, Chen, Jinsong, Hsu, Jesse, Zhang, Xiaoming, Saunders, Milda R., Brown, Julia, McAdams-DeMarco, Mara, Mohanty, Madhumita Jena, Vyas, Rahul, Hajjiri, Zahraa, Carmona-Powell, Eunice, Meza, Natalie, Porter, Anna C., Ricardo, Ana C., and Lash, James P.

Published
2024
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12. Edelman Revisited: Concepts, Achievements, and Challenges

Author

Rohrscheib, Mark, Sam, Ramin, Raj, Dominic S, Argyropoulos, Christos P, Unruh, Mark L, Lew, Susie Q, Ing, Todd S, Levin, Nathan W, and Tzamaloukas, Antonios H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Generic health relevance, dysnatremia, hyponatremia, hypernatremia, osmotic sodium inactivation, hydrophilic compounds, Biomedical and clinical sciences, Health sciences
Abstract

The key message from the 1958 Edelman study states that combinations of external gains or losses of sodium, potassium and water leading to an increase of the fraction (total body sodium plus total body potassium) over total body water will raise the serum sodium concentration ([Na]S), while external gains or losses leading to a decrease in this fraction will lower [Na]S. A variety of studies have supported this concept and current quantitative methods for correcting dysnatremias, including formulas calculating the volume of saline needed for a change in [Na]S are based on it. Not accounting for external losses of sodium, potassium and water during treatment and faulty values for body water inserted in the formulas predicting the change in [Na]S affect the accuracy of these formulas. Newly described factors potentially affecting the change in [Na]S during treatment of dysnatremias include the following: (a) exchanges during development or correction of dysnatremias between osmotically inactive sodium stored in tissues and osmotically active sodium in solution in body fluids; (b) chemical binding of part of body water to macromolecules which would decrease the amount of body water available for osmotic exchanges; and (c) genetic influences on the determination of sodium concentration in body fluids. The effects of these newer developments on the methods of treatment of dysnatremias are not well-established and will need extensive studying. Currently, monitoring of serum sodium concentration remains a critical step during treatment of dysnatremias.

Published
2022

14. The design and baseline characteristics for the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis

Author

Dember, Laura M., Hsu, Jesse Y., Bernardo, Leah, Cavanaugh, Kerri L., Charytan, David M., Crowley, Susan T., Cukor, Daniel, Doorenbos, Ardith Z., Edwards, David A., Esserman, Denise, Fischer, Michael J., Jhamb, Manisha, Joffe, Steven, Johansen, Kirsten L., Kalim, Sahir, Keefe, Francis J., Kimmel, Paul L., Krebs, Erin E., Kuzla, Natalie, Mehrotra, Rajnish, Mishra, Puneet, Pellegrino, Bethany, Steel, Jennifer L., Unruh, Mark L., White, David M., Yabes, Jonathan G., and Becker, William C.

Published
2024
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15. Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD

Author

Srivastava, Anand, Cai, Xuan, Mehta, Rupal, Lee, Jungwha, Chu, David I, Mills, Katherine T, Shafi, Tariq, Taliercio, Jonathan J, Hsu, Jesse Y, Schrauben, Sarah J, Saunders, Milda R, Diamantidis, Clarissa J, Hsu, Chi-yuan, Waikar, Sushrut S, Lash, James P, Isakova, Tamara, Investigators, CRIC Study, Appel, Lawrence J, Feldman, Harold I, Go, Alan S, He, Jiang, Nelson, Robert G, Rahman, Mahboob, Rao, Panduranga S, Shah, Vallabh O, Townsend, Raymond R, and Unruh, Mark L

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Kidney Disease, Prevention, Renal and urogenital, Good Health and Well Being, chronic kidney disease, end-stage kidney disease, hospital utilization, hospitalization, trajectory, CRIC Study Investigators, Biomedical and clinical sciences, Health sciences
Abstract

IntroductionManagement of chronic kidney disease (CKD) entails high medical complexity and often results in high hospitalization burden. There are limited data on the associations of longitudinal hospital utilization patterns with adverse clinical outcomes in individuals with CKD.MethodsWe derived cumulative all-cause hospitalization trajectory groups using latent class trajectory analysis in 3012 participants of the Chronic Renal Insufficiency Cohort (CRIC) Study who were alive and did not reach end-stage kidney disease (ESKD) within 4 years of study entry. Cox proportional hazards models tested the associations between hospitalization trajectory groups and risks of ESKD and death prior to the onset of ESKD (ESKD-censored death).ResultsWithin 4 years of study entry, there were 5658 hospitalizations among 3012 participants. We identified 3 distinct subgroups of individuals with CKD based on cumulative all-cause hospitalization trajectories over 4 years: low-utilizer (n = 1066), intermediate-utilizer (n = 1802), and high-utilizer (n = 144). High-utilizers represented a patient population of lower socioeconomic status who had a greater prevalence of comorbid conditions and lower kidney function compared with intermediate- and low-utilizers. After the 4-year ascertainment period to form the trajectory subgroups, there were 544 ESKD events and 437 ESKD-censored deaths during a median follow-up time of 5.1 years. Compared with low-utilizers, intermediate-utilizers and high-utilizers were at 1.49-fold (95% confidence interval [CI] 1.22-1.84) and 1.75-fold (95% CI 1.20-2.56) higher risk of ESKD in adjusted analyses, respectively. Compared with low-utilizers, intermediate-utilizers and high-utilizers were at 1.48-fold (95% CI 1.17-1.87) and 2.58-fold (95% CI 1.74-3.83) higher risk of ESKD-censored death in adjusted analyses, respectively.ConclusionsTrajectories of cumulative all-cause hospitalization identify subgroups of individuals with CKD who are at high risk of ESKD and death.

Published
2021

16. Fibroblast Growth Factor 23 and Risk of Heart Failure Subtype: The CRIC (Chronic Renal Insufficiency Cohort) Study

Author

Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Leidner, Alexander S., Cai, Xuan, Zelnick, Leila R., Lee, Jungwha, Bansal, Nisha, Pasch, Andreas, Kansal, Mayank, Anderson, Amanda Hyre, Sondheimer, James H., Townsend, Raymond R., Shah, Sanjiv J., Wolf, Myles, Isakova, Tamara, and Mehta, Rupal C.

Published
2023
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17. Blood Pressure, Incident Cognitive Impairment, and Severity of CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Lash, James P., Nelson, Robert G., Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Babroudi, Seda, Tighiouart, Hocine, Schrauben, Sarah J., Cohen, Jordana B., Fischer, Michael J., Rahman, Mahboob, Hsu, Chi-yuan, Sozio, Stephen M., Weir, Matthew, Sarnak, Mark, Yaffe, Kristine, Kurella Tamura, Manjula, and Drew, David

Published
2023
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18. Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Bagasha, Peace, Bargman, Joanne M., Bavanandan, Sunita, Beckwith, Hannah, Bennett, Paul N., Bohm, Clara, Brennan, Frank, Burton, James O., Cavanaugh, Kerri L., Chilcot, Joseph, Choi, Peter, Cukor, Daniel, Dember, Laura M., Dong, Jie, Edwards, Dawn, Erickson, Kevin F., Figueiredo, Ana, Finkelstein, Fredric O., Fukagawa, Masafumi, Germain, Michael, Guillano, Franklin B., Hurst, Helen, Iseki, Kunitoshi, Jardine, Meg J., Jauré, Allison, Jha, Vivekanand, Jhamb, Manisha, Kanjanabuch, Talerngsak, Lerma, Edgar, Kam-Tao Li, Philip, Liew, Adrian, Małyszko, Jolanta, Proenca de Moraes, Thyago, Moranne, Olivier, Nam Ng, Marques Shek, Ostermann, Marlies, Perl, Jeffrey, Pigford, Jayne, Pommer, Wolfgang, Richardson, Michelle M., Rivara, Matthew B., Roberts, Glenda V., Sarafidis, Pantelis, Shroff, Rukshana, Slon Roblero, Maria Fernanda, Smyth, Brendan, Søndergaard, Henning, Van Der Veer, Sabine N., Vassalotti, Joseph A., Vervloet, Marc, Vincent, Lloyd, Walker, Rachael, Warren, Madeleine, Wasylynuk, Betty Ann, West, Melissa, Wilkie, Caroline, Mehrotra, Rajnish, Davison, Sara N., Farrington, Ken, Flythe, Jennifer E., Foo, Marjorie, Madero, Magdalena, Morton, Rachael L., Tsukamoto, Yusuke, Unruh, Mark L., Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., and Brown, Edwina A.

Published
2023
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19. Ultraprocessed Foods and Kidney Disease Progression, Mortality, and Cardiovascular Disease Risk in the CRIC Study

Author

Cohen, Debbie L., Feldman, Harold I., Go, Alan S., Nelson, Robert G., Rahman, Mahboob, Shah, Vallabh O., Sullivan, Valerie K., Appel, Lawrence J., Anderson, Cheryl A.M., Kim, Hyunju, Unruh, Mark L., Lash, James P., Trego, Marsha, Sondheimer, James, Dobre, Mirela, Pradhan, Nishigandha, Rao, Panduranga S., Chen, Jing, He, Jiang, and Rebholz, Casey M.

Published
2023
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20. Cardiac Structure and Function and Subsequent Kidney Disease Progression in Adults With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Cohen, Debbie L., Feldman, Harold I., Lash, James P., Nelson, Robert G., Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Ishigami, Junichi, Kansal, Mayank, Mehta, Rupal, Srivastava, Anand, Rahman, Mahboob, Dobre, Mirela, Al-Kindi, Sadeer G., Go, Alan S., Navaneethan, Sankar D., Chen, Jing, He, Jiang, Bhat, Zeenat Yousuf, Jaar, Bernard G., Appel, Lawrence J., and Matsushita, Kunihiro

Published
2023
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22. High Performance Implementation of the Hierarchical Likelihood for Generalized Linear Mixed Models. An Application to estimate the potassium reference range in massive Electronic Health Records datasets

Author

Bologa, Cristian H, Pankratz, Vernon Shane, Unruh, Mark L, Roumelioti, Maria Eleni, Shah, Vallabh, Shaffi, Saeed Kamran, Arzhan, Soraya, Cook, John, and Argyropoulos, Christos

Subjects
Statistics - Applications, 62P10, 65D25, 62-04, 62F10, 62R07
Abstract

Converting electronic health record (EHR) entries to useful clinical inferences requires one to address the poor scalability of existing implementations of Generalized Linear Mixed Models (GLMM) for repeated measures. The major computational bottleneck concerns the numerical evaluation of integrals, which even for the simplest EHR analyses may involve millions of dimensions (one for each patient). The hierarchical likelihood (h-lik) approach to GLMMs is a framework for the estimation of GLMMs that is based on the Laplace Approximation (LA), which replaces integration with numerical optimization, and thus scales very well with dimensionality. We present a high-performance implementation of the h-lik for GLMMs in the R package TMB. Using this approach, we examined the relation of serum potassium measurements and survival in the Cerner Real World Data (CRWD) EHR database. Analyzing this data requires the evaluation of an integral in over 3 million dimensions. We also assessed the scalability and accuracy of LA in smaller samples of 1 and 10% size of the full dataset that were analyzed via the a) original, interconnected Generalized Linear Models (iGLM), approach to h-lik, b) Adaptive Gaussian Hermite (AGH) and c) the gold standard of Markov Chain Monte Carlo (MCMC) for multivariate integration. Random effects estimates generated by the LA were within 10% of the values obtained by the iGLMs, AGH and MCMC techniques. The H-lik approach was 4-30 times faster than AGH and nearly 800 times faster than MCMC. We found that the combination of the LA and AD offers a computationally efficient, numerically accurate approach for the analysis of extremely large, real world repeated measures data via the h-lik approach to GLMMs. The clinical inference from our analysis may guide choices of threatment thresholds for treating potassium disorders in the clinic.

Published
2019

24. Low concentrations of medium-sized HDL particles predict incident CVD in chronic kidney disease patients

Author

Kretzler, Matthias, Gipson, Debbie, Bitzer, Markus, Gadegbeku, Crystal, Bellovich, Keith, Bhat, Zeenat, Massengill, Susan, Perumal, Kalyani, Appel, Lawrence J., Cohen, Debbie L., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Shah, Vallabh O., Unruh, Mark L., Shao, Baohai, Afshinnia, Farsad, Mathew, Anna V., Ronsein, Graziella E., Thornock, Carissa, Irwin, Angela D., Kansal, Mayank, Rao, Panduranga S., Dobre, Mirela, Al-Kindi, Sadeer, Weir, Matthew R., Go, Alan, He, Jiang, Chen, Jing, Feldman, Harold, Bornfeldt, Karin E., and Pennathur, Subramaniam

Published
2023
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25. Excess risk of cardiovascular events in patients in the United States vs. Japan with chronic kidney disease is mediated mainly by left ventricular structure and function

Author

Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Lash, James P., Nelson, Robert G., Rao, Panduranga S., Rahman, Mahboob, Shah, Vallabh O., Unruh, Mark L., Imaizumi, Takahiro, Fujii, Naohiko, Hamano, Takayuki, Yang, Wei, Taguri, Masataka, Kansal, Mayank, Mehta, Rupal, Shafi, Tariq, Taliercio, Jonathan, Go, Alan, Rao, Panduranga, Hamm, L. Lee, Deo, Rajat, Maruyama, Shoichi, Fukagawa, Masafumi, and Feldman, Harold I.

Published
2023
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27. Matrix Metalloproteinase-2 and CKD Progression: The Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Baudier, Robin L., primary, Orlandi, Paula F., additional, Yang, Wei, additional, Chen, Hsiang-Yu, additional, Bansal, Nisha, additional, Blackston, J. Walker, additional, Chen, Jing, additional, Deo, Rajat, additional, Dobre, Mirela, additional, He, Hua, additional, He, Jiang, additional, Ricardo, Ana C., additional, Shafi, Tariq, additional, Srivastava, Anand, additional, Xie, Dawei, additional, Susztak, Katalin, additional, Feldman, Harold I., additional, Anderson, Amanda H., additional, Appel, Lawrence J., additional, Cohen, Debbie, additional, Dember, Laura, additional, Go, Alan S., additional, Lash, James P., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2024
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28. Five‐Year Cumulative Cardiovascular Health and Clinical Events in Patients With Chronic Kidney Disease: The CRIC Study

Author

Cao, Qiuyu, primary, Bi, Yufang, additional, Alvarado, Flor, additional, Anderson, Amanda H., additional, Mills, Katherine T., additional, Jaeger, Byron C., additional, Chen, Jing, additional, He, Jiang, additional, Bundy, Joshua D., additional, Appel, Lawrence J., additional, Cohen, Debbie, additional, Dember, Laura M., additional, Go, Alan S., additional, Lash, James P., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2024
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29. Aspirin for Primary and Secondary Prevention of Mortality, Cardiovascular Disease, and Kidney Failure in the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Appel, Lawrence J., Cohen, Debbie L., Feldman, Harold I., Lash, James P., Nelson, Robert G., Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Taliercio, Jonathan J., Nakhoul, Georges, Mehdi, Ali, Yang, Wei, Sha, Daohang, Schold, Jesse D., Kasner, Scott, Weir, Matthew, Hassanein, Mohamed, Navaneethan, Sankar D., Krishnan, Geetha, Kanthety, Radhika, Go, Alan S., Deo, Rajat, Lora, Claudia M., Jaar, Bernard G., Chen, Teresa K., Chen, Jing, He, Jiang, and Rahman, Mahboob

Published
2022
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30. Urinary Plasmin(ogen) as a Prognostic Factor for Hypertension

Author

Ray, Evan C, Miller, Rachel G, Demko, John E, Costacou, Tina, Kinlough, Carol L, Demko, Casey L, Unruh, Mark L, Orchard, Trevor J, and Kleyman, Thomas R

Subjects
Epidemiology, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Cardiovascular, Clinical Research, Kidney Disease, Hypertension, Aetiology, 2.1 Biological and endogenous factors, Metabolic and endocrine, Good Health and Well Being, albumin, ENaC, diabetes, hypertension, plasmin, Biomedical and clinical sciences, Health sciences
Abstract

IntroductionPlasmin and its precursor, plasminogen, are detectable in urine from patients with glomerular disease. Urinary plasmin(ogen) levels correlate with blood pressure (BP) and may contribute to renal Na+ retention by activating the epithelial Na+ channel (ENaC). In a longitudinal nested-cohort study, we asked whether urinary plasmin(ogen) levels predict subsequent increase in BP, incident hypertension, or mortality in subjects with type I diabetes, who often develop proteinuria.MethodsThe Pittsburgh Epidemiology of Diabetes Complications (EDC) study followed up type I diabetic subjects for 25 years. Urine specimens from 70 subjects with a spectrum of baseline urinary albumin levels were examined. Outcomes included increased BP after 2 years (≥1 SD over baseline systolic or diastolic BP, examined via logistic regression), 25-year incident hypertension (≥140/90 mm Hg or initiating BP-lowering medications), and all-cause or cardiovascular mortality, examined using Cox regression.ResultsSubjects experiencing a 2-year increase in BP had higher baseline urinary plasmin(ogen)/creatinine levels (uPl/Cr) than other subjects (P = 0.04); the difference in baseline urinary albumin/creatinine levels (uAlb/Cr) was similar (P = 0.07). Baseline uPl/Cr was associated with increased 25-year hypertension incidence (hazard ratio = 2.05, P = 0.001), all-cause mortality (HR = 2.05, P = 0.01) and cardiovascular mortality (HR = 3.30, P = 0.005), although not independent of uAlb/Cr.ConclusionThis is the first long-term prospective study addressing clinical outcomes associated with increased urinary plasmin(ogen). Findings are consistent with a role for plasmin(ogen) in promoting increased BP, but also demonstrate the difficulty in distinguishing effects due to plasmin(ogen) from those of albuminuria.

Published
2018

31. Probing the Association between Acute Kidney Injury and Cardiovascular Outcomes

Author

McCoy, Ian E., Hsu, Jesse Y., Zhang, Xiaoming, Diamantidis, Clarissa J., Taliercio, Jonathan, Go, Alan S., Liu, Kathleen D., Drawz, Paul, Srivastava, Anand, Horwitz, Edward J., He, Jiang, Chen, Jing, Lash, James P., Weir, Matthew R., Hsu, Chi-yuan, Appel, Lawrence J., Cohen, Debbie L., Feldman, Harold I., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., and Unruh, Mark L.

Published
2023
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33. Emergency Department/Urgent Care as Usual Source of Care and Clinical Outcomes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study

Author

Appel, Lawrence J., Feldman, Harold I., Go, Alan S., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Townsend, Raymond R., Unruh, Mark L., Toth-Manikowski, Stephanie M., Hsu, Jesse Y., Fischer, Michael J., Cohen, Jordana B., Lora, Claudia M., Tan, Thida C., He, Jiang, Greer, Raquel C., Weir, Matthew R., Zhang, Xiaoming, Schrauben, Sarah J., Saunders, Milda R., Ricardo, Ana C., and Lash, James P.

Published
2022
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34. Prediction of Incident Heart Failure in CKD: The CRIC Study

Author

Appel, Lawrence J., Chen, Jing, Cohen, Debbie, Feldman, Harold I., Go, Alan S., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Unruh, Mark L., Zelnick, Leila R., Shlipak, Michael G., Soliman, Elsayed Z., Anderson, Amanda, Christenson, Robert, Kansal, Mayank, Deo, Rajat, He, Jiang, Jaar, Bernard G., Weir, Matthew R., Rao, Panduranga, Cohen, Debbie L., Cohen, Jordana B., Go, Alan, and Bansal, Nisha

Published
2022
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35. Upper Reference Limits for High-Sensitivity Cardiac Troponin T and N-Terminal Fragment of the Prohormone Brain Natriuretic Peptide in Patients With CKD

Author

Appel, Lawrence J., Feldman, Harold I., Lash, James P., Nelson, Robert G., Rao, Panduranga S., Rahman, Mahboob, Shah, Vallabh O., Townsend, Raymond R., Unruh, Mark L., Bansal, Nisha, Zelnick, Leila R., Ballantyne, Christie M., Chaves, Paulo H.M., Christenson, Robert H., Coresh, Josef, deFilippi, Christopher R., de Lemos, James A., Daniels, Lori B., Go, Alan S., He, Jiang, Hedayati, S. Susan, Matsushita, Kunihiro, Nambi, Vijay, Shlipak, Michael G., Taliercio, Jonathan J., and Seliger, Stephen L.

Published
2022
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36. Iron status, fibroblast growth factor 23 and cardiovascular and kidney outcomes in chronic kidney disease

Author

Appel, Lawrence J., Go, Alan S., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Townsend, Raymond R., Unruh, Mark L., Mehta, Rupal C., Cho, Monique E., Cai, Xuan, Lee, Jungwha, Chen, Jing, He, Jiang, Flack, John, Shafi, Tariq, Saraf, Santosh L., David, Valentin, Feldman, Harold I., Isakova, Tamara, and Wolf, Myles

Published
2021
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37. Depressive Symptoms, Antidepressants, and Clinical Outcomes in Chronic Kidney Disease: Findings from the CRIC Study

Author

Hernandez, Rosalba, primary, Xie, Dawei, additional, Wang, Xue, additional, Jordan, Neil, additional, Ricardo, Ana C., additional, Anderson, Amanda H., additional, Diamantidis, Clarissa J., additional, Kusek, John W., additional, Yaffe, Kristine, additional, Lash, James P., additional, Fischer, Michael J., additional, Appel, Lawrence J., additional, Chen, Jing, additional, Cohen, Debbie L., additional, Feldman, Harold I., additional, Go, Alan S., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2024
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40. Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD

Author

Appel, Lawrence J., Feldman, Harold I., Go, Alan S., He, Jiang, Nelson, Robert G., Rahman, Mahboob, Rao, Panduranga S., Shah, Vallabh O., Townsend, Raymond R., Unruh, Mark L., Srivastava, Anand, Cai, Xuan, Mehta, Rupal, Lee, Jungwha, Chu, David I., Mills, Katherine T., Shafi, Tariq, Taliercio, Jonathan J., Hsu, Jesse Y., Schrauben, Sarah J., Saunders, Milda R., Diamantidis, Clarissa J., Hsu, Chi-yuan, Waikar, Sushrut S., Lash, James P., and Isakova, Tamara

Published
2021
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41. Renal Replacement Therapy and Incremental Hemodialysis for Veterans with Advanced Chronic Kidney Disease

Author

Kalantar‐Zadeh, Kamyar, Crowley, Susan T, Beddhu, Srinivasan, Chen, Joline LT, Daugirdas, John T, Goldfarb, David S, Jin, Anna, Kovesdy, Csaba P, Leehey, David J, Moradi, Hamid, Navaneethan, Sankar D, Norris, Keith C, Obi, Yoshitsugu, O'Hare, Ann, Shafi, Tariq, Streja, Elani, Unruh, Mark L, Vachharajani, Tushar J, Weisbord, Steven, and Rhee, Connie M

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Services, Bioengineering, Clinical Trials and Supportive Activities, Clinical Research, Assistive Technology, Kidney Disease, Renal and urogenital, Good Health and Well Being, Humans, Kidney, Kidney Failure, Chronic, Quality of Life, Renal Dialysis, Renal Replacement Therapy, United States, Veterans, Urology & Nephrology, Clinical sciences
Abstract

Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources. Data from the United States Renal Data System Special Study Center "Transition-of-Care-in-CKD" suggest that Veterans who receive dialysis in a VA unit exhibit greater survival compared with the non-VA centers. Substantial financial expenditures arise from the high volume of outsourced care and higher dialysis reimbursement paid by the VA than by Medicare to outsourced providers. Given the exceedingly high mortality and abrupt decline in residual kidney function (RKF) in the first dialysis year, it is possible that incremental transition to dialysis through an initial twice-weekly hemodialysis regimen might preserve RKF, prolong vascular access longevity, improve patients' quality of life, and be a more patient-centered approach, more consistent with "personalized" dialysis. Broad implementation of incremental dialysis might also result in more Veterans receiving care within a VA dialysis unit. Controlled trials are needed to examine the safety and efficacy of incremental hemodialysis in Veterans and other populations; the administrative and health care as well as provider structure within the VA system would facilitate the performance of such trials.

Published
2017

42. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Author

Adragão, Teresa, Anumudu, Samaya J., Chan, Christopher T., Cheung, Alfred K., Costanzo, Maria Rosa, Dasgupta, Indranil, Davenport, Andrew, Davies, Simon J., Dekker, Marijke J.E., Dember, Laura M., Gallego, Daniel, Gómez, Rafael, Hawley, Carmel M., Hecking, Manfred, Iseki, Kunitoshi, Jha, Vivekanand, Kooman, Jeroen P., Kovesdy, Csaba P., Lacson, Eduardo, Jr., Liew, Adrian, Lok, Charmaine E., McIntyre, Christopher W., Mehrotra, Rajnish, Miskulin, Dana C., Movilli, Ezio, Paglialonga, Fabio, Pecoits-Filho, Roberto, Perl, Jeff, Pollock, Carol A., Riella, Miguel C., Rossignol, Patrick, Shroff, Rukshana, Solá, Laura, Søndergaard, Henning, Tang, Sydney C.W., Tong, Allison, Tsukamoto, Yusuke, Watnick, Suzanne, Weir, Matthew R., Wetmore, James B., Wilkie, Caroline, Wilkie, Martin, Flythe, Jennifer E., Chang, Tara I., Gallagher, Martin P., Lindley, Elizabeth, Madero, Magdalena, Sarafidis, Pantelis A., Unruh, Mark L., Wang, Angela Yee-Moon, Weiner, Daniel E., Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., and Polkinghorne, Kevan R.

Published
2020
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43. Acute Kidney Injury Associates with Long-Term Increases in Plasma TNFR1, TNFR2, and KIM-1: Findings from the CRIC Study

Author

McCoy, Ian E., Hsu, Jesse Y., Bonventre, Joseph V., Parikh, Chirag R., Go, Alan S., Liu, Kathleen D., Ricardo, Ana C., Srivastava, Anand, Cohen, Debbie L., He, Jiang, Chen, Jing, Rao, Panduranga S., Hsu, Chi-yuan, Appel, Lawrence J., Feldman, Harold J., Lash, James P., Nelson, Robert G., Rahman, Mahboob, Shah, Vallabh O., and Unruh, Mark L.

Published
2022
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45. The design and baseline characteristics for the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis

Author

Dember, Laura M., primary, Hsu, Jesse Y., additional, Bernardo, Leah, additional, Cavanaugh, Kerri L., additional, Charytan, David M., additional, Crowley, Susan T., additional, Cukor, Daniel, additional, Doorenbos, Ardith Z., additional, Edwards, David A., additional, Esserman, Denise, additional, Fischer, Michael J., additional, Jhamb, Manisha, additional, Joffe, Steven, additional, Johansen, Kirsten L., additional, Kalim, Sahir, additional, Keefe, Francis J., additional, Kimmel, Paul L., additional, Krebs, Erin E., additional, Kuzla, Natalie, additional, Mehrotra, Rajnish, additional, Mishra, Puneet, additional, Pellegrino, Bethany, additional, Steel, Jennifer L., additional, Unruh, Mark L., additional, White, David M., additional, Yabes, Jonathan G., additional, and Becker, William C., additional

Published
2023
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46. Organic Pollutant Exposure and CKD: A Chronic Renal Insufficiency Cohort Pilot Study

Author

Charytan, David M., primary, Wu, Wenbo, additional, Liu, Mengling, additional, Li, Zhong-Min, additional, Kannan, Kurunthachalam, additional, Trasande, Leonardo, additional, Pal, Vineet Kumar, additional, Lee, Sunmi, additional, Trachtman, Howard, additional, Appel, Lawrence J., additional, Chen, Jing, additional, Cohen, Debbie L., additional, Feldman, Harold I., additional, Go, Alan S., additional, Lash, James P., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2023
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47. Fibroblast Growth Factor 23 and Risk of Heart Failure Subtype: The CRIC (Chronic Renal Insufficiency Cohort) Study

Author

Leidner, Alexander S., primary, Cai, Xuan, additional, Zelnick, Leila R., additional, Lee, Jungwha, additional, Bansal, Nisha, additional, Pasch, Andreas, additional, Kansal, Mayank, additional, Chen, Jing, additional, Anderson, Amanda Hyre, additional, Sondheimer, James H., additional, Lash, James P., additional, Townsend, Raymond R., additional, Go, Alan S., additional, Feldman, Harold I., additional, Shah, Sanjiv J., additional, Wolf, Myles, additional, Isakova, Tamara, additional, Mehta, Rupal C., additional, Appel, Lawrence J., additional, Cohen, Debbie L., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2023
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