scholarly journals The impact of chronic kidney disease on outcomes following peripheral vascular intervention

2020 ◽  
Vol 43 (11) ◽  
pp. 1308-1316 ◽  
Author(s):  
Dennis I. Narcisse ◽  
Elizabeth Hope Weissler ◽  
Jennifer A. Rymer ◽  
Ehrin J. Armstrong ◽  
Eric A. Secemsky ◽  
...  
2017 ◽  
Vol 119 (4) ◽  
pp. 669-674 ◽  
Author(s):  
Joe X. Xie ◽  
Thomas J. Glorioso ◽  
Philip B. Dattilo ◽  
Vikas Aggarwal ◽  
P. Michael Ho ◽  
...  

2019 ◽  
Vol 55 ◽  
pp. 5-6
Author(s):  
Zdenek Novak ◽  
Johnston L. Moore ◽  
John C. Axley ◽  
Emily L. Spangler ◽  
Benjamin J. Pearce ◽  
...  

2021 ◽  
Vol 52 (10-11) ◽  
pp. 845-853
Author(s):  
Qurat-Ul-Ain Jelani ◽  
Fiorella Llanos-Chea ◽  
Pragati Bogra ◽  
Camila Trejo-Paredes ◽  
Jiaming Huang ◽  
...  

<b><i>Introduction:</i></b> Guideline-directed medical therapy (GDMT) is imperative to improve cardiovascular and limb outcomes for patients with critical limb ischemia (CLI), especially amongst those at highest risk for poor outcomes, including those with comorbid chronic kidney disease (CKD). Our objective was to examine GDMT prescription rates and their variation across individual sites for patients with CLI undergoing peripheral vascular interventions (PVIs), by their comorbid CKD status. <b><i>Methods:</i></b> Patients with CLI who underwent PVI (October 2016–April 2019) were included from the Vascular Quality Initiative (VQI) database. CKD was defined as GFR &#x3c;60 mL/min/1.73 m<sup>2</sup>. GDMT included the composite use of antiplatelet therapy and a statin, as well as an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker if hypertension was present. The use of GDMT before and after the index procedure was summarized in those with and without CKD. Adjusted median odds ratios (MORs) for site variability were calculated. <b><i>Results:</i></b> The study included 28,652 patients, with a mean age of 69.4 ± 11.7 years, and 40.8% were females. A total of 47.5% had CKD. Patients with CKD versus those without CKD had lower prescription rates both before (31.7% vs. 38.9%) and after (36.5% vs. 48.8%) PVI (<i>p</i> &#x3c; 0.0001). Significant site variability was observed in the delivery of GDMT in both the non-CKD and CKD groups before and after PVI (adjusted MORs: 1.31–1.41). <b><i>Discussion/Conclusion:</i></b> In patients with CLI undergoing PVI, patients with comorbid CKD were less likely to receive GDMT. Significant variability of GDMT was observed across sites. These findings indicate that significant improvements must be made in the medical management of patients with CLI, particularly in patients at high risk for poor clinical outcomes.


Author(s):  
Denise Genereux ◽  
Lida Fan ◽  
Keith Brownlee

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.


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