scholarly journals GU Evaluation and Management of Renal Transplant Candidates and Recipients

2004 ◽  
Vol 4 ◽  
pp. 41-45 ◽  
Author(s):  
Peter N. Bretan
Keyword(s):  
United States ◽  
High Risk ◽  
Renal Transplant ◽  
End Stage Renal Disease ◽  
The United States ◽  
Common Cause ◽  
Transplant Candidates ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

There are more than 200,000 end stage renal disease (ESRD) patients who are potential transplant candidates and more than 100,000 previously transplanted renal recipients with functioning allografts in the United States1. Fifty-seven percent of these patients are male and forty percent are greater than 50 years of age2, 3. Diabetes is the most common cause of kidney failure. It is evident that many patients are at high risk for development of urologic problems and thus it is estimated that the average urologist will care for up to ten of these patients yearly4. Thus a review of the genitourinary (GU) evaluation and management of these patients is timely.

Abstract MP10: Increasing Obesity Prevalence in the United States End-stage Renal Disease Population

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Brittany Shelton ◽  
Deanna McWilliams ◽  
Rhiannon D Reed ◽  
Margaux Mustian ◽  
Paul MacLennan ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Obesity Prevalence ◽  
The Us ◽  
Prevalence Of Obesity ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Obesity has become a national epidemic, and is associated with increased risk for comorbid diseases including end-stage renal disease (ESRD). Among ESRD patients, obesity may improve dialysis-survival but decreases likelihood of transplantation, and as such, obesity prevalence may directly impact growth of the incident dialysis population. Methods: Incident adult ESRD patients with complete body mass index (BMI, kg/m 2 ) data were identified from the United States Renal Data System from 01/01/1995-12/31/2010 (n=1,822,598). Data from the Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention (n=4,303,471) represented the US population when weighted. Trends in BMI and obesity classes I (BMI of 30-34.9), II (BMI of 35-39.9), and III (BMI ≥40) were examined by year of dialysis initiation. Trends in median BMI slope were compared between the ESRD and US populations using linear regression. Results: Median BMI of ESRD patients in 1995 was 24.2 as compared to 28.0 in 2010, a 15.7% increase, while the US population’s median BMI increased from 24.2 in 1995 to 25.6 in 2010, a 5.8% increase. Comparable trends were noted with respect to prevalence of obesity classes I, II, and III (Table). BMI increase among the ESRD population was significantly more rapid than among the US population (β: 0.15, 95% CI: 0.14-0.17, p<0.001) (Figure). Conclusion: The median BMI of ESRD patients and prevalence of obesity among ESRD patients is increasing more rapidly than the US population. Given the increased dialysis-survival and decreased likelihood of transplantation associated with obesity, healthcare costs will likely increase, and thus, future research should be directed at examining medical expenditures.

scholarly journals Improved survival with renal transplantation for end-stage renal disease due to granulomatosis with polyangiitis: data from the United States Renal Data System

2018 ◽  
Vol 77 (9) ◽  
pp. 1333-1338 ◽  
Author(s):  
Zachary S Wallace ◽  
Rachel Wallwork ◽  
Yuqing Zhang ◽  
Na Lu ◽  
Frank Cortazar ◽  
...  
Keyword(s):  
United States ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
End Stage Renal Disease ◽  
Granulomatosis With Polyangiitis ◽  
The United States ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage

BackgroundRenal transplantation is the optimal treatment for selected patients with end-stage renal disease (ESRD). However, the survival benefit of renal transplantation among patients with ESRD attributed to granulomatosis with polyangiitis (GPA) is unknown.MethodsWe identified patients from the United States Renal Data System with ESRD due to GPA (ESRD-GPA) between 1995 and 2014. We restricted our analysis to waitlisted subjects to evaluate the impact of transplantation on mortality. We followed patients until death or the end of follow-up. We compared the relative risk (RR) of all-cause and cause-specific mortality in patients who received a transplant versus non-transplanted patients using a pooled logistic regression model with transplantation as a time-varying exposure.ResultsDuring the study period, 1525 patients were waitlisted and 946 received a renal transplant. Receiving a renal transplant was associated with a 70% reduction in the risk of all-cause mortality in multivariable-adjusted analyses (RR=0.30, 95% CI 0.25 to 0.37), largely attributed to a 90% reduction in the risk of death due to cardiovascular disease (CVD) (RR=0.10, 95% 0.06–0.16).DiscussionRenal transplantation is associated with a significant decrease in all-cause mortality among patients with ESRD attributed to GPA, largely due to a decrease in the risk of death to CVD. Prompt referral for transplantation is critical to optimise outcomes for this patient population.

scholarly journals Emergency Department Use by Patients with End-stage Renal Disease in the United States

2020 ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Jian Zhao ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD vs. those without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits were ESRD patients. ED patients with ESRD were mostly non-Hispanic whites (51.5%) and males were more likely to be ESRD patients than females (aOR: 1.48; 95% CI: 1.47–1.48). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.22; 95% CI: 2.21–2.22) and intensive care unit (ICU) (aOR: 1.53; 95% CI: 1.52–1.54) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests, get medical imaging tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

scholarly journals Emergency Department Use by Patients With End-stage Renal Disease in the United States

2020 ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Jian Zhao ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD vs. those without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits were ESRD patients. ED patients with ESRD were mostly non-Hispanic whites (51.5%) and males were more likely to be ESRD patients than females (aOR: 1.48; 95% CI: 1.47–1.48). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.22; 95% CI: 2.21–2.22) and intensive care unit (ICU) (aOR: 1.53; 95% CI: 1.52–1.54) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests, get medical imaging tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

scholarly journals Emergency department use by patients with end-stage renal disease in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Anna Prushinskaya ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

AbstractBackgroundWe sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients.MethodsWe analyzed data from 2014 to 2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits.ResultsApproximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09–1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97–3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95–3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70; 95% CI: 2.13–3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45–3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests.ConclusionWe described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

scholarly journals Forecast of the Number of Patients with End-Stage Renal Disease in the United States to the Year 2010

2001 ◽  
Vol 12 (12) ◽  
pp. 2753-2758 ◽  
Author(s):  
Jay L. Xue ◽  
Jennie Z. Ma ◽  
Thomas A. Louis ◽  
Allan J. Collins
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Dialysis Patients ◽  
Forecasting Models ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

ABSTRACT. As the United States end-stage renal disease (ESRD) program enters the new millennium, the continued growth of the ESRD population poses a challenge for policy makers, health care providers, and financial planners. To assist in future planning for the ESRD program, the growth of patient numbers and Medicare costs was forecasted to the year 2010 by modeling of historical data from 1982 through 1997. A stepwise autoregressive method and exponential smoothing models were used. The forecasting models for ESRD patient numbers demonstrated mean errors of −0.03 to 1.03%, relative to the observed values. The model for Medicare payments demonstrated −0.12% mean error. The R2 values for the forecasting models ranged from 99.09 to 99.98%. On the basis of trends in patient numbers, this forecast projects average annual growth of the ESRD populations of approximately 4.1% for new patients, 6.4% for long-term ESRD patients, 7.1% for dialysis patients, 6.1% for patients with functioning transplants, and 8.2% for patients on waiting lists for transplants, as well as 7.7% for Medicare expenditures. The numbers of patients with ESRD in 2010 are forecasted to be 129,200 ± 7742 (95% confidence limits) new patients, 651,330 ± 15,874 long-term ESRD patients, 520,240 ± 25,609 dialysis patients, 178,806 ± 4349 patients with functioning transplants, and 95,550 ± 5478 patients on waiting lists. The forecasted Medicare expenditures are projected to increase to $28.3 ± 1.7 billion by 2010. These projections are subject to many factors that may alter the actual growth, compared with the historical patterns. They do, however, provide a basis for discussing the future growth of the ESRD program and how the ESRD community can meet the challenges ahead.

scholarly journals Emergent Dialysis and its Impact on Quality of Life in Undocumented Patients with End-Stage Renal Disease

2017 ◽  
Vol 27 (1) ◽  
pp. 39 ◽  
Author(s):  
Andrew N. Hogan ◽  
William R. Fox ◽  
Lynn P. Roppolo ◽  
Robert E. Suter
Keyword(s):  
Quality Of Life ◽  
United States ◽  
End Stage Renal Disease ◽  
The United States ◽  
Dialysis Patients ◽  
Study Population ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

<p class="Pa7"><strong>Objective: </strong>This study aimed to define the ethnographic composition and assess the health-related quality of life (HRQoL) of a large population of undocumented patients with end-stage renal disease (ESRD) seeking emergent dialysis in the emergency depart­ment (ED) of a large public hospital in the United States.</p><p class="Pa7"><strong>Design: </strong>All ESRD patients presenting to the hospital’s main ED were identified during a 4-week consecutive enrollment period. Consenting patients completed two surveys—an ethnographic questionnaire and the validated kidney disease quality of life-36 (KDQOL-36) instrument.</p><p class="Pa7"><strong>Setting: </strong>The study was conducted at a large county hospital in Dallas, Texas. In 2013, the hospital recorded &gt;50,000 ED visits and administered approximately 6,000 dialysis treatments to ED patients.</p><p class="Pa7"><strong>Participants: </strong>88 of 101 unfunded patients presenting to the ED during the study period consented to participate, resulting in an 87.1% response rate. 65 of these patients were undocumented immigrants.</p><p class="Pa7"><strong>Main Outcome Measures: </strong>Quantitative scores for the 5 subscales of the KDQOL-36 were calculated for the study population.</p><p class="Pa7"><strong>Results: </strong>Measures of physical and mental health in our study population were lower than those published for scheduled dialysis patients. 79.5% of our patients lost employ­ment due to their dialysis requirements. At least 71.4% of the study patients were unaware that they required dialysis before immigrating to the United States.</p><p class="Pa7"><strong>Conclusions: </strong>Quality of life scores were found to be low among our population of undocumented emergent dialysis patients. Our data also provide some evidence that availability of dialysis at no cost is not a primary driver of illegal immigration of ESRD patients to the United States.</p><p class="Pa7"><em>Ethn Dis. </em>2017;27(1):39-44; doi:10.18865/ed.27.1.39.</p>

scholarly journals Emergency Department Use by Patients with End-stage Renal Disease in the United States

2020 ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Anna Prushinskaya ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09–1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97 – 3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95–3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70 ; 95% CI: 2.13-3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45-3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

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