Examining the Role of Caregiver towards Blood Transfusion Decisions Among Individuals with Chronic Kidney Disease

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4760-4760
Author(s):  
Ahmad B Naim ◽  
Danielle Walls ◽  
Jan Gollins ◽  
Chuck Reynolds
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Transfusion ◽  
Treatment Decision ◽  
The United States ◽  
Treatment Decisions ◽  
Daily Basis ◽  
Caregiver Support ◽  
Patient Consent ◽  
The Right

Abstract Abstract 4760 Objective: Examine the roles of a caregiver in supporting treatment decisions towards blood transfusions among individuals with chronic kidney disease (CKD) currently not on dialysis. Methods: An online survey was conducted from a nationally representative patient panel in 1Q2011. All respondents consented to participate through informed consent. IRB review was sought through Western Institutional Review Board (WIRB). Respondents were aged ≥18 years, living in the United States, and diagnosed with CKD by a physician. Eligible participants have stage 3 or 4 CKD and not currently undergoing dialysis treatment and have health insurance. Participants were asked about blood transfusion history, presence of anemia, types of caregivers, and roles of the caregiver in assisting with management of their CKD and making health and treatment decisions towards blood transfusion. Informed patient consent was provided Results: A total of 416 individuals responded to the survey. 59% (n=246) were female; 40% (n=165) were >65 years. 35% (n=144) had stage 4 and 58% (n=240) stage 3 CKD. 53% were insured by Medicare, 49% were insured under a commercial PPO plan, and 3% had various other types of commercial insurance coverage. 54% (n=226) were anemic. 43% (n=179) had received blood transfusion, whereas, 57% (n=237) had no transfusions. Among all respondents (n=416), over half (53%, n=220) reported that no one helps them with their daily activities, over one-third (36%, n=150) said that their spouse helps them, followed by child (9%, n=37), friend (7%, n=29), another relative (5%, n=21), parent (3%, n=12), paid helper (3%, n=12), a visiting doctor or nurse (3%, n=12). Among those who seek caregiver help (n=195), two-thirds (64%) reported being cared for by their spouse, 42% said they seek help from a friend, and 21% get care from their child on a daily basis. When asked about how often someone helps with making health and medical care decision, 86% reported that their spouse helps them, followed by friend (51%), and child (46%) always or sometimes. Almost two-thirds (63%) indicated that they have the right amount of caregiver support in making the treatment choice for a blood transfusion and 61% reported that they made an informed decision, whereas, 40% said that they feel pressured by others to make the decision. Furthermore, a higher percentage (74%) of previously transfused individuals agreed that they have the right amount of caregiver support in making a transfusion choice as compared to the not transfused group (55%). Among previously transfused, only 50% indicated they shared in treatment decision with their doctor, whereas 40% indicated their doctor or someone else had made the decision for them. Among those who indicated someone else made the decision, 82% indicated that they like to make a shared decision. Among not transfused, over 75% would like to share decision to have blood transfusion with their doctor. Conclusions: Caregivers play an important role in helping individuals with their health and medical treatment decision. Spouse, child, and friend are the main types of caregivers providing care on a daily basis. Furthermore, caregivers play a major role in providing health and treatment decision support. Visiting doctors and nurses are also sought as caregivers to a lesser extent. A significant number feel that they feel pressured into making treatment decisions towards blood transfusion. Disclosures: Naim: Janssen Scientific Affairs, LLC: Employment. Walls:Janssen Scientific Affairs, LLC: Consultancy. Gollins:Janssen Scientific Affairs, LLC: Consultancy. Reynolds:Janssen Scientific Affairs, LLC: Consultancy.

scholarly journals Vanderbilt O'Brien Kidney Center

2020 ◽  
Author(s):  
Ambra Pozzi ◽  
Raymond C Harris
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Scientific Community ◽  
State Of The Art ◽  
Kidney Diseases ◽  
The United States ◽  
Outreach Program ◽  
Personalized Care ◽  
Education And Outreach ◽  
The Right

The Vanderbilt O'Brien Kidney Center (VOKC) is one of the eight NDDK-P30 funded Centers in the United States. The mission of these core-based Centers is to provide technical and conceptual support to enhance and facilitate research in the field of kidney diseases. The goal of the VOKC is to provide support to understand mechanisms and identify potential therapies for acute and chronic kidney disease. The services provided by the VOKC are meant to help the scientific community to have the right support and tools as well as to select the right animal model, statistical analysis, and clinical study design to perform innovative research and translate discoveries into personalized care to prevent, diagnose and cure kidney disease. To achieve these goals, the VCKD has in place a program to foster collaborative investigation into critical questions of kidney disease; to personalize diagnosis and treatment of kidney disease; and to disseminate information about kidney disease and the benefits of the VOKC services and research. The Center is complemented by state-of-the art Cores and an Education and Outreach program whose goals are to provide an educational platform to enhance the study of kidney disease; to publicize information about services available through the VOKC; and to provide information about kidney disease to patients and other interested members of the community. In this review we highlight the major services and contributions of the VOKC.

scholarly journals Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Health And Retirement Study ◽  
Disease Epidemiology ◽  
Lower Egfr ◽  
Everyday Discrimination ◽  
Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p < .05), and while attenuated, remained significant (B = −0.79, p < .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

scholarly journals Sickle Cell Trait and Renal Function in Hispanics in the United States: the Northern Manhattan Study

2017 ◽  
Vol 27 (1) ◽  
pp. 11 ◽  
Author(s):  
Nicole D. Dueker ◽  
David Della-Morte ◽  
Tatjana Rundek ◽  
Ralph L. Sacco ◽  
Susan H. Blanton
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
African Americans ◽  
Kidney Disease ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
The United States ◽  
Genetic Mutation ◽  
Single Mutation ◽  
Increased Risk

<p class="Pa7">Sickle cell anemia (SCA) is a common hematological disorder among individu­als of African descent in the United States; the disorder results in the production of abnormal hemoglobin. It is caused by homozygosity for a genetic mutation in HBB; rs334. While the presence of a single mutation (sickle cell trait, SCT) has long been considered a benign trait, recent research suggests that SCT is associated with renal dysfunction, including a decrease in estimated glomerular filtration rate (eGFR) and increased risk of chronic kidney disease (CKD) in African Americans. It is currently unknown whether similar associations are observed in Hispanics. Therefore, our study aimed to determine if SCT is associated with mean eGFR and CKD in a sample of 340 Dominican Hispanics from the Northern Manhattan Study. Using regression analyses, we tested rs334 for association with eGFR and CKD, adjusting for age and sex. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equa­tion and CKD was defined as eGFR &lt; 60 mL/min/1.73 m2. Within our sample, there were 16 individuals with SCT (SCT carriers). We found that SCT carriers had a mean eGFR that was 12.12 mL/min/1.73m2 lower than non-carriers (P=.002). Additionally, SCT carriers had 2.72 times higher odds of CKD compared with non-carriers (P=.09). Taken together, these novel results show that Hispanics with SCT, as found among African Americans with SCT, may also be at increased risk for kidney disease.</p><p class="Pa7"><em>Ethn Dis. </em>2017; 27(1)<strong>:</strong>11-14; doi:10.18865/ed.27.1.11.</p><p class="Pa7"> </p>

SHARP: a stab in the right direction in chronic kidney disease

The Lancet ◽  
2011 ◽  
Vol 377 (9784) ◽  
pp. 2153-2154 ◽  
Author(s):  
Kathryn K Stevens ◽  
Alan G Jardine
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Right

scholarly journals Trends in anemia care in non-dialysis-dependent chronic kidney disease (CKD) patients in the United States (2006–2015)

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Haesuk Park ◽  
Xinyue Liu ◽  
Linda Henry ◽  
Jeffrey Harman ◽  
Edward A. Ross
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The United States

scholarly journals Telomere attrition, kidney function, and prevalent chronic kidney disease in the United States

Oncotarget ◽  
2017 ◽  
Vol 8 (46) ◽  
pp. 80175-80181 ◽  
Author(s):  
Moshen Mazidi ◽  
Peyman Rezaie ◽  
Adriac Covic ◽  
Jolanta Malyszko ◽  
Jacek Rysz ◽  
...  
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Telomere Attrition

Visual Acuity, Intraocular Pressure, and Macular Thickness in Patients Undergoing Dialysis

2021 ◽  
Vol 19 (6) ◽  
pp. 98-106
Author(s):  
Monawar Muhsin Jabr ◽  
Hussain S. Hasan ◽  
Hind Ahmed Mahdi
Keyword(s):  
Chronic Kidney Disease ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Standard Deviation ◽  
Kidney Disease ◽  
Refractive Error ◽  
Average Thickness ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
The Right

Background: Chronic kidney disease (CKD) is a public health problem over all the world. CKD may also be defined by the presence of kidney damage or a reduced glomerular filtration rate (GFR), which is the best overall indicator or index of kidney function. CKD patients are usually treated using kidney dialysis (hemodialysis) that uses a blood filtration mechanism (HD). Several metabolic parameters, such as blood urea, sodium, potassium, and glucose levels, can alter during HD. Osmotic alterations in blood, aqueous and vitreous humor, and other extracellular fluids arise from these fluctuations. That also can affect visual acuity, intraocular pressure (IOP), and retinal thickness. Aim of the Study: To evaluate some of the ocular findings undergoing HD to keep prevent the loss of patient vision such as visual acuity (VA), intraocular pressure (IOP), central corneal thickness (CCT), central Foveal Thickness (CFT), retinal nerve fiber layer (RNFL). Patient& Methods: This is a cohort (prospective) design study. This study including Seventy nine patients divided into two groups the first group from one week to six month (9 femal & 18 males) another group over than six month (36 female & 16 male) the average age between (12 to 70 years). This research performed in the three places department of the eye in Al-Hussein hospital in Samawah city, Al-Haboby hospital, Al-Hussein hospital in Dhi Qar city finally in Al-Shaheed Gazy hospital and Baghdad teaching hospital in Baghdad. Examining Visual Acuity by Snellen chart & auto refractometer, IOP& CCT by (CT.1 Computerized Tonometer TOPCON), RNLF and Central Foveal Thickness by OCT (Carl ZEISS, TOPCON). The inclusion criteria were as follows: all the patients undergoing dialysis from one week to over six months. Exclusion criteria were as follows: the patients have diabetic, any patients have a hereditary disease or glaucoma history or laser therapy, or intraocular injection in the eye before dialysis, the patients have a problem in the eye before dialysis such as cataracts or opacity leads to does surgery, the patients who have a refractive error or wear glass had been also excluded. Result: Includes the results of seventy-nine patients (45 females and 34 males) with chronic kidney disease examined ocular findings before a session of dialysis divided into two groups based on their duration of dialysis. Group one with twenty-seven patients (9 female & 18 male) under dialysis from one week to six months with mean & standard deviation (3.2037, ± 1.89259), group tow with fifty tow patients (36 female & 16 male) under dialysis from the duration over than six months with mean & standard deviation (44.2308, ± 26.24367) respectively. Patients aged (12 to 70 years) had mean age & ± standard deviation (35.1481, ± 12.88918), (44.4038, ± 15.42249) for two groups respectively. Patients in two groups had IOP (Right eye), its mean & standard deviation (15, ± 2.34), (15.69, ± 2.56) for group one & group tow respectively. Also, patients had CCT (Right eye) with mean & standard deviation (5.3467E2, ± 39.00296), (5.2312E2, ± 30.44162) for group one & group tow respectively. Patients had CCT (Left) with mean & standard deviation (5.2878E2, ± 37.55748), (5.2179E2, ± 29.58957) for group one & group tow respectively. Patients in two groups had average thickness RNFL (Right eye) with mean & standard deviation (1.0604E2, ± 25.17551), (95.6154, ± 21.27150) for group one & group tow respectively. Also, patients had average thickness RNFL (left eye) with mean & standard deviation (1.0930E2, ±23.80177), (98.7500, ± 23.77334) for group one & group tow respectively. Conclusions: This study found CCT effective with dialysis tend to be thin (53 patient,18 patient in group one &35 in group two) and that will be had a threefold higher risk of developing glaucoma when compared with thick average because of the IOP value affected by it. Refractive error effective with dialysis & become was more prominent that can be shown in the group two have (40 patient from 52) while (15 patient from27) in the group one although a lot of them corrected to the BCVA. In conclusion high value of the C/D ratio formed about (45.57%, 53.16%) to the right &left eye respectively this value will be form important sign of risk factor to progressive of glaucomatous need to be alert in the future. Also our research reveals CFT effective undergoing dialysis the thick value was (56 in the right eye, 55 in the left eye) high compared with the thin (9 in the right&9 in the left eye) & normal (14 in the right eye, 15 in the left eye). All the two groups of patients will be effected by the duration of dialysis with a time.

Sign in / Sign up

Export Citation Format

Share Document