Conversion from Intravenous Vitamin D Analogs to Oral Calcitriol in Patients Receiving Maintenance Hemodialysis

Background and objectivesIn the United States, intravenous vitamin D analogs are the first-line therapy for management of secondary hyperparathyroidism in hemodialysis patients. Outside the United States, oral calcitriol (1,25-dihydroxyvitamin D3) is routinely used. We examined standard laboratory parameters of patients on in-center hemodialysis receiving intravenous vitamin D who switched to oral calcitriol.Design, setting, participants, & measurementsWe conducted a retrospective cohort study of adult patients treated within Fresenius Kidney Care clinics. During a 6-month period (December 2013 to May 2014), we identified patients on an intravenous vitamin D analog (doxercalciferol or paricalcitol) who switched to oral calcitriol and matched them to patients receiving an intravenous vitamin D analog. Mean serum calcium, phosphate, and intact parathyroid hormone (iPTH) concentrations were examined for up to 12 months of follow-up. We used Poisson and Cox proportional hazards regression models to examine hospitalization and survival rates. The primary analysis was conducted as intention-to-treat; secondary analyses included an as-treated evaluation.ResultsA total of 2280 patients who switched to oral calcitriol were matched to 2280 patients receiving intravenous vitamin D. Compared with patients on intravenous vitamin D, mean calcium and phosphate levels in the oral calcitriol group were lower after the change to oral calcitriol. In contrast, iPTH levels were higher in the oral calcitriol group. At 12 months, the percentage of patients with composite laboratories in target range (calcium <10 mg/dl, phosphate 3.0–5.5 mg/dl, and iPTH 150–600 pg/ml) were comparable between groups (45% versus 45%; P=0.96). Hospital admissions, length of hospital stay, and survival were comparable between groups. An as-treated analysis and excluding those receiving cinacalcet did not reveal significant between-group differences.ConclusionsAmong patients receiving in-center hemodialysis who were switched to oral calcitriol versus those on an intravenous vitamin D analog, the aggregate of all mineral and bone laboratory parameters in range was largely similar between groups.

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Trends and Variations in Intravenous Vitamin D Use among Hemodialysis Patients in the United States

Renal Failure ◽

10.3109/0886022x.2012.734260 ◽

2012 ◽

Vol 35 (1) ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Anne C. Beaubrun ◽

M. Alan Brookhart ◽

Betsy Sleath ◽

Lily Wang ◽

Abhijit V. Kshirsagar

Keyword(s):

United States ◽

Vitamin D ◽

The United States ◽

Hemodialysis Patients ◽

Intravenous Vitamin

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Risk of Osteoarthritis is Positively Associated with Vitamin D Status, but Not Bone Mineral Density, in Older Adults in the United States

Journal of the American College of Nutrition ◽

10.1080/07315724.2020.1787907 ◽

2021 ◽

pp. 1-9

Author(s):

Hansaem Park ◽

Clara Yongjoo Park

Keyword(s):

United States ◽

Bone Mineral Density ◽

Older Adults ◽

Vitamin D ◽

Bone Mineral ◽

The United States ◽

Vitamin D Status ◽

Mineral Density

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VITAMIN D INTAKE IN THE UNITED STATES

Journal of the American Dietetic Association ◽

10.1016/s0002-8223(08)70036-1 ◽

2003 ◽

Vol 103 ◽

pp. 23 ◽

Cited By ~ 1

Author(s):

Carolyn E. Moore ◽

Mary M. Murphy ◽

Debra R. Keast

Keyword(s):

United States ◽

Vitamin D ◽

The United States ◽

Vitamin D Intake

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Impact of alcohol and drug use on bicycle and electric scooter injuries and hospital admissions in the United States

Trauma ◽

10.1177/14604086211044353 ◽

2021 ◽

pp. 146040862110443

Author(s):

Nikan K Namiri ◽

Austin W Lee ◽

Gregory M Amend ◽

Jason Vargo ◽

Benjamin N Breyer

Keyword(s):

United States ◽

Drug Use ◽

Head Trauma ◽

Hospital Admissions ◽

Body Part ◽

The United States ◽

Severe Injuries ◽

Injury Surveillance System ◽

Alcohol And Drug Use ◽

Awareness Campaigns

Introduction Bicycles and electric scooters (e-scooters) are convenient and accessible means of transportation. Participant safety is contingent on available infrastructure and safe riding practices including not riding while intoxicated. Understanding national prevalence and injury characteristics of bicycle and e-scooter riders who ride while intoxicated may promote awareness campaigns for safe riding practices and decrease morbidity. Methods The National Electronic Injury Surveillance System (NEISS) provides national estimates of injuries that present to emergency departments across the United States. We obtained case information on admitting status, body part injured, diagnosis of injury, age, sex, alcohol usage, and drug usage. We then queried NEISS for injuries related to bicycles and e-scooters in 2019. Results A weighted total of 270,571 (95% confidence interval (CI): 204,517–336,625) bicycle injuries occurred in the United States during 2019; alcohol and drug use were associated with 7% (95% CI: 6–9) and 2% (95% CI: 2–3) of all injuries, respectively. Twenty-four percent (CI: 18--31) of alcohol- and 29% (95% CI: 20–41) of drug-related bicycle injuries resulted in hospital admissions, compared to 15% (95% CI: 12–17) of non–alcohol- and 15% (95% CI: 13–18) of non–drug-related injuries ( p < .001 and p = .002, respectively). A total of 28,702 (95% CI: 13,975–43,428) e-scooter injuries occurred in 2019; alcohol and drug use were associated with 8% (95% CI: 5–12) and 1% (95% CI: 1–2) of injuries, respectively. Sixty percent (95% CI: 47–72) of alcohol-related e-scooter injuries resulted in head trauma, compared to 28% (95% CI: 24–32) of non–alcohol-related injuries ( p < .001). Conclusions Intoxication is associated with increasingly severe injuries, hospital admissions, and head trauma in bicycle and e-scooter riders. The findings support awareness campaigns to educate riders about risky practices, improve non-auto infrastructure, and promote helmet usage.

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Role of Image-Guided Percutaneous Drainage in Pancreatic Collections

Digestive Disease Interventions ◽

10.1055/s-0038-1655772 ◽

2018 ◽

Vol 02 (02) ◽

pp. 125-130

Author(s):

Katayoun Samadi ◽

Ronald Arellano

Keyword(s):

United States ◽

Acute Pancreatitis ◽

Percutaneous Drainage ◽

Hospital Admissions ◽

Disease Process ◽

The United States ◽

Morbidity And Mortality ◽

Image Guided ◽

Gastrointestinal Conditions

AbstractAcute pancreatitis is one of the major gastrointestinal conditions that lead to around 300,000 hospital admissions per year in the United States. While mild inflammation of the pancreas is often managed conservatively, progression of the disease process to necrosis significantly increases the overall morbidity and mortality and often requires surgical or other interventional techniques for management. The purpose of this review is to describe the role of percutaneous drainage for the management of complicated pancreatitis.

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Air Pollution Increases Influenza Hospitalizations

10.1101/2020.04.07.20057216 ◽

2020 ◽

Cited By ~ 2

Author(s):

Gregor Singer ◽

Joshua Graff Zivin ◽

Matthew Neidell ◽

Nicholas Sanders

Keyword(s):

United States ◽

Air Pollution ◽

Air Quality ◽

Seasonal Influenza ◽

Hospital Admissions ◽

The United States ◽

Inpatient Hospitalization ◽

Vaccination Rates ◽

Health Burden ◽

Severe Influenza

AbstractSeasonal influenza is a recurring health burden shared widely across the globe. We study whether air quality affects the occurrence of severe influenza cases that require inpatient hospitalization. Using longitudinal information on local air quality and hospital admissions across the United States, we find that poor air quality increases the incidence of significant influenza hospital admissions. Effects diminish in years with greater influenza vaccine effectiveness. Apart from increasing vaccination rates, improving air quality may help reduce the spread and severity of influenza.

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COVID-19 Incidence and Hospitalization Rates are Inversely Related to Vaccination Coverage Among the 112 Most Populous Counties in the United States

10.1101/2021.08.17.21262195 ◽

2021 ◽

Author(s):

Jeffrey E. Harris

Keyword(s):

United States ◽

Vaccination Coverage ◽

Hospital Admissions ◽

The United States ◽

Lower Half ◽

Linear Regression Models ◽

Percentage Point Increase ◽

Hospitalization Rates ◽

Point Increase ◽

Log Linear

AbstractWe tested whether COVID-19 incidence and hospitalization rates were inversely related to vaccination coverage among the 112 most populous counties in the United States, each with a population exceeding 600,000. We measured vaccination coverage as the percent of the total population fully vaccinated as of July 15, 2021, with the exception of 11 Texas counties, where the cutoff date was July 14, 2021. We measured COVID-19 incidence as the number of confirmed cases per 100,000 population during the 14-day period ending August 12, 2021. We measured hospitalization rates as the number of confirmed COVID-19 admissions per 100,000 population during the same 14-day period. COVID-19 incidence was significantly higher among counties in the lower half of the distribution of vaccination coverage (incidence 543.8 per 100,000 among 56 counties with mean coverage 42.61%) than among counties in the lower half of the distribution of coverage (incidence 280.7 per 100,000 among 56 counties with mean coverage 57.37%, p < 0.0001). Hospital admissions were also significantly higher among counties in the lower half of the distribution (55.37 per 100,000) than in the upper half of the distribution (20.48 per 100,000, p < 0.0001). In log-linear regression models, a 10-percentage-point increase in vaccination coverage was associated with a 28.3% decrease in COVID-19 incidence (95% confidence interval, 16.8 – 39.7%), a 44.9 percent increase in the rate of COVID-19 hospitalization (95% CI, 28.8 – 61.0%), and a 16.6% decrease in COVID-19 hospitalizations per 100 cases (95% CI, 8.4 – 24.8%). Higher vaccination coverage is associated not only with significantly lower COVID-19 incidence, but also significantly less severe cases of the disease.

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Acute Coronary Syndromes

The Brigham Intensive Review of Internal Medicine ◽

10.1093/med/9780199358274.003.0078 ◽

2014 ◽

pp. 806-818

Author(s):

Susan Cheng ◽

Marc S. Sabatine

Keyword(s):

United States ◽

Recurrent Events ◽

Hospital Admissions ◽

The United States ◽

Threatening Condition ◽

Life Threatening ◽

Coronary Syndromes ◽

Artery Disease ◽

Ventricular Dysrhythmias ◽

Key Aspects

In total, ACS presentations account for over 2 million annual hospital admissions in the United States. Almost 1.4 million people suffer an ACS each year, of which 55% are new events, 31% are recurrent events, and 14% are silent events. Of all diagnosed MIs, approximately 30% are STEMI and 70% are NSTE-ACS events. Despite recent declines in associated mortality, coronary artery disease causes one out of every five deaths in the United States. Notably, half of MI-related deaths occur within the first hour, primarily due to ventricular dysrhythmias. Therefore, the presentation of ACS challenges the clinician to rapidly integrate key aspects of the history, physical examination, and diagnostic tests in order to diagnose correctly and manage effectively this potentially life-threatening condition.

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