For many of us, work is a necessary and vital part of our lives. The development and/or progression of chronic illness can make it difficult or impossible to work, which can impact finances, social roles and relationships, and notions of self-worth. In their 1978 essay entitled “The social and economic costs of end-stage renal disease,”1 James and Anne Campbell describe the substantial toll that James’ kidney failure took on the couple’s finances and careers along with the large amount of hidden work involved in accessing public assistance.
Category: American Journal of Kidney Diseases
American Journal of Kidney Diseases
Staphylococcus aureus Bacteremia Among Patients Receiving Maintenance Hemodialysis: Trends in Clinical Characteristics and Outcomes
Staphylococcus aureus bacteremia (SAB) is a leading cause of morbidity and mortality in patients with kidney failure on hemodialysis. Clinical characteristics and characteristics of the Staphylococcus aureus isolates have changed over time, but it is unknown how these changes have affected patient outcomes. In this study, we examined these changing characteristics and their associations with clinical outcomes among 453 hemodialysis-dependent patients hospitalized with SAB over a period of 21 years. The most common suspected sources of infection changed over time. Additionally, virulent strains of Staphylococcus aureus became more prevalent. These changes were associated with worse outcomes, including SAB-attributable mortality, persistent...
Developing an AKI Consensus Definition for Database Research: Findings From a Scoping Review and Expert Opinion Using a Delphi Process
The KDIGO definition of AKI is used in both clinical practice and in research. Our scoping review demonstrated that there is a wide variation of practice in how this definition is applied and also a lack of transparency about how researchers applied it. An international panel of experts in AKI was formed in an attempt to achieve consensus on how this definition should be applied. They participated in a Delphi process and while they were able to agree on some aspects of how the definition should be implemented, there were many areas in which no agreement could be reached. We...
Stratification of chronic kidney disease (CKD) patients at risk for progressing to end-stage kidney disease (ESKD) requiring kidney replacement therapy (KRT) is important for clinical decision-making and trial enrollment.
Upper Reference Limits for High-Sensitivity Cardiac Troponin T and N-Terminal Fragment of the Prohormone Brain Natriuretic Peptide in Patients With CKD
The cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hsTnT) are frequently used clinically to evaluate patients for suspected acute heart failure or myocardial infarction. However, the utility of conventional upper reference limits (URL) for NT-proBNP) and hsTnT in chronic kidney disease (CKD) remains debated. We analyzed the distribution of hsTnT and NT-proBNP in ambulatory CKD participants to examine how conventional URL apply to this population. In this ambulatory CKD population with no self-reported history of CVD, we found that the majority of participants had concentrations of NT-proBNP and hsTnT above conventional URL. Developing thresholds...