Abstract:
BACKGROUND/AIMS:Chronic kidney disease (CKD) and serious mental illness (SMI) are both associated with an increased risk for repeated hospitalization. The objective of this study was to determine if co-occurring SMI exacerbates the risk for subsequent hospitalization, particularly through the emergency department (ED), among people with CKD. METHODS:People hospitalized in Washington State from April 2006 to December 2008 were separated into cohorts with diagnoses of CKD (n = 31,166), SMI (defined by schizophrenia and/or mood disorder; n = 20,167) or CKD with co-occurring SMI (n = 717), and a reference cohort without either diagnosis (n = 548,532). Main outcomes were rehospitalization for condition(s) other than mental illness: (1) through the ED; (2) any admission, and (3) admission resulting in death. Cox regression was used to analyze time to main outcomes controlling for prespecified covariates associated with rehospitalization. RESULTS:The risk of rehospitalization via the ED was increased for people with CKD (hazard ratio, HR = 1.24, 95% confidence interval, CI = 1.21-1.28, p < 0.001) and co-occurring SMI (HR = 1.33, 95% CI = 1.29-1.38, p < 0.001) cohorts, but was significantly greater in the combined cohort (HR = 1.55, 95% CI = 1.40-1.73, p < 0.001). Similarly, the risk of any rehospitalization was increased for CKD (HR = 1.21, 95% CI = 1.17-1.25, p < 0.001) and co-occurring SMI (HR = 1.14, 95% CI = 1.11-1.17, p < 0.001) cohorts, while a significantly greater risk was observed for the combined cohort (HR = 1.36, 95% CI = 1.24-1.48, p < 0.001). The risk of rehospitalization resulting in death was not significantly increased in the combined cohort. CONCLUSION:In people with CKD, co-occurring SMI increased the risk of experiencing rehospitalization, particularly through the ED. Studies of strategies to address SMI in the CKD population are needed to mitigate the risk of repeat hospital admissions.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
McPherson S,Barbosa-Leiker C,Daratha K,Short R,McDonell MG,Alicic R,Roll J,Tuttle Kdoi
10.1159/000360095subject
Has Abstractpub_date
2014-01-01 00:00:00pages
260-7issue
3eissn
0250-8095issn
1421-9670pii
000360095journal_volume
39pub_type
杂志文章abstract:BACKGROUND:To determine the association of vancomycin with acute kidney injury (AKI) in relation to its serum concentration value and to examine the risk of AKI in patients treated with vancomycin when compared with a matched cohort of patients receiving non-glycopeptide antibiotics (linezolid/daptomycin). METHODS:Fro...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000496484
更新日期:2019-01-01 00:00:00
abstract::The use of Dacron cuff double-lumen permanent catheters for hemodialysis has become more common in the dialysis unit as patients await for creation or maturation of a permanent hemoaccess for various reasons. Placement of these catheters is often done by surgeons. Nephrologists skilled in the placement of temporary ce...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013425
更新日期:1999-01-01 00:00:00
abstract::An 18-year-old woman complained of fever and edema and was admitted to Showa University Hospital for treatment of thrombocytopenia and deteriorating renal function. Laboratory studies demonstrated the presence of lupus anticoagulant (LA), prolongation of prothrombin time, hemolytic anemia, a negative Coombs' test, the...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013526
更新日期:1999-01-01 00:00:00
abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:The optimal level of serum ferritin (s-ft) for anemia control and good survival in hemodialysis (HD) patients remains unclear. A 10-year survey was performed to clarify the appropriate quantities of s-ft and investigate the relationships among s-ft, transferrin saturation (TSAT), and mortality in HD patients...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000370317
更新日期:2014-01-01 00:00:00
abstract::We studied plasma, dialysate, and muscle carnitine levels in patients with stable chronic renal failure on hemodialysis, and intermittent peritoneal, or continuous ambulatory peritoneal dialysis (CAPD). In patients on hemodialysis, plasma carnitine levels fell from 46.2 +/- 4.5 mumol/l (mean +/- SEM) to 18.8 +/- 2.7 m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166711
更新日期:1983-07-01 00:00:00
abstract::The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the co...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168491
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Dietary sodium may influence cognitive function through its effects on cerebrovascular function and cerebral blood flow. METHODS:The aim of this study was to evaluate the association of dietary sodium intake with cognitive decline in community-dwelling older adults. We also evaluated the associations of die...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000486580
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is evidence that hereditary predisposition contributes to the development of diabetic nephropathy and hypertension. Polymorphisms in the genes for bradykinin receptors (B(1)R and B(2)R) were found to be associated with decreased risk of the development of end-stage renal disease. This study examin...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000068035
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND/AIMS:Recent retrospective studies suggest an association of therapy with erythropoiesis-stimulating agents (ESAs) and increased mortality in renal transplant recipients (RTR). Large artery structure and function are significantly impaired in RTR which contributes to their high cardiovascular morbidity and co...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000343140
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Clinical indicators for accurately distinguishing diabetic nephropathy (DN) from non-diabetic renal disease in type 2 diabetes (T2D) are lacking. This study aimed to develop and validate a nomogram for predicting DN in T2D patients with kidney disease. METHODS:A total of 302 consecutive patients with T2D wh...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000505145
更新日期:2020-01-01 00:00:00
abstract::A national sample of dialysis physicians was used to obtain data for a comparison of patient characteristics, comorbid conditions and treatment patterns associated with the five leading causes of end-stage renal disease (ESRD). The data are used to assess trends in physician care for ESRD patients and likely changes i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167949
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Adherence is paramount in treating hypertension; however, no gold standard method is available for non-adherence screening, delineating high-risk patients. An International Classification of Diseases 9th Edition non-adherence diagnostic code (V15.81) has been available for decades; but, its utility is poorly...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000440685
更新日期:2015-01-01 00:00:00
abstract::We have demonstrated considerable variability in the volumes of different glomeruli in given individuals (individual glomerular volume: IGV) in a stereologic study of kidneys at forensic autopsy performed to investigate sudden or unexpected death in people without manifest kidney disease. We review some important asso...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000327044
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Almost 20 million people in the US have chronic kidney disease (CKD). Cardiovascular disease and arterial wall abnormalities are common in this population. Because angiotensin II may have adverse effects on the arterial wall, we hypothesized that an angiotensin receptor blocker (ARB) would improve arterial c...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000087211
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Transplant glomerulopathy (TG) represents a major cause of long-term allograft failure and is the leading cause of overall post-transplant proteinuria. The extent to which histopathologic features predicts prognostication is uncertain. METHODS:A single-center retrospective cohort with biopsy-proven TG was i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000500043
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Tacrolimus is mainly metabolized by cytochrome P450 3A5 (CYP3A5), which is expressed in the liver. However, CYP3A5 is also expressed in the kidney tissue and may contribute to local tacrolimus clearance in the kidney allograft. We aimed to evaluate the association between the allograft CYP3A5 genotype and tr...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487857
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Insufficient evidenced-based information is available for the treatment of osteoporosis in hemodialysis (HD) patients. METHODS:In 102 HD patients, bone mineral density (BMD) was measured twice 16 ± 3 months apart. In the second BMD measurement 66 of them had a femoral neck (FN) T-score <-2.5. Of these 66 pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341864
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski's histological score o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000346257
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:In the US, native kidney biopsies are usually inpatient procedures. We developed an outpatient biopsy protocol for low-risk patients and assessed its safety and efficacy. METHODS:Patients with an SBP <140 mm Hg and a BMI ≤35 who were not taking anticoagulants, ASA and NSAIDS in the preceding week were inclu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000337359
更新日期:2012-01-01 00:00:00
abstract::This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013316
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cisplatin (CIS) induces nephrotoxicity partly through renal vasoconstriction and decreased glomerular filtration effects thought to involve adenosine acting on adenosine A(1) receptors (A1Rs). We studied the effect of the orally active, A1R antagonist tonapofylline (BG9928) on biochemical measures of re...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000248762
更新日期:2009-01-01 00:00:00
abstract::To determine the prevalence and type of glomerulonephritis (GN) associated with hepatitis C virus (HCV) cirrhosis, we prospectively evaluated 28 consecutive Saudi patients with HCV cirrhosis for liver transplantation. Six patients (21%) underwent kidney biopsies for proteinuria, unexplained elevated serum creatinine o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168874
更新日期:1995-01-01 00:00:00
abstract::The number of patients with end-stage renal disease undergoing kidney transplantation - both cadaveric and living-donor - continues to rise. With long-term graft survival relatively fixed, this trend means that increasing numbers of patients are returning to dialysis after graft loss. Most will never be retransplanted...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000342626
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Vitamin D deficiency, sympathetic activation and endothelial dysfunction are associated with increased cardiovascular risk in patients with chronic kidney disease (CKD). Studies have so far failed to establish the role of vitamin D and vitamin D receptor activator (VDRA) treatment in moderate CKD. This trial...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000441364
更新日期:2015-01-01 00:00:00
abstract::Glomerulosclerosis frequently complicates most renal diseases and is characterized by mesangial matrix accumulation. Oxidized low-density lipoprotein (Ox-LDL) could induce oxidative stress and profibrotic gene expression in mesangial cells. This article will review our current understanding of the pathogenetic mechani...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000151277
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cystic epithelia in polycystic kidney disease display features similar to malignant cells. Thiazolidinediones have been shown to have anti-neoplastic properties, therefore we tested the hypothesis that pioglitazone reduces cyst formation, improves renal function, and prolongs survival in a mouse model o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000242432
更新日期:2009-01-01 00:00:00
abstract::In general, nonrheumatic atrial fibrillation is associated with a high risk of stroke. However, its impact on stroke in the setting of chronic hemodialysis treatment is insufficiently addressed in the literature. We assessed the incidence of stroke among 430 chronic hemodialysis patients and the impact of atrial fibri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046216
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Older adults with advanced non-dialysis-dependent chronic kidney disease (NDD-CKD) face a high risk of hospitalization and related adverse events. METHODS:This prospective cohort study followed nephrology clinic patients ≥60 years old with NDD-CKD stages 4-5. After an eligible patient's office visit, study ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000509046
更新日期:2020-01-01 00:00:00
abstract:AIM:To develop and assess a semiautomated method for segmenting and counting individual renal cysts from mid-slice MR images in patients with autosomal dominant polycystic kidney disease (ADPKD). METHODS:A semiautomated method was developed to segment and count individual renal cysts from mid-slice MR images in 241 su...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000358604
更新日期:2014-01-01 00:00:00