Abstract：
BACKGROUND:Previous studies on end-of-life (EOL) care among patients with chronic kidney disease (CKD) have been largely limited to White hemodialysis patients. In this study, we sought to explore racial variability in EOL communication, care preferences and advance care planning (ACP) among patients with advanced CKD prior to decisions regarding the initiation of dialysis. METHODS:We performed a cross-sectional study between 2013 and 2015 of Black and White patients with stage IV or V CKD (per the Modified Diet in Renal Disease estimation of GFR <30 ml/min/1.73 m2) from 2 academic centers in Boston. We assessed experiences with EOL communication, ACP, EOL care preferences, hospice knowledge, spiritual/religious and cultural beliefs, and distrust of providers. RESULTS:Among 152 participants, 41% were Black. Black patients were younger, had less education, and lower income than White patients (all p < 0.01). Black patients also had less knowledge of hospice compared to White patients (17 vs. 61%, p < 0.01). A small fraction of patients (8%) reported having EOL discussions with their nephrologists and the majority had no advance directives. In multivariable analyses, Blacks were more likely to have not communicated EOL preferences (adjusted OR 2.70, 95% CI 1.08-6.76) and more likely to prefer life-extending treatments (adjusted OR 3.06, 95% CI 1.23-7.60) versus Whites. CONCLUSIONS:As Black and White patients with advanced CKD differ in areas of EOL communication, preferences, and hospice knowledge, future efforts should aim to improve patient understanding and promote informed decision-making.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Eneanya ND,Wenger JB,Waite K,Crittenden S,Hazar DB,Volandes A,Temel JS,Thadhani R,Paasche-Orlow MKdoi
10.1159/000447097subject
Has Abstractpub_date
2016-01-01 00:00:00pages
46-53issue
1eissn
0250-8095issn
1421-9670pii
000447097journal_volume
44pub_type
杂志文章abstract：:Most pretransplant malignancies require a tumor-free waiting period before transplantation. End-stage renal disease (ESRD) patients have an increased risk of renal cell carcinoma (RCC), which is mostly detected from routine screening during pre-kidney transplant evaluation. RCC must be quiescent prior to kidney transp...
journal_title：American journal of nephrology
pub_type： 杂志文章,评审
doi：10.1159/000365201
更新日期：2014-01-01 00:00:00
abstract：:Left ventricular hypertrophy (LVH) is a common finding in hypertensive autosomal dominant polycystic kidney disease (ADPKD) patients. There are few studies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relationship between BP, hum...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000013583
更新日期：2000-05-01 00:00:00
abstract：BACKGROUND:2009 influenza A has spread globally. Respiratory complications and renal failure have been the leading causes for hospitalization and critical illness. We describe the risk factors and complications of acute kidney injury (AKI) in patients with influenza A. METHODS:Observational study of adult patients tes...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000328386
更新日期：2011-01-01 00:00:00
abstract：:A dramatic response was noted in a patient at our hospital who received hemodialysis therapy for severe acidosis secondary to an unknown toxin, subsequently identified as cyanide. We were unable to find any information concerning the hemodialysis clearance and extraction ratio of cyanide; thus, we studied the effect o...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000166918
更新日期：1985-01-01 00:00:00
abstract：:Investigations of biopsy material from human kidneys with different forms of glomerulonephritis (n = 1,240) and with diabetic glomerulosclerosis (n = 406) performed in order to find changes caused by hyperperfusion of the kidney tissue gave the following results: (1) Hyperperfusion injury occurs in the different forms...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000167579
更新日期：1988-01-01 00:00:00
abstract：:We report a 29-year-old female with recurrent focal glomerulosclerosis (FGS) presenting as heavy proteinuria immediately following renal transplantation. From day 13 after transplantation, daily plasma exchange was performed 6 times. Proteinuria decreased from 13 to 0.2 g/day after plasma exchange and remained to be l...
journal_title：American journal of nephrology
pub_type： 杂志文章,评审
doi：10.1159/000168637
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:To evaluate the predictive value of dialysate interleukin-6 (IL-6) representing local subclinical intraperitoneal inflammation for the development of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS:Stable prevalent CAPD patients were enrolled in this prospective study. IL-6...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000489271
更新日期：2018-01-01 00:00:00
abstract：:Maimonides (Moses ben Maimon) was born in 1135 in Cordoba, the son of a Jewish rabbi. After a seminomadic upbringing in Spain and North Africa during the rule of the Almohades, Maimonides settled in Fostate (Old Cairo), where he became renowned as a physician, eventually being appointed as court physician to Saladin a...
journal_title：American journal of nephrology
pub_type： 传,历史文章,杂志文章
doi：10.1159/000168739
更新日期：1994-01-01 00:00:00
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：: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：:This study was designed to evaluate beta-adrenergic responsiveness as assessed by the generation of cyclic AMP after the subcutaneous administration of epinephrine in 31 subjects: normal controls, patients with chronic renal insufficiency, hemodynamically stable patients on chronic acetate dialysis and hemodynamically...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000167985
更新日期：1989-01-01 00:00:00
abstract：:Shortage of kidney donor is still a major limitation for renal transplantation programs. This review focuses on the emerging practices, adopted to increase transplant activities, of expanding the criteria for donor and recipient selection without exposing the recipient to the drawbacks of a graft with inadequate nephr...
journal_title：American journal of nephrology
pub_type： 杂志文章,评审
doi：10.1159/000072055
更新日期：2003-07-01 00:00:00
abstract：BACKGROUND:Obesity is an independent risk factor for morbidity and mortality in cardiovascular diseases not only in the general population, but also in hemodialysis (HD) patients. We previously reported that an increased visceral fat area (VFA) determined using computed tomography (CT) scans was associated with atheros...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000358335
更新日期：2014-01-01 00:00:00
abstract：:A 50-year-old woman presented with thrombocytopenia, microangiopathic hemolytic anemia, and nephrotic syndrome. Although a high level of circulating immune complexes, mild hypocomplementemia, and the antinuclear antibody also were present, the criteria for collagen disease were not fulfilled. Renal biopsy demonstrated...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000013326
更新日期：1998-01-01 00:00:00
abstract：:Historically, stroke, heart failure and renal insufficiency were seen as the major complications of untreated hypertension. More recently, it has become evident that coronary heart disease is probably the most common outcome of this condition. Unlike the other complications of hypertension, coronary events have not be...
journal_title：American journal of nephrology
pub_type： 杂志文章,评审
doi：10.1159/000169000
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:The value of chronic kidney disease (CKD) screening in the general population remains unclear but may be beneficial in populations with high disease prevalence. We examined risk factors for albuminuria among participants in a state-wide CKD screening program in Hawaii. METHODS:The National Kidney Foundation...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000455389
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Elevated osteoprotegerin (OPG) levels are inversely correlated with creatinine clearance and end-stage renal disease in patients with diabetes, however its role in predicting decline in renal function and progression to a more advanced stage disease in the elderly general population is unknown. METHODS:This...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000357787
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Chronic kidney disease (CKD) impairs intestinal barrier function which by allowing influx of noxious products causes systemic inflammation. We have recently shown that intestinal barrier dysfunction in CKD is due to degradation of epithelial tight junction (TJ) which is, in part, mediated by influx of urea a...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000351171
更新日期：2013-01-01 00:00:00
abstract：:We report on a Mycobacterium marinum infection in a diabetic woman 8 years after undergoing a combined pancreas-kidney transplantation. This is, to our knowledge, the first case report on an isolated skin infection with atypical mycobacteria after simultaneous pancreas-kidney transplantation. A genetic probe categoriz...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000065271
更新日期：2002-09-01 00:00:00
abstract：:Autopsy reports on 155 successive end-stage renal disease (ESRD) patients and 147 control patients without ESRD, matched for age, race and gender, were collected. Cystic transformation of the kidneys was noted in 58% of the ESRD patients and 13.6% of the control patients. There were 25 ESRD patients with renal adenoma...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000167988
更新日期：1989-01-01 00:00:00
abstract：:Administration of a single dose of 1,25-OH(2)D(3) can lower PTH levels for up to 4 days in chronic hemodialysis patients. Our purpose was to verify the effects of the same weekly dose of calcitriol per os given in one, two or three administrations, to patients on dialysis with secondary hyperparathyroidism. Thirty pat...
journal_title：American journal of nephrology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1159/000046197
更新日期：2000-11-01 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：:Tuberculosis associated with dialysis was studied at the Artificial Kidney Unit (AKU) in Abha, Saudi Arabia. There were 13 tuberculosis patients out of 270 patients on maintenance hemodialysis from August 1986 to July 1993, a prevalence of 4.8%. Ten (77%) were female and 3 (23%) were male, mean age of 51.23 +/- 11.62 ...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000169068
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND:To promote understanding of immunoglobulin A nephropathy (IgAN) pathophysiology, we tried to elucidate glomerular protein profiles in IgAN, using microsieving that we established recently to isolate glomeruli from renal biopsy samples and proteomic approaches. METHODS:Glomeruli were isolated from renal biop...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000357788
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous p...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000358496
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Kidney failure is believed to have a negative impact on cognitive function, and cognitive impairment is common among maintenance hemodialysis (HD) patients. Previous studies have shown a beneficial effect of kidney transplantation in certain cognitive tests but not across all cognitive domains assessed. But,...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000330849
更新日期：2011-01-01 00:00:00
abstract：:To define the incidence of non-A, non-B (NANB) hepatitis and evaluate possible risk factors, we reviewed records of 163 patients on chronic dialysis during a 3-year period. 23 cases of NANB hepatitis occurred, 13 (27%) in 49 center dialysis, 8 (10%) in 77 home hemodialysis (p less than 0.02) and 2 (5%) in 37 peritonea...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000166815
更新日期：1984-01-01 00:00:00
abstract：:This study describes 10 cases of IgM nephropathy in whom the main morphological findings consisted of diffuse mesangial deposition of IgM and varying degrees of mesangial cell proliferation. In addition, focal segmental sclerosis was present in 1 patient and global sclerosis in another. An ill-defined electron-dense d...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000167485
更新日期：1987-01-01 00:00:00
abstract：:Thymoglobulin (Thymoglobulin®; Genzyme, Cambridge, Mass., USA) is a polyclonal antibody which has been used in the field of transplantation over the last four decades. With an initial hesitancy, it is widely used now in the prevention and treatment of rejection following renal transplantation. Thymoglobulin's lack of ...
journal_title：American journal of nephrology
pub_type： 杂志文章,评审
doi：10.1159/000351643
更新日期：2013-01-01 00:00:00
abstract：:A 22-year-old woman presented glomerulonephritis with Schönlein-Henoch-like syndrome and monoclonal abnormality. One month later, she developed a rapidly progressive glomerulonephritis with hypertension and persistent purpura. In the two renal biopsies performed during the first and the second attack, mesangial expans...
journal_title：American journal of nephrology
pub_type： 杂志文章
doi：10.1159/000168276
更新日期：1991-01-01 00:00:00
