Abstract:
BACKGROUND:Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescription trend for P2Y12i remains unclear. METHODS:Using national VA corporate warehouse data, we used International Classification of Diseases-9 codes to identify Veterans with CKD, dialysis-dependent CKD, and CV events. VA pharmacy data were used to count P2Y12i prescriptions for the federal fiscal years (FY) 2011 through 2015. RESULTS:The period prevalence of Veterans with CKD was 378,233 (6.1%). The point prevalence of CKD increased by 49% from 132,979 (2.30%) in FY11 to 213,444 (3.42%) in FY15. The period prevalence of Veterans with dialysis-dependent CKD was 150,298 (2.4%). In all, 128,703 (56.7%) CV events occurred in Veterans with CKD. Veterans with CKD were given 50.1% of prescriptions for clopidogrel, 49.3% for prasugrel, and 60.4% for ticagrelor. In this patient population, year-to-year increases in P2Y12i prescriptions were observed with a dramatic increase in ticagrelor prescriptions. CONCLUSION:CKD is common among Veterans and its true prevalence is likely being underestimated. The prevalence of dialysis-dependent CKD is higher among Veterans than the non-Veteran US population. CV events are widely co-prevalent and these patients are commonly prescribed P2Y12i. The recent increase in ticagrelor prescriptions in this patient population and large cost differences between the 3 P2Y12i underline the need for future studies to identify the preferred P2Y12i for these patients.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Singh M,Raghavan D,Williams JS,Martin BC,Hudson TJ,Owen RR,Jain Ndoi
10.1159/000486647subject
Has Abstractpub_date
2018-01-01 00:00:00pages
67-71issue
2eissn
0250-8095issn
1421-9670pii
000486647journal_volume
47pub_type
杂志文章abstract:BACKGROUND:We determined the familial aggregation of end-stage renal disease (ESRD) in a large, population-based sample of incident ESRD cases to assess the feasibility of developing a targeted screening and prevention program directed at members of families at high risk for kidney disease. METHODS:Between January 1, ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000088491
更新日期:2005-11-01 00:00:00
abstract::Several medical inventors in Europe and North America brought the artificial kidney (hemodialysis) to practical usefulness in the late 1940s, but there were very few early successes. It was used at first for only desperate cases of acute renal failure. Renal authorities in the 'metabolic' tradition favored newly quant...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000169117
更新日期:1997-01-01 00:00:00
abstract::Chronic kidney disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importan...
journal_title:American journal of nephrology
pub_type: 社论
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更新日期:2018-01-01 00:00:00
abstract::Accelerated atherosclerosis is both a cause and a consequence of chronic renal failure. Vascular smooth muscle cells (VSMCs) are an important component of atherosclerotic plaques, responsible for promoting plaque stability in advanced lesions. In contrast, VSMC apoptosis has been implicated in a number of deleterious ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000097815
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a critical need for more noninvasive biomarkers to identify nephritis in patients with systemic lupus erythematosus (SLE). Recent studies in a model mouse and an adult SLE patient cohort suggest that anti-basement membrane antibody levels correlate well with lupus activity and kidney injury. Th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000381965
更新日期:2015-01-01 00:00:00
abstract::Fifty-four patients with noninsulin-dependent diabetes mellitus, who had established nephropathy, were examined to evaluate the risk factors for the progression of diabetic nephropathy. Time-averaged values of blood pressure, serum total cholesterol and fasting plasma glucose concentrations, and the degree of proteinu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168891
更新日期:1995-01-01 00:00:00
abstract::Renal function and life expectancy can be improved by aggressive antihypertensive therapy in severe hypertension. However, most reports of severe hypertension and renal failure concern primary hypertensive states. 3 cases of primary renal disease, 1 glomerular, 1 obstructive and 1 of chronic pyelonephritis, are descri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166576
更新日期:1982-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168588
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HD patients, we conducted a meta-analysis of the pub...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the effect of exercise on health is well established, nephrologists seldom consider physical activity in the treatment of chronic kidney disease (CKD) or CKD in the presence of diabetes mellitus (DM/CKD). The aim of the present study was to analyze the benefits of leisure-time physical activity...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000357133
更新日期:2013-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330854
更新日期:2011-01-01 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::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:BACKGROUND:Serum phosphorus concentrations reflect a dynamic balance between generation, exchanges, and removal. Time-averaged phosphorus concentrations (TAC(phos)) reflect the overall exposure better than single time-point concentrations, especially in dialysis patients treated with an intermittent modality. The prese...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000336308
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:Intradialytic hypotension is the most common complication of modern day haemodialysis (HD). Convective modalities, including haemodiafiltration (HDF) are reported to result in greater cardiovascular stability compared to standard HD, which has been suggested to be due to improved solute transport betwee...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349925
更新日期:2013-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169078
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Data concerning long-term mortality predictors among large, purely diabetic hemodialysis collectives are scarce. METHODS:We used data from a multicenter, prospective, randomized trial among 1,255 hemodialysis patients with type 2 diabetes mellitus (T2DM) and its observational follow-up study. The associatio...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000485842
更新日期:2018-01-01 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:BACKGROUND:We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349931
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Increased mortality and morbidity are reported in association with high ultrafiltration rate (UFR) and with long dialysis recovery time (DRT). We studied the association between UFR and DRT. METHODS:This is a cross-sectional, observational study was conducted. Patients on thrice-weekly hemodialysis (HD) wit...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000476076
更新日期:2017-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166799
更新日期:1984-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167931
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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
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000206697
更新日期:2009-01-01 00:00:00
abstract::The purpose of the present investigation was to determine whether dexamethasone, an agent known to preserve the blood-brain barrier, and colchicine, an agent that impairs mobilization of macrophages, can prevent demyelinating lesions associated with rapid correction of hyponatremia in the experimental animal. Hyponatr...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168071
更新日期:1990-01-01 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:BACKGROUND:Renal insufficiency is a well-described risk factor for perioperative morbidity and shortened survival after major vascular procedures. Due to the potential inaccuracy of serum creatinine levels alone in measuring kidney function, our aim was to determine whether estimated creatinine clearance more consisten...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000098150
更新日期:2006-01-01 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: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
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000363421
更新日期:2014-01-01 00:00:00