Uptal D Patel

..We hypothesized that high-dose ESA requirement would be associated with elevated inflammatory biomarkers, decreased adipokines, and increased circulating, endogenous soluble erythropoietin receptors (sEpoR)...

..Although current empiric evidence supports a link between fetal programming and childhood/adult kidney disease, affected pathways may vary by race...

..Although anemia at the time of discharge has been associated with poor functional status and survival, its impact over time is not clear...

..These differential outcomes underscore the need for dedicated trials in these subpopulations...

..However, the impact of changes in ESRD patient volume and characteristics over time on operative outcomes is unclear...

..Our objective was to determine patterns of discharge disposition after CABG surgery in the United States...

..Although some early recovery is common, its effect on long-term outcomes is unclear. We tested the hypothesis that early renal recovery after CSA-AKI is independently associated with improved long-term survival...

..However, these studies, because of the small number of patients, were unable to adequately account for patient case-mix and included both those undergoing elective surgery and those undergoing urgent surgery...

..Prospective studies are needed to confirm this relationship and determine safe dosing algorithms for patients unable to achieve target hemoglobin...

..These findings warrant further investigation on dialysis facilities' provision of a preferred, potentially beneficial, and cost-effective therapy...

..We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated acute renal failure needing dialysis (ARF-D) had declined during this period...

..Thus, major emphasis should be on prevention of ARF in patients undergoing CABG...

..Our study found that in prevalent dialysis subjects, a decrease in pulse pressure during dialysis was associated with improved outcomes. Further study is needed to identify how to control pulse pressure to improve outcomes...

..The extent to which hospital performance affects the care of patients with CKD and non-ST-segment elevation acute coronary syndromes (NSTE ACSs) is unknown...

..Herein, we sought to determine whether changes in erythropoiesis-stimulating agent (ESA) dose and in hemoglobin were predictive of changes in blood pressure (BP) and whether these changes were associated with cardiovascular outcomes...

..Nonetheless, AVF rates remain suboptimal, indicating a need for ongoing vascular access evaluation and improvement...

..In this article, general principles of trial design will be discussed and the potential lessons learned from recent trials in nephrology will be critically reviewed...

..We examined associations between WRF and 30-day readmission, mortality, and costs among Medicare beneficiaries hospitalized with heart failure...

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..The Institute of Medicine has endorsed the use of clinical decision support (CDS) for implementing guidelines. The authors' objective was to identify the requirements of an optimal CDS system for CKD management...

..This study sought to define the association of an elevated eGFR on the risk for death and cardiovascular outcomes among subjects with atherosclerotic cardiovascular disease...

..Based on similar observations in other clinical settings, we tested the hypothesis that the diagnosis of acute renal failure associated with coronary artery bypass graft surgery is increasing in the United States...

..This study seeks to define the relationship between IDWG and BP in prevalent hemodialysis subjects...

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..The relative effectiveness of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) for lowering blood pressure is unknown...

..We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers...

..We sought to describe how nephrologists and older patients discuss and understand the prognosis and course of kidney disease leading to renal replacement therapy...

..This study describes trends in the regional supply of PD services in dialysis facilities between 1995 and 2003...

..This study examines the timing of software implementation by individual VHA laboratories and factors associated with implementation...

..The objective of the Chronic Kidney Disease model is to provide guidance to decision makers. We describe this model and give an example of how it can inform clinical and policy decisions...

..Both heart failure (HF) and chronic kidney disease (CKD) are highly prevalent conditions that often coexist; however, the quality of care received by hospitalized patients with both is not known...

..Cardiac interventions are underutilized in patients with chronic kidney disease (CKD) following acute coronary syndrome (ACS) partly due to nephrotoxicity concerns...

..Several considerations that arise while making such decisions are discussed...

..Given this lack of clear evidence, pragmatic clinical trials and comparative effectiveness studies are needed to help identify the appropriate use of ICD and CRT devices in this high-risk population of patients with HF and CKD...

..The disproportionate increase in ARF burden after heart transplantation is a concern due to its strong association with chronic kidney disease and mortality...

..In this review, the focus will be on advances in risk stratification, evolving definitions and improving early diagnosis of AKI, identification of effective individualized therapies, and future directions...