Health System Purchasing Professionals' Approaches to Considering Equity in Procurement.

Background: Continuing data on racial bias in pulse oximeters and artificial intelligence has sparked calls for health systems to drive innovation against racial bias in healthcare device and artificial intelligence markets by incorporating equity concerns explicitly into purchasing decisions.

Research Question: How do healthcare purchasing professionals integrate equity concerns into purchasing decision-making?

Study Design And Methods: Between 8/2023-3/2024, we conducted semi-structured interviews via videoconferencing with healthcare purchasing professionals about purchasing processes for pulse oximeters and other devices-and whether and where equity concerns arise in decision-making. An abductive approach was used to analyze perspectives on how equity and disparity concerns are currently integrated into healthcare purchasing decision-making.

Factors that Facilitate Informal Advance Care Planning Conversations With Family: A Cross-Sectional Survey of Black Adults With Kidney Failure.

Advance care planning in adults with kidney failure has been understudied and limited to written advance directives. Many Black adults prefer informal conversations with family, and yet this form of advance care planning is underexplored in research. In this study, we aimed to identify the multilevel factors that facilitate informal advance care planning with family among Black adults with kidney failure.

Working Together to Promote Kidney Health.

The American Nephrology Nurses Association (ANNA) and American Society of Nephrology (ASN) have joined forces with the goal of advancing improvements in kidney care through transformative change. Through the integration of expertise, resources, and networks from both organizations, these collaborations have the potential to improve patient outcomes, advance clinical practice, and shape policy initiatives. In this article, we describe our focus on three areas: strengthening the nephrology and nephrology nursing workforce, championing health care equity, and advocating for kidney health.

Endothelial Dysfunction Biomarkers and CKD Incidence in the REGARDS Cohort.

Introduction: Chronic kidney disease (CKD) is only partly caused by traditional risk factors. Endothelial dysfunction is common in CKD and may contribute to CKD incidence. We studied the association of circulating biomarkers reflecting endothelial dysfunction with incident CKD.

Medical Distrust Among Kidney Transplant Candidates.

Background: Medical distrust may hinder kidney transplantation (KT) access. Among KT candidates evaluated for waitlisting, we identified factors associated with high distrust levels and quantified their association with waitlisting.

Methods: Among 812 candidates (2018-2023), we assessed distrust using the Revised Health Care System Distrust Scale across composite, competence, and values subscales.

Equitable Care for Hypertension: Blood Pressure and Patient-Reported Outcomes of the RICH LIFE Cluster Randomized Trial.

Background: Disparities in hypertension control are well documented but underaddressed.

Methods: RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) was a 2-arm, cluster randomized trial comparing the effect on blood pressure (BP) control (systolic BP ≤140 mm Hg, diastolic BP ≤90 mm Hg), patient activation, and disparities in BP control of 2 multilevel interventions, standard of care plus (SCP) and collaborative care/stepped care (CC/SC). SCP included BP measurement standardization, audit and feedback, and equity-leadership training.

Sex Differences in Cardiovascular Outcomes in Patients With Kidney Failure.

Background: Cardiovascular disease is the leading cause of mortality in patients with kidney failure, and their risk of cardiovascular events is 10 to 20 times higher as compared with the general population.

Methods And Results: We evaluated 508 822 patients who initiated dialysis between January 1, 2005 and December 31, 2014 using the United States Renal Data System with linked Medicare claims. We determined hospitalization rates for cardiovascular events, defined by acute coronary syndrome, heart failure, and stroke.

"Hang Ups, Let Downs, Bad Breaks, Setbacks": Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black.

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as "hang ups, let downs, bad breaks, setbacks" that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies.

Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana.

Background: Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana.

Association of Sevelamer Initiation with Gastrointestinal Bleeding Hospitalization in Individuals Requiring Hemodialysis.

Introduction: Case reports have suggested a causative role between sevelamer use and subsequent gastrointestinal bleeding (GIB), but no large observational studies have evaluated this association.

Methods: Using the United States Renal Data System database from 2015 to 2019, we examined the association between initiation of sevelamer (vs. non-sevelamer containing phosphate binders) and GIB hospitalization as well as all-cause mortality among individuals on hemodialysis.

Using Photovoice to Explore the Lived Environment and Experience of Older Adults with Frailty on their Kidney Transplant Journey.

Key Points: Photovoice, a qualitative method, visually depicted the daily lives of participants with frailty, providing insights into independence and symptom management to guide clinicians and researchers. This photovoice study uncovered subthemes of home safety and organization, revealing potential safety hazards like dialysis fluid storage, and suggests its potential use in geriatric nephrology. The findings emphasize the importance of integrating participant values and goals into care decisions and interventional design in the context of kidney transplant journeys for frail adults.

Neighborhood Segregation and Access to Live Donor Kidney Transplantation.

Importance: Identifying the mechanisms of structural racism, such as racial and ethnic segregation, is a crucial first step in addressing the persistent disparities in access to live donor kidney transplantation (LDKT).

Objective: To assess whether segregation at the candidate's residential neighborhood and transplant center neighborhood is associated with access to LDKT.

Design, Setting, And Participants: In this cohort study spanning January 1995 to December 2021, participants included non-Hispanic Black or White adult candidates for first-time LDKT reported in the US national transplant registry.

Patients' Perspectives on Health-Related Social Needs and Recommendations for Interventions: A Qualitative Study.

Rationale & Objective: People with low socioeconomic status are disproportionately affected by kidney failure, and their adverse outcomes may stem from unmet health-related social needs. This study explored hemodialysis patient perspectives on health-related social needs and recommendations for intervention.

Study Design: Qualitative study using semistructured interviews.