Cause of death with graft function among renal transplant recipients in an integrated healthcare system.

Background: Cardiovascular disease (CVD) is the leading cause of death in renal transplant recipients with a functioning allograft. Modification of CVD risk factors may, therefore, decrease overall mortality in this patient population. We studied renal transplant recipients within an integrated healthcare system (IHS) that uses case management and electronic health records to determine mortality from CVD.

Hospitalization rates in daily home hemodialysis versus peritoneal dialysis patients in the United States.

Background: Daily hemodialysis (DHD) is associated with improvements in hypertension, left ventricular hypertrophy, mineral metabolism, nutrition, and quality of life, but efficacy is uncertain because of potential selection bias. To reduce the influence of selection bias, we sought to compare hospital admissions for our population of DHD patients with peritoneal dialysis (PD) patients who initiated training during the same period. We also compared our hospital data with the US Renal Data Service database.

Impact of predialysis care on clinical outcomes.

Introduction: A structured predialysis multidisciplinary team program is beneficial in improving quality of life in patients with end-stage renal disease (ESRD). Educating pre-ESRD patients about their disease is vital in their care. Patients who can identify signs and symptoms of impending problems can seek help and avoid complications that may lead to hospital admissions.

Management of patients with chronic kidney disease at Kaiser Permanente.

In the Southern California Kaiser Permanente health plan, all patients having serum creatinine measured will automatically have their GFR reported. Those with reduced GFR are identified and classified into one of the five CKD stages. The PCPs are encouraged to be involved in the care of patients in CKD stages 1-3.

Benefits of a multidisciplinary predialysis program in maintaining employment among patients on home dialysis.

We evaluated the benefits of a multidisciplinary predialysis intervention to help home dialysis patients maintain employment. This program was shown to be successful with in-center hemodialysis patients in a case-controlled study published in the American Journal of Kidney Disease in September, 1993. We looked at 30 patients on home dialysis (28 on continuous ambulatory peritoneal dialysis and 2 on home hemodialysis) as of March, 1995.

Agranulocytosis related to vancomycin therapy.

A patient with renal failure due to Goodpasture's syndrome was treated with vancomycin. After he had received 3 g of the drug, his white blood cell count fell to a level of 200/microliter. Bone marrow biopsy disclosed severe myeloid hypoplasia.