Cardiovascular disease in kidney donors: matched cohort study.

Objective: To determine whether people who donate a kidney have an increased risk of cardiovascular disease.

Design: Retrospective population based matched cohort study.

Participants: All people who were carefully selected to become a living kidney donor in the province of Ontario, Canada, between 1992 and 2009.

A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease.

Background And Objectives: Despite reporting estimated GFR (eGFR), use of evidence-based interventions in CKD remains suboptimal. This study sought to determine the effect of an enhanced eGFR laboratory prompt containing specific management recommendations, compared with standard eGFR reporting in CKD.

Design, Setting, Participants, & Measurements: A cluster randomized trial of a standard or enhanced eGFR laboratory prompt was performed in 93 primary care practices in Alberta, Canada.

Evaluation of an education intervention to increase the pursuit of living kidney donation: a randomized controlled trial.

Context: Many transplant candidates have concerns about living donation.

Objective: To determine whether a structured educational session increased eligible kidney transplant candidates' pursuit of living donation.

Design And Intervention: Eligible transplant candidates were randomized to standard of care (n = 50) or to the educational intervention (n = 50), which included both written materials and a 2-hour education session.

Why do patients choose self-care dialysis?

Background: Self-care dialysis (SCD) is associated with cost savings and possibly improved quality of life compared to in-centre haemodialysis. Despite this, less than one in four dialysis patients are currently treated with SCD. Our objectives were to identify perceived advantages of SCD associated with increased odds of selecting SCD, and to evaluate the effect of an educational intervention on patients' perceptions of these advantages.

The effect of increasing dialysis dose in overweight hemodialysis patients on quality of life: a 6-week randomized crossover trial.

Background: Using standard hemodialysis regimens, overweight patients often do not reach Kidney Disease Outcomes Quality Initiatives (KDOQI) Kt/V targets, and this has been associated with lower health-related quality of life (HRQL). Whether increasing dialysis adequacy in large patients not achieving KDOQI targets improves HRQL is unknown.

Study Design: Randomized blinded crossover study.

The impact of education on chronic kidney disease patients' plans to initiate dialysis with self-care dialysis: a randomized trial.

Background: Compared with in-center hemodialysis, self-care dialysis (including home and self-care hemodialysis and peritoneal dialysis) is less resource intensive and associated with similar clinical outcomes. However, utilization of self-care dialysis has been very low. We performed a randomized controlled trial in predialysis patients with chronic kidney disease (CKD) (GFR <30 mL/min) to determine the impact of a patient-centered educational intervention on patients' intention to initiate dialysis with self-care dialysis.

Illustrating the impact of including future costs in economic evaluations: an application to end-stage renal disease care.

There are strong theoretical arguments for including future costs for related and unrelated medical care and non-medical expenditures within economic evaluations. Nevertheless, there is limited data on how inclusion of such costs affects the cost effectiveness of medical interventions in practice. For a low-cost intervention that improves survival in end-stage renal disease (ESRD) patients, we sought to determine how the inclusion of future costs for related medical care (i.

Why patients with ESRD do not select self-care dialysis as a treatment option.

Background: In-center hemodialysis is the most prevalent (and resource-intense) form of dialysis in North America despite many patients being capable of performing dialysis themselves. The purpose of this study is to describe reasons in-center hemodialysis patients choose not to perform self-care dialysis and identify variables associated with a negative attitude toward self-care dialysis.

Methods: We conducted a cross-sectional survey (return rate, 83%) of prevalent in-center hemodialysis patients and combined this with demographic and comorbidity data obtained from our prospectively maintained database.

Dialysis adequacy and health related quality of life in hemodialysis patients.

Patients with end-stage renal disease have significant impairments in health related quality of life (HRQOL). The determinants of HRQOL, including the effect of dialysis adequacy, have not been well studied. This study was designed to investigate whether dialysis adequacy is associated with HRQOL in hemodialysis patients.

Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access.

Background: Care of patients with end-stage renal disease (ESRD) is important and resource intense. To enable ESRD programs to develop strategies for more cost-efficient care, an accurate estimate of the cost of caring for patients with ESRD is needed.

Methods: The objective of our study is to develop an updated and accurate itemized description of costs and resources required to treat patients with ESRD on dialysis therapy and contrast differences in resources required for various dialysis modalities.

To reuse or not to reuse? An economic evaluation of hemodialyzer reuse versus conventional single-use hemodialysis for chronic hemodialysis patients.

Objectives: To evaluate the cost-effectiveness of reusing hemodialyzers for patients with kidney failure on dialysis employing either a heated citric acid or formaldehyde sterilization method, in comparison to the standard practice of single-use dialysis.

Methods: A meta-analysis of all relevant studies was performed to determine whether hemodialyzer reuse was associated with an increased relative risk of mortality or hospitalization. A decision tree was constructed to model the effect of three different dialysis strategies (single-use dialysis, heated citric acid, and formaldehyde dialyzer reuse) on the costs and quality-adjusted life expectancy of "typical" hemodialysis patients.