Patient, Caregiver, and Provider Perspectives on Improving Provider-Patient Interactions in Hemodialysis: A Qualitative Study.

Background: Improving interactions between people receiving hemodialysis and health care providers of facility-based hemodialysis care is a top priority for patients, caregivers, and health care providers.

Objective: To identify challenges for high-quality clinical interactions in facility-based hemodialysis care as well as potential solutions.

Design: Multicentre qualitative study using focus groups and semi-structured interviews to elicit the perspectives of patients, caregivers, and health care providers.

Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA.

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT).

Effect of End-Tethered Methoxy-PEO Chain Density on Uremic Toxin Adsorption.

In 2023, around 850 million people globally were affected by chronic kidney disease, which leads to the retention of uremic toxins and excess fluid in the blood. This study examines the adsorption of these toxins to poly(ethylene oxide) (PEO) films, known for their low-fouling properties. The gold surfaces were treated with 5 mM end-thiolated methoxy-terminated PEO (-PEO) and analyzed using dynamic contact angle measurements, X-ray photoelectron spectroscopy, and spectroscopic ellipsometry to confirm the PEO film's presence and determine chain density.

Regional hotspots for chronic kidney disease: A multinational study from the ISN-GKHA.

Chronic kidney disease (CKD) disproportionately affects certain populations as demonstrated by well-established subnational geographic hotspots of CKD in Central America and South Asia. Using data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), we aimed to systematically identify sub-national geographic or population clusters with high prevalence of CKD. The ISN-GKHA survey was conducted from July to September 2022, and included questions regarding whether a regional CKD hotspot existed in the respondents' country and possible contributors.

Landscape of kidney replacement therapy provision in low- and lower-middle income countries: A multinational study from the ISN-GKHA.

In low- and lower-middle-income countries (LLMICs), delivering equitable kidney care presents substantial challenges, resulting in significant disparities in disease management and treatment outcomes for people with kidney failure. This comprehensive report leveraged data from the International Society of Nephrology-Global Kidney Health Atlas (ISN-GKHA), to provide a detailed update on the landscape of kidney replacement therapy (KRT) in LLMICs. Among the 65 participating LLMICs, reimbursement for KRT (publicly funded by the government and free at the point of delivery) was available in 28%, 15%, and 8% for hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT), respectively.

The centre for health informatics: a novel approach to accelerating the field of health data science.

Precision Medicine and Precision Public Health are approaches to improve population health. Achieving these goals requires innovation in health informatics. The Centre for Health Informatics (CHI) within the Cumming School of Medicine (CSM) at the University of Calgary (UC), Canada, was created to respond to this need by fostering multidisciplinary collaborations, building capacity by recruiting and training outstanding faculty and students, and harnessing Alberta's rich health data to advance health informatics.

Prospective Analysis of Arteriovenous Fistula Performance in the Context of Competing Risks.

Background: Many patients with newly created arteriovenous fistulas (AVF) may die before the AVF is needed for hemodialysis. However, formal competing risks frameworks are rarely used to report AVF patency, which may lead to biased estimates. We sought to identify the proportion of newly created AVF experiencing primary non-function and to describe long-term patency using a competing risk framework.

Associations Between Hearing Loss and Health-Related Costs: A Retrospective Population-Based Cohort Study.

Purpose: Hearing loss (HL) is a leading cause of disability worldwide, but its health-related costs have been incompletely studied. Our objective was to examine the association between HL and direct health care costs and identify subgroups in which costs associated with HL are especially high.

Method: This was a retrospective population-based cohort study of adults treated in a universal health care system between April 2008 and March 2019.

Adsorption Dynamics of Uremic Toxins to Cyclodextrin-Coated Magnetic Nano-Adsorbents.

Chronic kidney disease entails a progressive decline in kidney function, hindering the kidneys' ability to excrete fluid, electrolytes, and metabolites. This dysfunction leads to metabolite accumulation in the bloodstream, which can reach toxic concentrations. Hemodialysis is an effective means of treating patients with kidney failure, but it does not clear all toxins effectively.

A global snapshot on health systems capacity for detection, monitoring, and management of acute kidney injury: A multinational study from the ISN-GKHA.

Acute kidney injury (AKI) is a significant cause of morbidity and mortality, especially in low and lower-middle income countries. Data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) were used to evaluate the organization of structures and services for the provision of AKI care in world countries and ISN regions. An international survey of key stakeholders (clinicians, policymakers, and patient advocates) from countries affiliated with the ISN was conducted from July to September 2022 to assess structures and services for AKI care across countries.

Progress of nations in the organisation of, and structures for, kidney care delivery between 2019 and 2023: cross sectional survey in 148 countries.

Objective: To assess changes in key measures of kidney care using data reported in 2019 and 2023.

Design: Cross sectional survey in 148 countries.

Setting: Surveys from International Society of Nephrology Global Kidney Health Atlas between 2019 and 2023 that included participants from countries in Africa (n=36), Eastern and Central Europe (n=16), Latin America (n=18), the Middle East (n=11), Newly Independent States and Russia (n=10), North America and the Caribbean (n=8), North and East Asia (n=6), Oceania and South East Asia (n=15), South Asia (n=7), and Western Europe (n=21).

A Metabolomics Approach to Identify Metabolites Associated With Mortality in Patients Receiving Maintenance Hemodialysis.

Introduction: Uremic toxins contributing to increased risk of death remain largely unknown. We used untargeted metabolomics to identify plasma metabolites associated with mortality in patients receiving maintenance hemodialysis.

Methods: We measured metabolites in serum samples from 522 Longitudinal US/Canada Incident Dialysis (LUCID) study participants.

Global data monitoring systems and early identification for kidney diseases.

Background: Data monitoring and surveillance systems are the cornerstone for governance and regulation, planning, and policy development for chronic disease care. Our study aims to evaluate health systems capacity for data monitoring and surveillance for kidney care.

Methods: We leveraged data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), an international survey of stakeholders (clinicians, policymakers and patient advocates) from 167 countries conducted between July and September 2022.

Global structures, practices, and tools for provision of chronic peritoneal dialysis.

Background: Worldwide, the uptake of peritoneal dialysis (PD) compared with hemodialysis remains limited. This study assessed organizational structures, availability, accessibility, affordability and quality of PD worldwide.

Methods: This cross-sectional study relied on data from kidney registries as well as survey data from stakeholders (clinicians, policymakers and advocates for people living with kidney disease) from countries affiliated with the International Society of Nephrology (ISN) from July to September 2022.

Global access and quality of conservative kidney management.

Background: Conservative kidney management (CKM) describes supportive care for people living with kidney failure who choose not to receive or are unable to access kidney replacement therapy (KRT). This study captured the global availability of CKM services and funding.

Methods: Data came from the International Society of Nephrology Global Kidney Health survey conducted between June and September 2022.

A global assessment of kidney care workforce.

Background: An adequate workforce is needed to guarantee optimal kidney care. We used the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to provide an assessment of the global kidney care workforce.

Methods: We conducted a multinational cross-sectional survey to evaluate the global capacity of kidney care and assessed data on the number of adult and paediatric nephrologists, the number of trainees in nephrology and shortages of various cadres of the workforce for kidney care.

Global structures, practices, and tools for provision of hemodialysis.

Background: Hemodialysis (HD) is the most commonly utilized modality for kidney replacement therapy worldwide. This study assesses the organizational structures, availability, accessibility, affordability and quality of HD care worldwide.

Methods: This cross-sectional study relied on desk research data as well as survey data from stakeholders (clinicians, policymakers and patient advocates) from countries affiliated with the International Society of Nephrology from July to September 2022.

Worldwide organization and structures for kidney transplantation services.

Background: Kidney transplantation (KT) is the preferred modality of kidney replacement therapy with better patient outcomes and quality of life compared with dialytic therapies. This study aims to evaluate the epidemiology, accessibility and availability of KT services in countries and regions around the world.

Methods: This study relied on data from an international survey of relevant stakeholders (clinicians, policymakers and patient advocates) from countries affiliated with the International Society of Nephrology that was conducted from July to September 2022.

A global overview of health system financing and available infrastructure and oversight for kidney care.

Background: Governance, health financing, and service delivery are critical elements of health systems for provision of robust and sustainable chronic disease care. We leveraged the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to evaluate oversight and financing for kidney care worldwide.

Methods: A survey was administered to stakeholders from countries affiliated with the ISN from July to September 2022.

Dialysis Outcomes Across Countries and Regions: A Global Perspective From the International Society of Nephrology Global Kidney Health Atlas Study.

Introduction: Kidney failure treated with hemodialysis (HD), or peritoneal dialysis (PD) is a major global health problem that is associated with increased risks of death and hospitalization. This study aimed to compare the incidence and causes of death and hospitalization during the first year of HD or PD among countries.

Methods: The third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) was conducted between June and September 2022.

Prescribing patterns and medications costs in patients on maintenance hemodialysis and peritoneal dialysis.

Background And Hypothesis: Polypharmacy is a significant clinical issue for patients on dialysis but has been incompletely studied. We investigated the prevalence and costs of polypharmacy in a population-based cohort of participants treated with hemodialysis (HD) or peritoneal dialysis (PD).

Methods: We studied adults aged ≥ 20 years in Alberta, Canada receiving maintenance HD or PD as of March 31, 2019.

Long-term clinical outcomes of bariatric surgery in adults with severe obesity: A population-based retrospective cohort study.

Background: Bariatric surgery leads to sustained weight loss in a majority of recipients, and also reduces fasting insulin levels and markers of inflammation. We described the long-term associations between bariatric surgery and clinical outcomes including 30 morbidities.

Methods: We did a retrospective population-based cohort study of 304,157 adults with severe obesity, living in Alberta, Canada; 6,212 of whom had bariatric surgery.

Organization and Structures for Detection and Monitoring of CKD Across World Countries and Regions: Observational Data From a Global Survey.

Rationale & Objective: Established therapeutic interventions effectively mitigate the risk and progression of chronic kidney disease (CKD). Countries and regions have a compelling need for organizational structures that enable early identification of people with CKD who can benefit from these proven interventions. We report the current global status of CKD detection programs.