Publications by authors named "Michael A Mao"

Background And Objectives: Home dialysis (peritoneal dialysis and home hemodialysis) is an important renal replacement therapy modality option for patients with end-stage kidney disease. As the Internet has become a primary source for healthcare information, this study aimed to analyze the global and regional interests in home dialysis using Google Trends™ data from January 2004 to March 2024.

Design Setting Participants And Measurements: A comprehensive analysis was conducted using Google Trends™ with the search terms "Peritoneal Dialysis" and "Home Hemodialysis.

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  • The study examines global and regional search queries related to Acute Kidney Injury (AKI) and Continuous Renal Replacement Therapy (CRRT) using Google Trends™ from January 2004 to March 2024.
  • It found that global interest in AKI peaked in October 2022, with the highest attention coming from Portugal, Zambia, and Spain, while the U.S. peaked in February 2008, particularly in Tennessee, Pennsylvania, and West Virginia.
  • For CRRT, global interest peaked in March 2024, led by South Korea and Bahrain, while in the U.S., peak interest was in April 2020, with West Virginia, Tennessee, and Kentucky showing the most attention, indicating varying awareness and
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  • Accurate ICD-10 coding is essential for healthcare reimbursement and patient care, and the study evaluates how ChatGPT can enhance this coding process by using simulated nephrology cases.* -
  • ChatGPT versions 3.5 and 4.0 were tested on 100 nephrology scenarios, with results showing that version 4.0 achieved higher accuracy (99%) compared to version 3.5 (91%) in the first round, and maintained high accuracy in the second round.* -
  • The findings suggest ChatGPT 4.0 significantly improves coding accuracy and could decrease physician workload, but emphasize the importance of continuing to refine AI systems to ensure high standards in healthcare.
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  • * It misidentified three medications due to errors in reading their imprints but showed 100% consistency upon retesting after feedback.
  • * The study concluded that while ChatGPT-4 shows promise as a tool for medication identification, improving its ability to read challenging imprints is necessary for better integration into digital health.
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  • Chronic kidney disease (CKD) patients can improve their health outcomes through personalized education on lifestyle and nutrition, potentially aided by chatbots.
  • In 2022, a study assessed the effectiveness of multiple AI chatbots, including different versions of ChatGPT and Bard AI, in answering lifestyle and nutrition questions based on established guidelines.
  • While ChatGPT 3.5 provided mostly accurate responses, later versions showed inconsistencies, and while chatbots can engage patients effectively and offer quick answers, some inaccuracies still persist.
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Introduction: Despite the data demonstrating an increased utilization of hepatitis C virus (HCV)-viremic kidneys, the acceptance and incorporation of HCV-viremic kidneys are not universal. We aimed to identify regional differences and their temporal changes in the utilization of HCV-viremic kidneys.

Methods: Using the Organ Procurement and Transplantation Network database, HCV-viremic kidneys utilized in kidney transplants from March 15, 2019, to March 14, 2023, were included.

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  • The study investigates global public awareness of kidney stones by analyzing online search interest using Google Trends from January 2004 to November 2023, highlighting a growing concern for the condition.* -
  • Time series analysis confirmed that the search interest for "kidney stone" peaked in August 2022 and remains high, with significant stationarity indicated by the ADF test.* -
  • The findings suggest widespread awareness across various countries, signaling a need for targeted health interventions and collaborative educational initiatives to address kidney stone issues globally.*
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  • - This study explored how well ChatGPT, an advanced AI, can simplify living kidney donation information to make it easier for people who read at an 8th-grade level or below, which is crucial given the average American adult's reading ability.
  • - ChatGPT 3.5 and 4.0 successfully lowered the readability of complex FAQs from an average grade level of 9.6 to 7.72 and 4.30 respectively, with ChatGPT 4.0 outperforming the earlier version in making nearly all content accessible below an 8th-grade level.
  • - The results highlight ChatGPT's potential to improve access to important medical information, promoting diversity and equity in living kidney donation, while suggesting further
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Posttransplant lymphoproliferative disorder (PTLD) poses a significant concern in Epstein-Barr virus (EBV)-negative patients transplanted from EBV-positive donors (EBV R-/D+). Previous studies investigating the association between different induction agents and PTLD in these patients have yielded conflicting results. Using the Organ Procurement and Transplant Network database, we identified EBV R-/D+ patients >18 years of age who underwent kidney-alone transplants between 2016 and 2022 and compared the risk of PTLD with rabbit antithymocyte globulin (ATG), basiliximab, and alemtuzumab inductions.

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Background: Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs) in kidney transplant recipients (KTRs) remains scarce. This systematic review and meta-analysis aims to evaluate the safety and efficacy of GLP-1RAs in this population.

Methods: A comprehensive literature search was conducted in the MEDLINE, Embase and Cochrane databases from inception through May 2023.

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: Limited evidence exists regarding the safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 2 diabetes mellitus (T2DM) patients with advanced chronic kidney disease (CKD) or end-stage kidney disease (ESKD). Thus, we conducted a systematic review and meta-analysis to assess the safety and efficacy of GLP-1RAs in T2DM patients with advanced CKD and ESKD. : We performed a systematic literature search in MEDLINE, EMBASE, and Cochrane database until 25 October 2023.

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The utilization of vasopressin receptor antagonists, known as vaptans, in the management of hyponatremia among patients afflicted with the syndrome of inappropriate antidiuretic hormone (SIADH) remains a contentious subject. This meta-analysis aimed to evaluate the safety and efficacy of vaptans for treating chronic hyponatremia in adult SIADH patients. Clinical trials and observational studies were identified by a systematic search using MEDLINE, EMBASE, and Cochrane Database from inception through September 2022.

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Contrast-induced encephalopathy (CIE) is an infrequent but serious neurological condition that occurs shortly after the administration of contrast during endovascular and angiography procedures. Patients suffering from chronic kidney disease (CKD) or end-stage kidney disease (ESKD) are considered to be at a higher risk of contrast medium neurotoxicity, due to the delayed elimination of the contrast medium. However, the occurrence and characteristics of CIE in CKD/ESKD patients have not been extensively investigated.

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Longer pre-transplant dialysis duration is known to be associated with worse post-transplant outcomes. Our study aimed to cluster kidney transplant recipients with prolonged dialysis duration before transplant using an unsupervised machine learning approach to better assess heterogeneity within this cohort. We performed consensus cluster analysis based on recipient-, donor-, and transplant-related characteristics in 5092 kidney transplant recipients who had been on dialysis ≥ 10 years prior to transplant in the OPTN/UNOS database from 2010 to 2019.

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Limited data are available on the utilization of sodium thiosulfate (STS) treatment for calciphylaxis in peritoneal dialysis (PD) patients, while it is well-studied in hemodialysis (HD) patients. A systematic literature search was conducted using Ovid MEDLINE, EBM Reviews-Cochrane Central Register of Controlled Trials, and EBM Reviews-Cochrane Database of Systematic Reviews to identify reported cases of PD patients with calciphylaxis who received STS. The search covered the inception of the databases through August 2022.

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Clinical outcomes of deceased donor kidney transplants coming from diabetic donors currently remain inconsistent, possibly due to high heterogeneities in this population. Our study aimed to cluster recipients of diabetic deceased donor kidney transplants using an unsupervised machine learning approach in order to identify subgroups with high risk of inferior outcomes and potential variables associated with these outcomes. Consensus cluster analysis was performed based on recipient-, donor-, and transplant-related characteristics in 7876 recipients of diabetic deceased donor kidney transplants from 2010 to 2019 in the OPTN/UNOS database.

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: The aim of our study was to categorize very highly sensitized kidney transplant recipients with pre-transplant panel reactive antibody (PRA) ≥ 98% using an unsupervised machine learning approach as clinical outcomes for this population are inferior, despite receiving increased allocation priority. Identifying subgroups with higher risks for inferior outcomes is essential to guide individualized management strategies for these vulnerable recipients. : To achieve this, we analyzed the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) database from 2010 to 2019 and performed consensus cluster analysis based on the recipient-, donor-, and transplant-related characteristics in 7458 kidney transplant patients with pre-transplant PRA ≥ 98%.

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Better understanding of the different phenotypes/subgroups of non-U.S. citizen kidney transplant recipients may help the transplant community to identify strategies that improve outcomes among non-U.

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Objectives: This study aimed to identify distinct clusters of very elderly kidney transplant recipients aged ≥80 and assess clinical outcomes among these unique clusters.

Design: Cohort study with machine learning (ML) consensus clustering approach.

Setting And Participants: All very elderly (age ≥80 at time of transplant) kidney transplant recipients in the Organ Procurement and Transplantation Network/United Network for Organ Sharing database database from 2010 to 2019.

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Patients with IgA nephropathy (IgAN), including Henoch-Schönlein purpura nephritis (HSP), who present with rapidly progressive glomerulonephritis (RPGN) have a poor prognosis despite aggressive immunosuppressive therapy. The utility of plasmapheresis/plasma exchange (PLEX) for IgAN/HSP is not well established. This systematic review aims to assess the efficacy of PLEX for IgAN and HSP patients with RPGN.

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Background: The utilization of multi-dimensional patient data to subtype hepatorenal syndrome (HRS) can individualize patient care. Machine learning (ML) consensus clustering may identify HRS subgroups with unique clinical profiles. In this study, we aim to identify clinically meaningful clusters of hospitalized patients for HRS using an unsupervised ML clustering approach.

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Background: Our study aimed to characterize kidney retransplant recipients using an unsupervised machine-learning approach.

Methods: We performed consensus cluster analysis based on the recipient-, donor-, and transplant-related characteristics in 17 443 kidney retransplant recipients in the OPTN/UNOS database from 2010 to 2019. We identified each cluster's key characteristics using the standardized mean difference of >.

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Purpose: This study aimed to assess efficacy of extracorporeal plasma therapy (EPT), including plasmapheresis (PE), immunoadsorption (IA), low-density lipoprotein apheresis (LDL-A), and lymphocytapheresis (LCAP) for adult native kidney patients with primary focal segmental glomerulosclerosis (FSGS).

Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane Databases through August 2022. Studies that reported outcomes of EPT in adult native kidneys with primary FSGS were enrolled.

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Background: Several studies suggest an association between periodic limb movements during sleep (PLMS) and hypertension; however, a systematic evaluation of this relationship is lacking.

Methods: We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio, comparing the risk of hypertension in persons with PLMS (defined by the level of periodic limb movements per hour of sleep depended on individual studies) versus those without PLMS. After assessing heterogeneity and bias, the pooled risk ratio and 95% confidence intervals (CIs) were determined using a random-effect, generic inverse variance method of DerSimonian and Laird.

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Background: The Mediterranean, Dietary Approach to Stop Hypertension (DASH), and plant-based diets may provide cardiovascular benefit to the general population. However, data on their effect on end stage kidney disease (ESKD) patients are limited. This systematic review aims to assess the impact of Mediterranean, DASH, and plant-based diets on outcomes among ESKD patients.

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