Opioid Prescriptions for US Patients Undergoing Long-Term Dialysis or with Kidney Transplant from 2011 to 2020.

Key Points: The rate of prescription of opioid medication decreased between 2011 and 2020 for patients with ESRD. The risk of death for dialysis and kidney transplant patients increased as morphine milligram equivalents in prescriptions increased.

Background: Pain is important for patients with kidney failure, but opioid medication prescriptions are associated with morbidity and mortality.

Association of Obesity, Metabolic Syndrome, and Diabetes With Urinary Incontinence and Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey, 2003-2020.

Purpose: Diabetes and obesity, components of the metabolic syndrome (MetS), are risk factors for urinary incontinence (UI) and chronic kidney disease (CKD). We interrogated US population-based data to explore independent, sex-specific associations between nondiabetic MetS, with and without obesity, and UI and/or CKD.

Materials And Methods: We analyzed data from 8586 males and 8420 females ≥20 years from the National Health and Nutrition Examination Survey.

Epidemiology of Infantile Ureteropelvic Junction Obstruction in the US.

Objective: To describe sex- and diagnosis-specific comorbidities, outcomes, and secular trends associated with ureteropelvic junction obstruction (UPJO) in a large, real-world population diagnosed with hydronephrosis in infancy.

Materials And Methods: We identified all infants ≤1 year old with ≥1 claim in the Optum Clinformatics 2007-2020 nationwide population database and used univariable and multivariable Cox regression analyses to estimate associations of demographic and clinical characteristics of infants with a UPJO diagnosis with surgical status.

Results: Of 22,349 infants with hydronephrosis (1.

Readmission and Mortality After Hospitalization With Acute Kidney Injury.

Rationale & Objective: Acute kidney injury (AKI) carries high rates of morbidity and mortality. This study quantified various short- and long-term outcomes after hospitalization with AKI.

Study Design: Retrospective propensity score (PS)-matched cohort study.

Transplantation Mediates Much of the Racial Disparity in Survival from Childhood-Onset Kidney Failure.

Background: The role of kidney transplantation in differential survival in Black and White patients with childhood-onset kidney failure is unexplored.

Methods: We analyzed 30-year cohort data of children beginning RRT before 18 years of age between January 1980 and December 2017 (=28,337) in the US Renal Data System. Cox regression identified transplant factors associated with survival by race.

Concomitant Use of Gabapentinoids with Opioids Is Associated with Increased Mortality and Morbidity among Dialysis Patients.

Background: The opioid epidemic is a public health emergency and appropriate medication prescription for pain remains challenging. Physicians have increasingly prescribed gabapentinoids for pain despite limited evidence supporting their use. We determined the prevalence of concomitant gabapentinoid and opioid prescriptions and evaluated their associations with outcomes among dialysis patients.

Racial/Ethnic Disparities in Atrial Fibrillation Treatment and Outcomes among Dialysis Patients in the United States.

Background: Because stroke prevention is a major goal in the management of ESKD hemodialysis patients with atrial fibrillation, investigating racial/ethnic disparities in stroke among such patients is important to those who could benefit from strategies to maximize preventive measures.

Methods: We used the United States Renal Data System to identify ESKD patients who initiated hemodialysis from 2006 to 2013 and then identified those with a subsequent atrial fibrillation diagnosis and Medicare Part A/B/D. Patients were followed for 1 year for all-cause stroke, mortality, prescription medications, and cardiovascular disease procedures.

Psychiatric Illness and Mortality in Hospitalized ESKD Dialysis Patients.

Background And Objectives: Limited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice.

Design, Setting, Participants, & Measurements: We examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models.

Epilepsy and antiseizure medications increase all-cause mortality in dialysis patients in the United States.

Seizures have been associated with uremia, but there are few data regarding the prevalence, treatment, and outcomes of patients with end-stage renal disease (ESRD) with epilepsy compared to those with ESRD without epilepsy. Here we conducted a retrospective cohort study using the United States Renal Data System to assess mortality and antiseizure medication prescriptions among patients with ESRD with and without a diagnosis of epilepsy. A modified Poisson regression with a robust variance was used to estimate the association between epilepsy status and mortality, and evaluate effect modification by neurology consultation.

p-Phosphonic acid calix[8]arene mediated synthesis of ultra-large, ultra-thin, single-crystal gold nanoplatelets.

Single-crystal Au nanoplatelets, as large as 28 μm in cross section and as thin as 6 nm, are generated by bubbling hydrogen gas into an aqueous solution of HAuCl4 in the presence of p-phosphonic acid calix[8]arene, which acts as both a catalyst and stabiliser. The use of the ultrathin Au nanoplatelets in oxygen gas sensing has also been established.

Opioid Prescription, Morbidity, and Mortality in US Transplant Recipients.

Background: Centers for Disease Control and Prevention guidelines recommend caution in prescribing opioids for chronic pain. The characteristics of opioid prescription (OpRx) among kidney transplant (KTx) recipients have not been described in a national population.

Methods: We assessed OpRx prevalence among prevalent KTx recipients, and associated duration (long-term, defined as ≥90 days in a year) and dosing (in morphine milligram equivalents per day of <50, 50-89, and ≥90) with outcomes, death and graft loss, among incident KTx recipients using 2006-2010 US Renal Data System files, including Medicare Part D for medication ascertainment.

Opioid Prescription, Morbidity, and Mortality in United States Dialysis Patients.

Aggressive pain treatment was advocated for ESRD patients, but new Centers for Disease Control and Prevention guidelines recommend cautious opioid prescription. Little is known regarding outcomes associated with ESRD opioid prescription. We assessed opioid prescriptions and associations between opioid prescription and dose and patient outcomes using 2006-2010 US Renal Data System information in patients on maintenance dialysis with Medicare Part A, B, and D coverage in each study year (=671,281, of whom 271,285 were unique patients).

p-Phosphonated Calix[n]arene Stabilizes Superparamagnetic Nanoparticles for Nitrate and Phosphate Uptake.

Highly faceted superparamagnetic magnetite nanoparticles roughly 11 nm in diameter are readily accessible in the presence of p-phosphonated calix[n]arenes of different ring sizes (n=4, 5 and 6), through the use of a simple co-precipitation technique. In contrast, the larger calix[8]arene affords spherical particles of comparable size. The maximum magnetization is 70-60 emu g , which decreases with increasing size of the calixarene macrocycle, and the evidence indicates that the calixarenes bind to the surface of the nanoparticles via the phosphonate head groups rather than the phenolic oxygen centers.

Patients receiving frequent hemodialysis have better health-related quality of life compared to patients receiving conventional hemodialysis.

Most patients with end-stage kidney disease value their health-related quality of life (HRQoL) and want to know how it will be affected by their dialysis modality. We extended the findings of two prior clinical trial reports to estimate the effects of frequent compared to conventional hemodialysis on additional measures of HRQoL. The Daily Trial randomly assigned 245 patients to receive frequent (six times per week) or conventional (three times per week) in-center hemodialysis.

Comparison of trends in colorectal cancer screening in the US end-stage renal disease population and the US Medicare population.

Background: Although patients treated with maintenance hemodialysis are at an increased risk of colorectal cancer compared with the general population, national practices for colorectal cancer screening have not been reported in this population. We assessed the performance of colorectal cancer screening in the US end-stage renal disease program in comparison with the US Medicare population.

Methods: We studied the United States Renal Data System for US prevalent hemodialysis patients between 2002 and 2011 who had Medicare as their primary insurer.

The effect of frequent hemodialysis on self-reported sleep quality: Frequent Hemodialysis Network Trials.

Background: Many patients who receive maintenance hemodialysis experience poor sleep. Uncontrolled studies suggest frequent hemodialysis improves sleep quality, which is a strong motivation for some patients to undertake the treatment. We studied the effects of frequent in-center ('daily') and nocturnal home hemodialysis on self-reported sleep quality in two randomized trials.

Social Determinants of Racial Disparities in CKD.

Significant disparities in CKD rates and outcomes exist between black and white Americans. Health disparities are defined as health differences that adversely affect disadvantaged populations, on the basis of one or more health outcomes. CKD is the complex result of genetic and environmental factors, reflecting the balance of nature and nurture.

Racial Disparities in Poverty Account for Mortality Differences in US Medicare Beneficiaries.

Higher mortality in Blacks than Whites has been consistently reported in the US, but previous investigations have not accounted for poverty at the individual level. The health of its population is an important part of the capital of a nation. We examined the association between individual level poverty and disability and racial mortality differences in a 5% Medicare beneficiary random sample from 2004 to 2010.

Paclitaxel-loaded phosphonated calixarene nanovesicles as a modular drug delivery platform.

A modular p-phosphonated calix[4]arene vesicle (PCV) loaded with paclitaxel (PTX) and conjugated with folic acid as a cancer targeting ligand has been prepared using a thin film-sonication method. It has a pH-responsive capacity to trigger the release of the encapsulated PTX payload under mildly acidic conditions. PTX-loaded PCV conjugated with alkyne-modified PEG-folic acid ligands prepared via click ligation (fP-PCVPTX) has enhanced potency against folate receptor (FR)-positive SKOV-3 ovarian tumour cells over FR-negative A549 lung tumour cells.