Publications by authors named "Robin Vernooij"
Article Synopsis
- The study examines how impaired liver function affects the toxicity of the anticancer drug paclitaxel, specifically focusing on hematological complications, dose modifications, and overall survival rates in cancer patients.
- It analyzes data from 569 patients treated at the University Medical Centre Utrecht between 2011 and 2022, comparing those with normal and impaired liver function based on specific medical criteria.
- Results show that patients with liver impairment experienced significantly higher risks of severe neutropenia and leukopenia, required more dose modifications, and had poorer overall survival in cases of inoperable esophageal and advanced ovarian cancers.
Background: Patients with kidney failure undergoing dialysis often suffer from anemia. Iron deficiency, along with a shortage in erythropoietin, is a common cause. Peritoneal dialysis (PD) patients may have a different iron metabolism compared to hemodialysis (HD) patients.
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- A large number of systematic reviews and meta-analyses have examined the impact of sodium intake on cardiovascular health, but the overall quality and consistency of these studies haven't been clearly summarized.
- An umbrella review was conducted to evaluate the strength of the evidence linking lower sodium intake to better cardiovascular outcomes, using rigorous quality assessment tools.
- The findings indicated that reducing sodium intake can significantly lower blood pressure and might reduce the risk of major cardiovascular events, especially in individuals with lower cardiovascular risk, with some benefits noted from using salt substitutes.
Background: High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality.
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- Pruritus, or itchiness, is commonly experienced by dialysis patients and linked to lower quality of life and sleep issues, but the reasons behind it and effective treatments are still not well understood.
- A study of 1,438 new dialysis patients showed that around 50.5% to 56.6% experienced pruritus within the first year, with 35% having persistent itching and only a small percentage receiving treatment; emollients even worsened the severity.
- Overall, pruritus negatively impacted both physical and mental health-related quality of life, indicating a significant need for better awareness and development of treatment options for affected patients.
Article Synopsis
- - The study examines the relationship between kidney function and echocardiography findings related to left ventricular diastolic dysfunction (LVDD) in patients from a university hospital, categorizing them by levels of kidney function based on estimated glomerular filtration rate (eGFR).
- - Among 4,022 patients, those with increasingly decreased kidney function showed higher odds of having abnormal echocardiographic parameters, including the E/e' ratio and left ventricular mass index (LVMI), indicating a clear connection between deteriorating kidney health and worsening cardiac function.
- - The findings reveal that even mildly decreased kidney function is associated with signs of LVDD, suggesting that as kidney function declines, the risk of echocardiographic abnormalities in
Background: Peritoneal dialysis (PD) is a home-based kidney replacement therapy (KRT) performed in people with kidney failure. PD can be performed by manual filling and draining of the abdominal cavity, i.e.
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- Frequent hemodialysis (more than three times a week) may lower mortality and improve quality of life for kidney failure patients, but the evidence is not clear.
- A systematic review of available studies found only seven eligible trials with a total of 518 participants, indicating limited data on the health effects of frequent hemodialysis.
- The analysis suggested a possibly lower risk of death with frequent hemodialysis, but results were uncertain, and important outcomes like cardiovascular events and patient-reported well-being were largely missing.
Objective: Acute kidney injury (AKI) is easily missed and underdiagnosed in routine clinical care. Timely AKI management is important to decrease morbidity and mortality risks. We recently implemented an AKI e-alert at the University Medical Center Utrecht, comparing plasma creatinine concentrations with historical creatinine baselines, thereby identifying patients with AKI.
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- * Researchers also assessed health-related quality of life (HRQoL) across various domains, finding that while both groups experienced a decline, the HDF group showed more favorable changes, particularly in cognitive function.
- * Overall, the trial indicated HDF not only benefits survival rates but also helps slow the decline in quality of life aspects for patients, particularly in physical and cognitive functioning.
Comparison of the Response to an Electronic Versus a Traditional Informed Consent Procedure in Terms of Clinical Patient Characteristics: Observational Study.
J Med Internet Res
July 2024
Background: Electronic informed consent (eIC) is increasingly used in clinical research due to several benefits including increased enrollment and improved efficiency. Within a learning health care system, a pilot was conducted with an eIC for linking data from electronic health records with national registries, general practitioners, and other hospitals.
Objective: We evaluated the eIC pilot by comparing the response to the eIC with the former traditional paper-based informed consent (IC).
Article Synopsis
- Glomerular filtration rate (GFR) is an important indicator of kidney function, commonly estimated using formulas based on factors like serum creatinine, age, and sex.
- The estimated GFR (eGFR) is limited as it doesn't capture the full range of kidney functions and should be used alongside urine analysis and other clinical information for a thorough assessment of kidney health.
- For effective monitoring, factors such as medication, diabetes, obesity, and pregnancy need to be carefully considered alongside eGFR to understand the overall impact on kidney function for the patient.
Objective: Predicting adverse outcomes in patients with peripheral arterial disease (PAD) is a complex task owing to the heterogeneity in patient and disease characteristics. This systematic review aimed to identify prognostic factors and prognostic models to predict mortality outcomes in patients with PAD Fontaine stage I - III or Rutherford category 0 - 4.
Data Sources: PubMed, Embase, and Cochrane Database of Systematic Reviews were searched to identify studies examining individual prognostic factors or studies aiming to develop or validate a prognostic model for mortality outcomes in patients with PAD.
Article Synopsis
- This update reviews the use of antiviral medications to prevent cytomegalovirus (CMV) infections in solid organ transplant recipients, building on findings from previous reviews in 2005, 2008, and 2013.
- The objective is to evaluate the benefits and potential harms of these medications, specifically their effect on preventing CMV disease and all-cause mortality.
- The analysis of 41 studies with over 5,000 participants found new insights into the effectiveness of antiviral prophylaxis, aiming to summarize results using risk ratios and mean differences.
Objective: Lower extremity peripheral arterial disease (PAD) is a severe condition that increases the risk of major adverse cardiovascular events, major adverse limb events, and all cause mortality. This study aimed to investigate the mortality risk among females and males hospitalised for the first time with lower extremity PAD.
Methods: Three cohorts of patients who were admitted for the first time with lower extremity PAD in 2007 - 2010, 2011 - 2014, and 2015 - 2018 were constructed.
Article Synopsis
- * Results indicated a significant improvement in limb perfusion following treatment with bone marrow-derived cells compared to control groups, although the studies showed considerable variability in outcomes.
- * The authors noted a lack of completeness in reporting across the studies, leading to a conclusion that the overall quality of preclinical research is insufficient to inform better human clinical trials, as assessed by GRADE standards.
COVID-19 is not only associated with substantial acute liver and kidney injuries, but also with an elevated risk of post-acute sequelae involving the kidney and liver system. We aimed to investigate whether COVID-19 exposure increases the long-term risk of kidney and liver disease, and what are the magnitudes of these associations. We searched PubMed, Embase, Web of Science, ClinicalTrials.
View Article and Find Full Text PDFImportance: Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease, but their systematic underrepresentation in cardiovascular randomized clinical trials (RCTs) limits the generation of appropriate evidence to guide cardiovascular risk management (CVRM).
Objective: To evaluate the underrepresentation of patients with CKD in cardiovascular RCTs, and to highlight evidence gaps in CVRM medications in this population.
Evidence Review: A systematic search was conducted in ClinicalTrials.
Objectives: To determine whether clinical trial register (CTR) searches can accurately identify a greater number of completed randomized clinical trials (RCTs) than electronic bibliographic database (EBD) searches for systematic reviews of interventions, and to quantify the number of eligible ongoing trials.
Study Design And Setting: We performed an evaluation study and based our search for RCTs on the eligibility criteria of a systematic review that focused on the underrepresentation of people with chronic kidney disease in cardiovascular RCTs. We conducted a combined search of ClinicalTrials.
Aims: The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs).
Methods And Results: EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias.