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Severe sepsis-associated acute kidney injury and outcomes: a longitudinal cohort study.
Intern Med J
January 2025
School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Background: Sepsis-associated acute kidney injury (SA-AKI) is common among patients admitted to the intensive care unit (ICU) with sepsis.
Aims: This study aimed to demonstrate an association between an episode of SA-AKI and progression to dialysis dependence, with a view to identifying a cohort who may be suitable for intensive nephrology follow-up.
Methods: Design: Retrospective data-linkage cohort study.
Current status and strategies to strengthen paediatric kidney replacement therapy in Nepal.
Pediatr Nephrol
January 2025
Department of Paediatrics, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.
Paediatric dialysis services have been available in Nepal for three decades but are limited to a few tertiary referral centres in major cities. The availability of a small number of paediatric nephrologists, an increasing number of adult nephrologists, and a modest increase in dialysis facilities have contributed to the gradual expansion of paediatric nephrology and kidney replacement therapy services in Nepal over the last decade. These services have grown steadily and will continue to grow because of the positive impact of government support for kidney replacement therapy and various public health initiatives to promote kidney health.
View Article and Find Full Text PDFUtilization of Telemedicine for Patients Receiving In-center Hemodialysis in the United States.
J Am Soc Nephrol
January 2025
Baylor College of Medicine, Section of Nephrology, Houston TX.
Background: In March 2020, responding to the COVID-19 pandemic, federal emergency waivers in the United States enabled kidney care providers (nephrologists and advanced practice providers) to substitute face-to-face in-center hemodialysis visits with telemedicine encounters. We examined whether the frequency of kidney care provider visits and hospitalizations were associated with telemedicine use in hemodialysis care.
Methods: We used Medicare claims to identify US patients receiving in-center hemodialysis during the first 16 months of the COVID-19 pandemic.
Penalized G-estimation for effect modifier selection in a structural nested mean model for repeated outcomes.
Biometrics
January 2025
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada.
Effect modification occurs when the impact of the treatment on an outcome varies based on the levels of other covariates known as effect modifiers. Modeling these effect differences is important for etiological goals and for purposes of optimizing treatment. Structural nested mean models (SNMMs) are useful causal models for estimating the potentially heterogeneous effect of a time-varying exposure on the mean of an outcome in the presence of time-varying confounding.
View Article and Find Full Text PDFNavigating the Complexities of Anterior Cord Syndrome in a 71-Year-Old: A Case Study of Vertebral Osteomyelitis and Methicillin-Resistant Staphylococcus aureus Bacteremia.
Cureus
December 2024
Internal Medicine, Merit Health Wesley, Hattiesburg, USA.
Anterior cord syndrome is a rare yet critical neurological condition that poses significant challenges in clinical management. We present the case of a 71-year-old male with a medical history of hypertension, uncontrolled type II diabetes mellitus, hypothyroidism, and end-stage renal disease requiring dialysis who presented to the emergency department with complaints of chills, back pain, abdominal pain, and vomiting episodes. Based on the severity of the patient's illness, it was decided that inpatient admission would be best.
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