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Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting:
a UK national study. Participants not receiving RRT could progress to (or remain in) any CKD
category, with transition probabilities estimated using multivariate multinomial logistic regression.
Below is the link to the electronic supplementary material. Outcomes Among Patients With
Advanced Kidney Disease Who Forgo Key Points. Nagy B, et al. Cost-effectiveness of a risk-based
secondary screening programme of type 2 diabetes. As guarantor and corresponding author, DS takes
full responsibility for the work as a whole and the decision to submit and publish the manuscript.
Due to the wide variety of possible causal factors, it seems unlikely that there. The Medical
Outcomes Study SF-12 and SF-36 were reported in 52 and 227 studies, respectively, KDQOL in
100, the World Health Organization Quality of Life (WHOQOL-BREF) instrument in 33, and EQ-
5D in 28. A systematic review and meta-analysis of utility-based quality of life in chronic kidney
disease treatments. PLoS Med. 2012;9(9):e1001307. Zazzeroni L, Pasquinelli G, Nanni E,
Cremonini V, Rubbi I. This systematic literature review explored treatments evaluated in patients
with CKD since 1990 to. Second, only primary publications of models were included as they were
deemed to contain the most relevant information regarding the model. In models of CKD with
diabetes, a number of authors cited the use of risk equations derived from the Framingham Heart
Study as a limitation to predicting cardiovascular events in those with CKD. American journal of
kidney diseases. 2000;36(6): S13-S23. The aim of the present study was to systematically review
published economic models that simulated long-term outcomes of kidney disease to inform cost-
effectiveness evaluations of CKD treatments. An experienced medical librarian (D. L.) performed a
comprehensive search of MEDLINE, Embase (Excerpta Medica Database), and CINAHL
(Cumulative Index of Nursing and Allied Health Literature) for all English language publications
pertaining to patients with advanced CKD who did not pursue maintenance dialysis from inception
through January 27, 2020, with a search update through December 3, 2021. A national hypertension
treatment program in Germany and its estimated impact on costs, life expectancy, and cost-
effectiveness. Further research may be required to explore the symptoms with broad confidence
intervals, and hence greater uncertainty. SR Globals Profile - Building Vision, Exceeding
Expectations. As novel interventions become available, estimates of economic and clinical outcomes
are needed to guide payer reimbursement decisions. However, it should be noted that the modelling
of these components was often relatively simplistic and failed to provide clinical justification or
rationale for the choice of modelled relationship. PA, et al. (2010) Effect of prior intensive insulin
treatment during. The bibliographies of relevant published SRs and cost-effectiveness analyses were
hand-searched to find additional articles that were not identified in the electronic database searches.
Long-term Outcomes Among Patients With Advanced Kidney Disease Who Forgo Maintenance
Dialysis: A Systematic Review. Summary of Findings of Current Systematic Review and
Recommendations to Advance Conservative Kidney Management Conservative Care for Kidney
Failure JAMA Network Open Invited Commentary March 14, 2022 Christine K. There was a total of
199,147 participants involved in the included studies (median 146, IQR 85 to 267, range 9 to
18,015). Participants not receiving RRT could progress to (or remain in) any CKD category, with
transition probabilities estimated using multivariate multinomial logistic regression. In total, 48
unique diabetes models were identified that modelled nephropathy using two different approaches.
Collectively, our findings demonstrate the need to implement systematic and unified research
methods for conservative kidney management and to develop models of care and the care
infrastructure to advance practice and outcomes of conservative kidney management. However, the
rationale for model selection was often not cited in the various model publications identified in this
review, and estimates of CKD progression in diabetes models with CKD components still rely
heavily on a limited number of older datasets that may not fully capture contemporary patient care. In
addition, many of the current methods did not explicitly consider patient heterogeneity or underlying
disease aetiology, except for diabetes.
Dendrin is a component of the slit diaphragm with a hypothetic role in ensuring its stability, by
directly interacting with nephrin and the scaffolding protein CD2AP in physiological conditions. For
studies comparing multiple treatment groups, we collected information only on groups of patients in
whom there was a decision not to pursue dialysis from each study. Where possible, HSU weights
used in a cost-effectiveness analysis could be limited to a single instrument relevant to the specific
research question for a cost-effectiveness analysis such as the EQ-5D-3L for cost-effectiveness
analyses submitted to NICE in England. Two independent reviewers (JC, JGS) screened the title and
abstract of each record (stage 1), as well as the full texts of all potentially eligible records identified
in stage 1 (stage 2). By focusing to the most generalisable and reliable Grade 1 studies, we hope to
present the most accurate summary of HSU weights in CKD. In addition, many of the current
methods did not explicitly consider patient heterogeneity or underlying disease aetiology, except for
diabetes. Proceedings of the 1994 Second Australian and New Zealand. However, a number of
studies did not differentiate between type of RRT, instead defining RRT as dialysis or transplant.
Semi-Markov model: As a Markov model but incorporating a time-dependency factor whereby
transition rates are dependent on the time spent in a health state and are, thus, not constant.
Irrespective of the type of diabetes, most models applied a core sub-model structure of diabetic
nephropathy based on a disease pathway of five health states: no nephropathy (or
normoalbuminuria), microalbuminuria, macroalbuminuria (or gross proteinuria), ESRD (comprising
dialysis or transplant as absorbing states) and death (Fig. 3 ). Some models also included a health
state of macroalbuminuria with impaired (estimated or measured) GFR. Transplantation, however,
did not restore quality of life to levels seen in those without CKD. If you wish to reuse any or all of
this article please use the link below which will take you to the Copyright Clearance Center’s
RightsLink service. The review was conducted across four databases (MEDLINE, Embase, the
Cochrane library and EconLit) and health technology assessment agency websites. Treatments for
Chronic Kidney Disease: A Systematic Literature Review Delaying disease progression and reducing
the risk of mortality are key goals in the treatment of chronic kidney disease (CKD). Our findings
offer insights into directions for research and clinical care to improve survival, quality of life, use of
health care resources, and end-of-life care for members of this population (eFigure in the Supplement
). The rate at which patients progressed from dialysis to transplant or from transplant to dialysis, and
the mortality risk multiplier attributable ESRD, were typically informed by country-specific registry
data. This could result in the estimation of different QALYs gained in cost-effectiveness models and
could affect the recommendation to adopt new treatments for CKD by HTA agencies. HRQLs for
haemodialysis and post-transplant patients were the most common. Although research on
conservative kidney management has been growing, available evidence is best regarded as very
limited and preliminary. American journal of kidney diseases. 2000;36(6): S13-S23. PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram showing the
model-selection process. Across all models, cardiovascular-related risk was most frequently derived
from the Framingham Heart Study, with estimates modified to reflect differences in specific
geographical populations or patient characteristics. The most infrequently reported elements were
conflicts of interest (47%), measurement and valuation of preference-based outcomes (34%) and
sources of funding (30%). 3.2 Chronic Kidney Disease (CKD) Models 3.2.1 framework and disease
pathway. Lukes Hospital and Texas Heart Institute, Houston, Texas, USA). Of all 74 patients, 43
cases had hypertension, 36 cases had diabetes mellitus, 14 cases had ischemic heart disease, 10 cases
had atrial fibrillation, three cases had chronic-disease anemia, and one case had thrombosis, and in
five cases no previous diseases were mentioned. Hybrid System of Tiered Multivariate Analysis and
Artificial Neural Network f. Health-related quality of life and its factors of hemodialysis patients in
Suzhou, China. The 30 days mortality rate for conservative treatment was 61.8%, and the mortality
rate for surgical treatment was 30%. Titles and abstracts of the identified citations were screened by
a single reviewer following specific PICOS (population, interventions, comparators, outcomes and
study design) eligibility criteria (Table 7 in Resource 1 of the ESM). The choice of model structure
may also play a key role in the validity of these extrapolations, underlining the importance of
understanding the implications of selecting a particular conceptual modelling approach.
Third, the review was limited to the information available in the study publication. BMC Med
Inform Decis Mak. 2011;11(1):41. Schlackow, I., et al., A policy model of cardiovascular disease in
moderate-to-advanced chronic kidney disease. Heart. 2017: p. heartjnl-2016-310970. The VR
intervention was delivered in either clinical 58 or unspecified setting. 59 Both interventions were
delivered weekly for 8 weeks, facilitated by a single intervention provider. This is probably mediated
by the generation of focal adhesions of PECs to the glomerular tuft, usually referred to as bridges,
which may represent preferential tracks for PECs to reach the site of injury into the glomerulus (
Figure 1 ). Surgical intervention after the occurrence of NSDH in HD can reduce patient mortality (
p There are limitations to our study. PM provided senior review and technical expertise and
contributed to the design of the research. These methodological inconsistencies probably account for
the variability in findings across studies and limit our ability to make detailed assessments of how
virtual realities might be used in populations with chronic disease and understand the unique
contribution different VR interventions might make to clinical practice. Funding The research was
completed with the support of funding from the Northern Ireland Health and Social Care Trust
(HSCNI) Business Services Organisation (BSO). Frameworks of future CKD models should be
informed and justified based on clinical rationale and data availability to ensure validity of model
results. Kidney disease as a risk factor for development of cardiovascular. Avalon Health Economics,
Morristown, NJ, USA Jacie T. Median survival varied widely by study region (A), age group (B),
year of study publication (C), and approach to conservative care (D). Impaired renal function is
associated with worse self-reported outcomes after kidney transplantation. The first approach
modelled diabetes through estimated glycated haemoglobin (HbA 1c ) change with time. Ten studies
(570 patients) 12, 19, 21, 34, 36, 39, 42, 45, 46, 48 provided information on use of health care
resources during follow-up ( Table 2 ). In addition, where contemporaneous data were available, we
were able to compare with controls. As novel interventions become available, estimates of economic
and clinical outcomes are needed to guide payer reimbursement decisions. Prospective studies,
retrospective studies, and case reports were included. Furthermore, in the CORE diabetes model,
patients were screened for the presence of micro- or macroalbuminuria; once either was detected,
they could be treated with angiotensin-converting enzyme inhibitors. The article selection process is
displayed in Fig. 2. PRISMA Diagram. Abbreviations: CKD, chronic kidney disease; PRISMA,
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Of the 52 included studies,
the grading process identified 17 Grade 1, 30 Grade 2, and 5 Grade 3 studies (Additional file 3 ).
IRJET -Improving the Accuracy of the Heart Disease Prediction using Hybrid Ma. The study
conducted among people with IBD provided a specific gut healing game. Any discrepancies
between first and second reviewer, that could not be resolved independently, were resolved through
a third reviewer. Fatal cerebritis and brain abscesses following a nontraumatic subdural hematoma in
a chronic hemodialyzed patient. Hillege HL, et al. Microalbuminuria is common, also in a
nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors
and cardiovascular morbidity. Object-oriented simulation model: Defined as a person-by-person,
object-by-object simulation, spanning from biological details to the care processes, logistics,
resources and costs of healthcare systems. Monte-Carlo simulation model: Defined as a form of
modelling where model inputs are drawn from distributions and are not treated as fixed values, with
the model run multiple times to provide a probabilistic distribution of results. A Novel Approach for
Tomato Diseases Classification Based on Deep Convolution. Economic Modelling of Chronic
Kidney Disease: A Systematic Literature Economic Modelling of Chronic Kidney Disease: A
Systematic Literature Review to Inform Conceptual Model Design.. This review provides an
overview of how chronic kidney disease (CKD) is typically modelled, with glomerular filtration rate
(GFR) and albuminuria, respectively, typically utilised as the key prognostic factor within CKD and.
The choice of model structure may also play a key role in the validity of these extrapolations,
underlining the importance of understanding the implications of selecting a particular conceptual
modelling approach. The aim of the present study was to systematically review published economic
models that simulated long-term outcomes of kidney disease to inform cost-effectiveness evaluations
of CKD treatments.
Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is
not guaranteed or endorsed by the publisher. The article selection process is displayed in Fig. 2.
PRISMA Diagram. Abbreviations: CKD, chronic kidney disease; PRISMA, Preferred Reporting
Items for Systematic Reviews and Meta-Analyses Of the 52 included studies, the grading process
identified 17 Grade 1, 30 Grade 2, and 5 Grade 3 studies (Additional file 3 ). A maximum horizon
of 50 years (up to the age of 100) was modelled across all analyses to limit the uncertainty between
modelled outcomes. 3.1 Summary of Included Models The search identified 2382 citations,
excluding any duplicate publications (Fig. 1 ). During the screening of titles and abstracts, a further
1880 citations were excluded. The diagnosis of NSDH was mainly made by imaging, among which
51 cases were found by CT examination and seven cases were found by carotid arteriography. For
each year of follow-up, data collected during that year were used to categorise participants into
respective health states (one of five CKD states, on maintenance dialysis, or having undergone a
kidney transplant). Generally, two core structures were identified, either a microsimulation model
involving albuminuria or a Markov model utilising CKD stages and a linear GFR decline (although
further variations on these model structures were also identified). The review identified a large
number of published studies that reported HSU weights for CKD populations. Summary of Included
Models The search identified 2382 citations, excluding any duplicate publications (Fig. 1 ). During
the screening of titles and abstracts, a further 1880 citations were excluded. IAEME Publication
IRJET- Feature Selection and Classifier Accuracy of Data Mining Algorithms IRJET- Feature
Selection and Classifier Accuracy of Data Mining Algorithms IRJET Journal IRJET -Improving the
Accuracy of the Heart Disease Prediction using Hybrid Ma. In general, patients who had received a
kidney transplant experienced fewer and less severe symptoms and had an improved quality of life,
but this was still worse than that of people without CKD. Health-related quality of life assessment in
chronic kidney disease. International Research Workshop on Mesoamerican Nephropathy, held in
2015, it. Methods: Electronic databases, including PubMed, EMBASE, and Web of Science were
searched by using various combinations of the keywords “Hemodialysis,” “Renal Insufficiency,”
“Extracorporeal Dialysis,” “Subdural Hematoma,” “Subdural Hemorrhage,” “Subdural Hematomas,”
and “Subdural Hemorrhages” in accordance with the PRISMA guidelines. IRJET Journal Similar to
Chronic Kidney Disease Prediction ( 20 ) Propose a Enhanced Framework for Prediction of Heart
Disease Propose a Enhanced Framework for Prediction of Heart Disease 1 springer format chronic
changed edit iqbal qc 1 springer format chronic changed edit iqbal qc DATA MINING
CLASSIFICATION ALGORITHMS FOR KIDNEY DISEASE PREDICTION DATA MINING
CLASSIFICATION ALGORITHMS FOR KIDNEY DISEASE PREDICTION APPLICATION OF
DATA MINING TECHNIQUES FOR THE PREDICTION OF CHRONIC KIDNEY DI.
Metformin is an inexpensive and effective oral hypoglycemic agent that is recommended as firstline.
Subdural hematomas in chronic dialysis patients: significant and increasing. In addition, where
contemporaneous data were available, we were able to compare with controls. Where reported,
ESRD models defined ESRD as (measured or estimated) GFR? 3.2.2 Characterisation of CKD
Progression In summary, five models (38%) predicted CKD outcomes based on rates of annual GFR
decline, four models (31%) used GFR transition probabilities and two models (15%) used
albuminuria transition probabilities. It can serve as a resource to the internist or primary care
physician deciding upon when to refer a patient to the nephrologist. Often there was no single table
of modelling assumptions; instead, structural or other assumptions underpinning the models were
reported in relevant sections of the publication. A total of 41 cohort studies comprising 5102 patients
(study size range, 11-812 patients; 5%-99% men; mean age range, 60-87 years) were included in this
review (eTable 1 in the Supplement ). 11 - 51 No clinical trials were identified in our search. All
exploratory subgroup analyses comparing HRQOL scores between populations showed statistically
significant differences, with the exception of the KDQOL symptoms and problems subscale
comparison between patients not on RRT and in receipt of a transplant (FDR-sharpened q -value
0.107) (HRQOL subgroup analyses available in S8 Appendix ). Ferrannini, G. et al. Energy balance
after sodium-glucose cotransporter 2 inhibition. Although among some cohorts, most patients
received hospice care, avoided burdensome procedures near the end-of-life, and died at home, for
other cohorts, only a minority accessed supportive care near the end of life. Cost-effectiveness of
haemodialysis and peritoneal dialysis for patients with end-stage renal disease in Singapore. A
number of aspects may affect the mix of patients included in the studies reported in this SR and,
therefore, the eventual HSU weights reported. Among diabetes models with nephropathy, there was
reasonable consistency with respect to starting health state, with only four of the 15 models not
initiating patients in the state of normoalbuminuria. In both, kidney disease was modelled as the
probability of ESRD. In general, models employed a core structure based on four health states: pre-
dialysis, dialysis, transplantation and death. Characterisation and comparison of health-related quality
of life for patients with renal failure.
A decision and cost-utility analysis of angiotensin-converting-enzyme inhibitor therapy for diabetic
nephropathy. First, only English articles were included in the search. The UK Prospective Diabetes
Study (UKPDS): clinical and therapeutic implications for type 2 diabetes. It should therefore be
valuable to the reader, whether involved in physician education or in clinical practice, or whether a
medical student, house officer or seasoned clinician. Navaneethan SD, et al., HMG CoA reductase
inhibitors (statins) for people with chronic kidney disease not requiring dialysis. In 14 articles,
heparin anticoagulation was used during HD in 72 cases. The timing of surgery is critical for acute
SDH in patients receiving anticoagulant therapy. Weight loss interventions in chronic kidney disease:
a systematic review and meta-analysis. We included peer-reviewed studies published in English
between January 2013 and April 2018 for As and Cd, and all dates prior to. This work was
supported by the Foundation Program of the Sichuan Provincial Health Commission (no. 21PJ181).
Conflict of interest The authors declare that the research was conducted in the absence of any
commercial or financial relationships that could be construed as a potential conflict of interest.
HRQLs for haemodialysis and post-transplant patients were the most common. Similarly, T2DM
models tended to use transition rates or transition probabilities to model the progression of diabetic
nephropathy. However, the variability of individual patients’ GFR and albuminuria trajectories
perhaps provides rationale for a model structure designed around the prediction of individual
patients’ GFR trajectories. Table 2 Summary of annual transition rates reported in identified studies
Assumptions: Where relevant, transitions were matched to a baseline patient age of 50 years. A total
of 31 studies were included in the review (see online supplemental table 1 ). Whereas 1 study (42
patients) 42 reported a mean of 4 hospital admissions per person-year and 38 in-hospital days per
person-year among its cohort members, the other studies (528 patients) 12, 19, 21, 34, 36, 39, 45, 46,
48 reported approximately 1 to 2 hospital admissions per person-year and 6 to 16 in-hospital days per
person-year. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive
and Kidney Diseases; 2018. The grey literature identified 83 studies, although no new studies met
our inclusion criteria (Additional file 2 ). Corresponding author Correspondence to Juan Jose Garcia
Sanchez. Treatments for Chronic Kidney Disease: A Systematic Literature Review Delaying disease
progression and reducing the risk of mortality are key goals in the treatment of chronic kidney
disease (CKD). Of all 74 patients, 43 cases had hypertension, 36 cases had diabetes mellitus, 14
cases had ischemic heart disease, 10 cases had atrial fibrillation, three cases had chronic-disease
anemia, and one case had thrombosis, and in five cases no previous diseases were mentioned.
Immersive VR as a platform to deliver therapeutic interventions The physical and psychological
consequences of chronic illness can have a debilitating effect on patients, which restricts their ability
and motivation to engage in meaningful activity. 14 A benefit of VR interventions is that it increases
the availability of realistic experiences to patients. A large quantity of data was available from
different settings, and this synthesis presents strong evidence for the ongoing and considerable
impact of CKD on patients’ lives. Studies were excluded if they met any of the following criteria: (a)
non-English language text; (b) non-immersive or semi-immersive VR intervention; (c) VR
intervention was specifically designed to provide cognitive remediation or physical motor
rehabilitation; (d) non-empirical research, such as expert reviews, opinion pieces etc; (e) qualitative
research. Open Access by Juniper Publishers is licensed under a Creative Commons Attribution 4.0
International License. However, the burr hole or twist drill should be wide enough to allow
continuous free drainage to prevent recurrence of the hematoma. Scienceand Software Engineering,
Vol. 3, pp:1114-1119, June 2013. The review included data collected using PROMs only, hence data
provided from CKD patients themselves. Therefore, within this context, a simplification or
generalisation of CKD aetiologies may be considered appropriate. As novel treatments for CKD
become available and require evaluation for inclusion into drug formularies, estimates of economic
(optimisation of budget usage) and clinical (maximisation of population benefits) outcomes are
needed to guide payer reimbursement decisions.