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Paul L. Kimmel - One of the best experts on this subject based on the ideXlab platform.
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Depression and Mortality in End-Stage Renal Disease
Current Psychiatry Reports, 2011Co-Authors: Nisha Ver Halen, Daniel Cukor, Melissa Constantiner, Paul L. KimmelAbstract:End-Stage Renal Disease is growing in prevalence and incidence. With technical advancements, patients are living longer on hemodialysis. Depression is the most prevalent comorbid psychiatric condition, estimated at about 25% of end-Stage Renal Disease samples. The identification and assessment of depression are confounded by the overlap between depression symptomatology and uremia. Several recent studies have employed time-varying models and identified a significant association between depression and mortality. Due to the high prevalence of depression and the potential impact on survival, well-constructed investigations are warranted.
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screening diagnosis and treatment of depression in patients with end Stage Renal Disease
Clinical Journal of The American Society of Nephrology, 2007Co-Authors: Scott D Cohen, Lorenzo Norris, Kimberly D Acquaviva, Rolf A Peterson, Paul L. KimmelAbstract:Depression is common in patients with end-Stage Renal Disease and has been linked to increased mortality. Screening for depression in the general medical population remains controversial; however, given the high prevalence of depression and its significant impact on morbidity and mortality, a strong case for depression screening in patients with end-Stage Renal Disease can be made. Several studies have been performed to validate the more common depression screening measures in patients with chronic kidney Disease. The Beck Depression Inventory, the Hamilton Rating Scale for Depression, the Nine-Question Patient Health Questionnaire, and the Center for Epidemiologic Studies Depression Scale are some of the measures that have been used to screen for depression in patients with end-Stage Renal Disease. Data suggest a higher Beck Depression Inventory cutoff score, of >14 to 16, will have increased positive predictive value at diagnosing depression in patients with end-Stage Renal Disease. There are limited data on the treatment of depression in this patient population. Pharmacotherapy, including selective serotonin reuptake inhibitors, can be used if deemed clinically indicated, and no active contraindication exists. There are even fewer data to support the role of cognitive behavioral therapy, social support group interventions, and electroconvulsive therapy for treatment of depression in patients with chronic kidney Disease. Larger randomized, controlled clinical trials aimed at the treatment of depression in patients with end-Stage Renal Disease are desperately needed.
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Psychiatric illness in patients with end-Stage Renal Disease.
The American Journal of Medicine, 1998Co-Authors: Paul L. Kimmel, Mae Thamer, Christian RichardAbstract:Abstract Purpose: We sought to determine the prevalence of psychiatric illness in hospitalized patients with end-Stage Renal Disease. We also examined the association between end-Stage Renal Disease treatment modality and risk of hospitalization with a diagnosis of a mental disorder, and compared rates of hospitalization with a diagnosis of psychiatric illness in Renal failure patients to patients with other chronic medical illnesses. Subjects and methods: We performed a cohort study of all Medicare-enrolled dialysis patients in 1993. Risk of hospitalization with a diagnosis of a mental disorder among Renal failure patients was compared with Medicare patients with diabetes mellitus, ischemic heart Disease, cerebrovascular Disease, and peptic ulcer Disease. Results: Almost 9% of all dialysis patients were hospitalized with a mental disorder. Men, African-Americans, and younger patients were more likely to be hospitalized with a mental disorder. The adjusted risk of hospitalization for peritoneal dialysis patients was lower compared with hemodialysis patients for any mental disorder, depression, and alcohol and drug use. Hospitalization with mental disorders was 1.5 to 3.0 times higher for Renal failure patients compared with other chronically ill patients. Conclusions: Hospitalization with a psychiatric illness is common among the US end-Stage Renal Disease population. Depression, dementia and drug-related disorders were especially common. The coexistence of psychiatric illness in patients with Renal failure who require specialized medical regimens represents a challenge to nephrologists in diagnosis and treatment. Disparities between hospitalization rates of psychiatric illnesses among end-Stage Renal Disease patients compared with other chronically ill populations warrant further research.
Yi-hua Lu - One of the best experts on this subject based on the ideXlab platform.
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End-Stage Renal Disease after hypertensive disorders in pregnancy
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Chia-chun Wu, Sheng-hsien Chen, Chung-han Ho, Fu-wen Liang, Hsien-yi Wang, Yi-hua LuAbstract:Objective The purpose of this study was to determine the long-term postpartum risk of end-Stage Renal Disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute Renal failure. Study Design We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7.79–10.02 years) to estimate the incidence of end-Stage Renal Disease; Cox regression analysis that was adjusted for potential confounding was used to determine the relative risk. Results Of the 13,633 women with hypertensive disorders in pregnancy, 46 experienced end-Stage Renal Disease. Women with hypertensive disorders in pregnancy had a risk of end-Stage Renal Disease that was 10.64 times greater than did women without them (95% confidence interval [CI], 7.53–15.05). The risk was highest in women with a history of preeclampsia superimposed on chronic hypertension (hazard ratio, 44.72; 95% CI, 22.59–88.51). Women with gestational hypertension had a higher risk of end-Stage Renal Disease than did women without hypertensive disorders in pregnancy (hazard ratio, 5.82; 95% CI, 2.15–15.77). Conclusion Women with hypertensive disorders in pregnancy have a higher risk of postpartum end-Stage Renal Disease, regardless of which type of hypertensive disorder they have. Women with a history of hypertensive disorders in pregnancy are encouraged to have regular postpartum checkups, especially of Renal function.
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End-Stage Renal Disease after hypertensive disorders in pregnancy.
American journal of obstetrics and gynecology, 2013Co-Authors: Chia-chun Wu, Sheng-hsien Chen, Chung-han Ho, Fu-wen Liang, Hsien-yi Wang, Yi-hua LuAbstract:The purpose of this study was to determine the long-term postpartum risk of end-Stage Renal Disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute Renal failure. We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7.79-10.02 years) to estimate the incidence of end-Stage Renal Disease; Cox regression analysis that was adjusted for potential confounding was used to determine the relative risk. Of the 13,633 women with hypertensive disorders in pregnancy, 46 experienced end-Stage Renal Disease. Women with hypertensive disorders in pregnancy had a risk of end-Stage Renal Disease that was 10.64 times greater than did women without them (95% confidence interval [CI], 7.53-15.05). The risk was highest in women with a history of preeclampsia superimposed on chronic hypertension (hazard ratio, 44.72; 95% CI, 22.59-88.51). Women with gestational hypertension had a higher risk of end-Stage Renal Disease than did women without hypertensive disorders in pregnancy (hazard ratio, 5.82; 95% CI, 2.15-15.77). Women with hypertensive disorders in pregnancy have a higher risk of postpartum end-Stage Renal Disease, regardless of which type of hypertensive disorder they have. Women with a history of hypertensive disorders in pregnancy are encouraged to have regular postpartum checkups, especially of Renal function. Copyright © 2014 Mosby, Inc. All rights reserved.
Jeremiah Stamler - One of the best experts on this subject based on the ideXlab platform.
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blood pressure and end Stage Renal Disease in men
The New England Journal of Medicine, 1996Co-Authors: Michael J Klag, Paul K Whelton, Bryan L Randall, James D Neaton, Frederick L Brancati, Charles E Ford, Neil B Shulman, Jeremiah StamlerAbstract:Background End-Stage Renal Disease in the United States creates a large burden for both individuals and society as a whole. Efforts to prevent the condition require an understanding of modifiable risk factors. Methods We assessed the development of end-Stage Renal Disease through 1990 in 332,544 men, 35 to 57 years of age, who were screened between 1973 and 1975 for entry into the Multiple Risk Factor Intervention Trial (MRFIT). We used data from the national registry for treated end-Stage Renal Disease of the Health Care Financing Administration and from records on death from Renal Disease from the National Death Index and the Social Security Administration. Results During an average of 16 years of follow-up, 814 subjects either died of end-Stage Renal Disease or were treated for that condition (15.6 cases per 100,000 person-years of observation). A strong, graded relation between both systolic and diastolic blood pressure and end-Stage Renal Disease was identified, independent of associations between th...
Michael J Klag - One of the best experts on this subject based on the ideXlab platform.
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blood pressure and end Stage Renal Disease in men
The New England Journal of Medicine, 1996Co-Authors: Michael J Klag, Paul K Whelton, Bryan L Randall, James D Neaton, Frederick L Brancati, Charles E Ford, Neil B Shulman, Jeremiah StamlerAbstract:Background End-Stage Renal Disease in the United States creates a large burden for both individuals and society as a whole. Efforts to prevent the condition require an understanding of modifiable risk factors. Methods We assessed the development of end-Stage Renal Disease through 1990 in 332,544 men, 35 to 57 years of age, who were screened between 1973 and 1975 for entry into the Multiple Risk Factor Intervention Trial (MRFIT). We used data from the national registry for treated end-Stage Renal Disease of the Health Care Financing Administration and from records on death from Renal Disease from the National Death Index and the Social Security Administration. Results During an average of 16 years of follow-up, 814 subjects either died of end-Stage Renal Disease or were treated for that condition (15.6 cases per 100,000 person-years of observation). A strong, graded relation between both systolic and diastolic blood pressure and end-Stage Renal Disease was identified, independent of associations between th...
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End-Stage Renal Disease Attributable to Diabetes Mellitus
Annals of Internal Medicine, 1994Co-Authors: Thomas V. Perneger, Frederick L Brancati, Paul K Whelton, Michael J KlagAbstract:Objective: To determine the proportion of end-Stage Renal Disease associated with diabetes mellitus in a biracial population, using population-attributable risk estimates. Design: Case-control stud...
Chia-chun Wu - One of the best experts on this subject based on the ideXlab platform.
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End-Stage Renal Disease after hypertensive disorders in pregnancy
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Chia-chun Wu, Sheng-hsien Chen, Chung-han Ho, Fu-wen Liang, Hsien-yi Wang, Yi-hua LuAbstract:Objective The purpose of this study was to determine the long-term postpartum risk of end-Stage Renal Disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute Renal failure. Study Design We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7.79–10.02 years) to estimate the incidence of end-Stage Renal Disease; Cox regression analysis that was adjusted for potential confounding was used to determine the relative risk. Results Of the 13,633 women with hypertensive disorders in pregnancy, 46 experienced end-Stage Renal Disease. Women with hypertensive disorders in pregnancy had a risk of end-Stage Renal Disease that was 10.64 times greater than did women without them (95% confidence interval [CI], 7.53–15.05). The risk was highest in women with a history of preeclampsia superimposed on chronic hypertension (hazard ratio, 44.72; 95% CI, 22.59–88.51). Women with gestational hypertension had a higher risk of end-Stage Renal Disease than did women without hypertensive disorders in pregnancy (hazard ratio, 5.82; 95% CI, 2.15–15.77). Conclusion Women with hypertensive disorders in pregnancy have a higher risk of postpartum end-Stage Renal Disease, regardless of which type of hypertensive disorder they have. Women with a history of hypertensive disorders in pregnancy are encouraged to have regular postpartum checkups, especially of Renal function.
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End-Stage Renal Disease after hypertensive disorders in pregnancy.
American journal of obstetrics and gynecology, 2013Co-Authors: Chia-chun Wu, Sheng-hsien Chen, Chung-han Ho, Fu-wen Liang, Hsien-yi Wang, Yi-hua LuAbstract:The purpose of this study was to determine the long-term postpartum risk of end-Stage Renal Disease in women with hypertensive disorders in pregnancy. Although most women with hypertensive disorders in pregnancy recover after delivery, some may experience acute Renal failure. We searched Taiwan's National Health Insurance Research Database to identify women with hypertensive disorders in pregnancies and deliveries between 1998 and 2002. All cases were followed for a maximum of 11 years (median, 9 years; interquartile range, 7.79-10.02 years) to estimate the incidence of end-Stage Renal Disease; Cox regression analysis that was adjusted for potential confounding was used to determine the relative risk. Of the 13,633 women with hypertensive disorders in pregnancy, 46 experienced end-Stage Renal Disease. Women with hypertensive disorders in pregnancy had a risk of end-Stage Renal Disease that was 10.64 times greater than did women without them (95% confidence interval [CI], 7.53-15.05). The risk was highest in women with a history of preeclampsia superimposed on chronic hypertension (hazard ratio, 44.72; 95% CI, 22.59-88.51). Women with gestational hypertension had a higher risk of end-Stage Renal Disease than did women without hypertensive disorders in pregnancy (hazard ratio, 5.82; 95% CI, 2.15-15.77). Women with hypertensive disorders in pregnancy have a higher risk of postpartum end-Stage Renal Disease, regardless of which type of hypertensive disorder they have. Women with a history of hypertensive disorders in pregnancy are encouraged to have regular postpartum checkups, especially of Renal function. Copyright © 2014 Mosby, Inc. All rights reserved.
