Increases in renal replacement therapy in Australia and New Zealand: Understanding trends in diabetic nephropathy

Grace, Blair; Clayton, Philip; McDonald, S.

doi:10.1111/j.1440-1797.2011.01512.x

Cited by 66 publications

(50 citation statements)

References 26 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The median age at time of first conception was 30.1 years (IQR, 26.1-32.3 years), and women with COD had a significantly older age distribution than those with CBD. The median eGFR at commencement of dialysis in the CBD group was higher than the COD group and the general dialysis population (23). There were no other demographic differences between the CBD and COD groups.…”

Section: Demographic Datamentioning

confidence: 73%

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Jesudason

Grace

McDonald

2014

Clinical Journal of the American Society of Nephrology

142

125

View full text Add to dashboard Cite

SummaryBackground and objectives Pregnancy in ESRD is rare and poses substantial risk for mother and baby. This study describes a large series of pregnancies in women undergoing long-term dialysis treatment and reviews maternal and fetal outcomes. Specifically, women who had conceived before and after starting long-term dialysis are compared.Design, setting, participants, & measurement All pregnancies reported to the Australian and New Zealand Dialysis and Transplantation Registry from 2001 to 2011 (n=77), following the introduction of specific parenthood data collection, were analyzed.Results Between 2001 and 2011, there were 77 pregnancies among 73 women. Of these, 53 pregnancies were in women who conceived after long-term dialysis was established and 24 pregnancies occurred before dialysis began. The overall live birth rate (after exclusion of elective terminations) was 73%. In pregnancies reaching 20 weeks gestation, the live birth rate was 82%. Women who conceived before dialysis commenced had significantly higher live birth rates (91% versus 63%; P=0.03), but infants had similar birthweight and gestational age. This difference in live birth rate was primarily due to higher rates of early pregnancy loss before 20 weeks in women who conceived after dialysis was established. In pregnancies that reached 20 weeks or more, the live birth rate was higher in women with conception before dialysis commenced (91% versus 76%; P=0.28). Overall, the median gestational age was 33.8 weeks (interquartile range, 30.6-37.6 weeks) and median birthweight was 1750 g (interquartile range, 1130-2417 g). More than 40% of pregnancies reached .34 weeks' gestation; prematurity at ,28 weeks was 11.4% and 28-day neonatal survival rate was 98%.Conclusions Women with kidney disease who start long-term dialysis after conception have superior live birth rates compared with those already established on dialysis at the time of conception, although these pregnancies remain high risk.

show abstract

Section: Demographic Datamentioning

confidence: 73%

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Jesudason

Grace

McDonald

2014

Clinical Journal of the American Society of Nephrology

142

125

View full text Add to dashboard Cite

show abstract

“…10,11 This trend has, in part, been explained by observational evidence suggesting improved outcomes with earlier dialysis initiation. 12,13 However, the trend of earlier dialysis initiation parallels the utilization of automated eGFR reporting.…”

Section: Discussionmentioning

confidence: 99%

Estimated GFR Reporting Influences Recommendations for Dialysis Initiation

Brimble

Mehrotra

Hawley

et al. 2013

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Automated reporting of estimated GFR (eGFR) with serum creatinine measurement is now common. We surveyed nephrologists in four countries to determine whether eGFR reporting influences nephrologists' recommendations for dialysis initiation. Respondents were randomly allocated to receive a survey of four clinical vignettes that included either serum creatinine concentration only or serum creatinine and the corresponding eGFR. For each scenario, the respondent was asked to rank his or her likelihood of recommending dialysis initiation on a modified 8-point Likert scale, ranging from 1 ("definitely not") to 8 ("definitely would"). Analysis of the 822 eligible responses received showed that the predicted likelihood of recommending dialysis increased by 0.55 points when eGFR was reported (95% confidence interval, 0.33 to 0.76), and this effect was larger for eGFRs .5 ml/min per 1.73 m 2 (P,0.001). Subgroup analyses suggested that physicians who had been in practice $13 years were more affected by eGFR reporting (P=0.03). These results indicate that eGFR reporting modestly increases the likelihood that dialysis is recommended, and physicians should be aware of this effect when assessing patients with severe CKD.

show abstract

“…평균 15년간 추적관찰한 결과 38%에서 미세단백뇨 및 현성단백뇨가 발생하였고 28%에서 신기능 저하(eGFR < 60 mL/min/1.73m 2 )가 발생하였으며, 14%는 단백뇨 및 신기능저하가 모두 발생하였다 [14]. 호주인을 대상으로 한 연구에서 전체 인구의 단백뇨 발생률이 연간 0.83%였던 반면, 당뇨병 인구의 단백뇨 발생률은 연간 3.1%에 이르렀다 [15]. …”

Section: 국외의 당뇨병성 신증의 유병률 및 발생률에 대한 연구unclassified

The Epidemiology of Diabetic Nephropathy

Kim

2013

J Korean Diabetes

View full text Add to dashboard Cite

Increases in renal replacement therapy in Australia and New Zealand: Understanding trends in diabetic nephropathy

Cited by 66 publications

References 26 publications

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Estimated GFR Reporting Influences Recommendations for Dialysis Initiation

The Epidemiology of Diabetic Nephropathy

Contact Info

Product

Resources

About