DIALYSIS CARE: CHOICES, OUTCOMES, COSTS AND TRADEOFFS

透析护理：选择、结果、成本和权衡

• 批准号: 2735420
• 负责人: NEIL R. POWE
• 金额: $ 125.07万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-07-01 至 2000-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2735420
• 关键词: Medicare /Medicaid; chronic renal failure; continuous ambulatory peritoneal dialysis; health care cost /financing; health care policy; health care service utilization; hemodialysis; human morbidity; human mortality; human subject; human therapy evaluation; longitudinal human study; medical complication; outcomes research; patient care management; quality of life

End Stage Renal Disease (ESRD) is a devastating chronic illness which affects nearly 200,000 patients each year in the United States. The average annual per-patient cost of treatment is nearly $30,000, nine to ten times that of an average individual. The aggregate cost of ESRD care, $7 billion, is growing rapidly due to increasing enrollment of patients age 65 and older. Despite the benefits of kidney transplantation, a limited pool of donors and comorbid disease obligates most ESRD patients to chronic dialysis. This care is performed on an ambulatory basis. Choices of dialysis prescription, modality and dose, by physicians and patients are fundamental to the care of ESRD patients, vary considerably in the U.S. and could have enormous cost implications given the large per-patient costs. The choice of therapy in routine practice should reflect a comprehensive understanding of outcomes and costs of alternative prescriptions, and of the tradeoffs which they entail. However, neither the outcomes, the costs nor the tradeoffs are characterized well. We have formed a multidisciplinary team to investigate factors that influence the choice of a particular dialysis prescription, to assess patient outcomes and costs of alternative dialysis prescriptions in the United States, and to formulate optimal dialysis strategies that take into account the perspectives of patients, providers and payers. Our research will include: 1) a national prospective cohort study of mortality, morbidity, symptoms, quality of life, patient satisfaction and costs associated with alternative dialysis prescriptions; 2) a cross- sectional and follow-up study of patient preferences for alternative prescriptions; 3) a cross-sectional survey of nephrologists and dialysis facility administrators to ascertain factors affecting the choice of therapy; 4) a study of the impact of resource utilization in outpatient dialysis on mortality, morbidity and overall costs for all facilities and facilities of different organizational types; and 5) an analysis of the cost-effectiveness of alternative prescriptions. This research will provide information that can be used by physicians and policymakers to guide and improve dialysis management in the United States.

终末期肾病（ESRD）是一种毁灭性的慢性疾病

项目成果

Race, Mineral Homeostasis and Mortality in Patients with End-Stage Renal Disease on Dialysis.

• DOI: 10.1159/000438999
• 发表时间: 2015
• 期刊: American journal of nephrology
• 影响因子: 4.2
• 作者: Scialla JJ;Parekh RS;Eustace JA;Astor BC;Plantinga L;Jaar BG;Shafi T;Coresh J;Powe NR;Melamed ML
• 通讯作者: Melamed ML

C-Reactive protein haplotype predicts serum C-reactive protein levels but not cardiovascular disease risk in a dialysis cohort.

C 反应蛋白单倍型可预测透析队列中的血清 C 反应蛋白水平，但不能预测心血管疾病风险。

• DOI: 10.1053/j.ajkd.2006.10.008
• 发表时间: 2007
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation
• 作者: Zhang,Lin;Kao,WHLinda;Berthier-Schaad,Yvette;Plantinga,Laura;Fink,Nancy;Smith,MichaelW;Coresh,Josef
• 通讯作者: Coresh,Josef

Association of Peritoneal Dialysis Clinic Size with Clinical Outcomes

腹膜透析诊所规模与临床结果的关系

• DOI: 10.1177/089686080902900312
• 发表时间: 2009
• 期刊: Peritoneal Dialysis International
• 影响因子: 2.8
• 作者: L. Plantinga;N. Fink;F. Finkelstein;N. Powe;B. Jaar
• 通讯作者: B. Jaar

Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study.

• DOI: 10.1053/j.ajkd.2014.07.010
• 发表时间: 2014-12
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation
• 作者: Banerjee T;Kim SJ;Astor B;Shafi T;Coresh J;Powe NR
• 通讯作者: Powe NR

Troponin I and NT-proBNP and the association of systolic blood pressure with outcomes in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study.

肌钙蛋白 I 和 NT-proBNP 以及收缩压与血液透析患者结局的关联：终末期肾病护理健康结局选择 (CHOICE) 研究。

• DOI: 10.1053/j.ajkd.2014.03.015
• 发表时间: 2014
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation
• 作者: Shafi,Tariq;Zager,PhilipG;Sozio,StephenM;Grams,MorganE;Jaar,BernardG;Christenson,RobertH;Boulware,LEbony;Parekh,RulanS;Powe,NeilR;Coresh,Josef
• 通讯作者: Coresh,Josef