ArticleBMC nephrology2018
Practice patterns in transitioning patients from chronic kidney disease to dialysis: a survey of United States nephrologists.
Article in BMC nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Pharmacological management of hypertension and outcome among patients on hemodialysis at Muhimbili National Hospital, Tanzania: a cross-sectional study.The Pan African medical journal · 2023Article
- Safety Influencing Factors and Management Countermeasures of Patients Transferred from ICU in Transition Period Based on Intelligent Processor Three-Dimensional Quality Model.Journal of healthcare engineering · 2022Review
- Correlation and Diagnostic Value of Serum RBP4 and sRAGE and the Condition of Patients with Chronic Kidney Disease.Evidence-based complementary and alternative medicine : eCAM · 2021Article
- The Pre-Dialysis Care Trajectory of Chronic Kidney Disease Patients and the Start of Dialysis in Emergency: A Mixed Method Study Protocol.International journal of environmental research and public health · 2019Article
- Antihypertensive Agents in the Dialysis Patient.Current hypertension reports · 2019Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are no guidelines for transitioning patients from chronic kidney disease stage 5 to hemodialysis. We conducted this study to determine if there are uniform patterns in how nephrologists transition patients to dialysis.
methodsWe designed an electronic survey with 39 questions and sent it to a database of practicing nephrologists at the National Kidney Foundation. Factors that were important for transitioning a patient to hemodialysis were evaluated, including medication changes on dialysis initiation, dry weight and dialysis prescription.
results160 US Nephrologists replied to the survey; 18% (29/160) of the responses were completed via social media sites. Prior to dialysis, 74% (118/160), prescribed furosemide and 67% (107/160) used furosemide with metolazone. Once dialysis started, only 46% (74/160) of the responders continued patients on diuretics daily. Hypertension medications prescribed in dialysis were calcium channel blockers 69% (112/160), beta blockers 36% (58/160), angiotensin converting enzyme inhibitor 32% (53/160), angiotensin receptor blocker 29% (46/160) and diuretics 25% (42/160). Once dialysis started, 68% (109/160) routinely changed medications. Most, 67% (107/160) ordered patients to avoid anti-hypertensive medications on dialysis days to allow for ultrafiltration. Dry weight was determined in the first week by 29% (46/160) and in the first month by 53% (85/160). Most, 59% (94/160) felt that multiple causes lead to hypertension. Most nephrologists would prescribe small dialyzers and a shorter period of time for the first dialysis session.
conclusionThe transition period to chronic hemodialysis has variations in practice patterns and may benefit from further studies to optimize clinical practice.
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