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Sex differences in clinical outcomes in Japanese incident dialysis patients: a prospective observational multicenter study.

Clin Exp Nephrol 2022 Jan 20. Epub 2022 Jan 20.

Department of Nephrology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.

Background: A Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown a one-to-one male-to-female mortality ratio, notwithstanding the statistically longer life expectancy of women in the general population. This finding contrasts with the recent report that Japanese women on dialysis treatment have a more favorable longevity. Accordingly, we further investigated the clinical procedures and outcomes to clarify the sex differences in Japanese patients undergoing dialysis treatment. Read More

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January 2022

The prevalence of predialysis hyperkalemia and associated characteristics among hemodialysis patients: The RE-UTILIZE study.

Hemodial Int 2022 Jan 17. Epub 2022 Jan 17.

AstraZeneca, Wilmington, Delaware, USA.

Introduction: Hyperkalemia (HK), defined as serum potassium (K ) >5.0 mEq/L, is an independent predictor of mortality in patients on maintenance hemodialysis (HD). This study investigated the annual prevalence of HK and examined patient characteristics potentially associated with a higher annual HK prevalence. Read More

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January 2022

Routinely measured cardiac troponin I and N-terminal pro-B-type natriuretic peptide as predictors of mortality in haemodialysis patients.

ESC Heart Fail 2022 Jan 13. Epub 2022 Jan 13.

Fukuoka Renal Clinic, Fukuoka, Japan.

Aims: Cardiac troponin (cTn) and B-type natriuretic peptide (BNP) are elevated in haemodialysis (HD) patients, and this elevation is associated with HD-induced myocardial stunning/myocardial strain. However, studies using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS) have shown that these cardiac biomarkers are measured in <2% of HD patients in real-world practice. This study aimed to examine whether routinely measured N-terminal pro-BNP (NT-proBNP) and cTnI (contemporary assay) are more appropriate than clinical models for reclassifying the risk of HD patients who have the highest risk of death. Read More

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January 2022

Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS.

BMC Nephrol 2022 Jan 3;23(1):11. Epub 2022 Jan 3.

Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.

Background: Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. Read More

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January 2022

The global impact of the Coronavirus 2019 pandemic on in-centre haemodialysis services: an International Society of Nephrology -Dialysis Outcomes Practice Patterns Study survey.

Kidney Int Rep 2021 Dec 13. Epub 2021 Dec 13.

Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom.

Introduction: To assess the impact of the COVID-19 pandemic impact on haemodialysis centres, The Dialysis Outcomes and Practice Patterns Study and International Society of Nephrology (ISN) collaborated on a web-survey of centres.

Methods: A combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centres in 78 countries and all 10 ISN regions. Read More

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December 2021

Assessing the impact of screening, early identification and intervention programmes for chronic kidney disease: protocol for a scoping review.

BMJ Open 2021 Dec 16;11(12):e053857. Epub 2021 Dec 16.

The George Institute for Global Health India, New Delhi, Delhi, India.

Introduction: Chronic kidney disease (CKD) is a major threat to public health, especially in low-income and lower middle-income countries, where resources for treating patients with advanced CKD are scarce. Although early CKD identification and intervention hold promise for reducing the burden of CKD and risk factors, it remains unclear if an uniform strategy can be applicable across all income groups. The aim of this scoping review is to synthesise available evidence on early CKD identification programmes in all world regions and income groups. Read More

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December 2021

Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis.

Pathogens 2021 Sep 7;10(9). Epub 2021 Sep 7.

Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Prevalence rates of HCV infection are decreasing in hemodialysis units of most developed countries; however, nosocomial transmission of HCV continues to occur in the hemodialysis setting, not only in the emerging world. According to the Dialysis Outcomes and Practice Patterns Study (DOPPS, 2012-2015), the prevalence of HCV among patients on regular hemodialysis was 9.9%; in incident patients, the frequency of HCV was approximately 5%. Read More

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September 2021

Blood flow rate: An independent risk factor of mortality in Chinese hemodialysis patients.

Semin Dial 2021 Sep 22. Epub 2021 Sep 22.

Department of Nephrology, Peking University People's Hospital, Beijing, China.

Background: Studies suggested the association between blood flow rate (BFR) and mortality might be beyond dialysis adequacy. This study aimed to explore if BFR is an independent predictor of clinical outcomes in Chinese hemodialysis (HD) patients.

Methods: This study included data from patients in China Dialysis Outcomes and Practice Patterns Study (DOPPS) Phase 5. Read More

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September 2021

Physical Function and Clinical Outcomes in Hemodialysis Patients: China Dialysis Outcomes and Practice Patterns Study.

Kidney Dis (Basel) 2021 Jul 10;7(4):315-322. Epub 2021 Mar 10.

Department of Nephrology, Peking University People's Hospital, Beijing, China.

Background: Hemodialysis (HD) patients usually have impaired physical function compared with the general population. Self-reported physical function is a simple method to implement in daily dialysis care. This study aimed to examine the association of self-reported physical function with clinical outcomes of HD patients. Read More

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European hemodialysis patient satisfaction with phosphate binders is associated with serum phosphorus levels: the Dialysis Outcomes and Practice Patterns Study.

Clin Kidney J 2021 Aug 11;14(8):1886-1893. Epub 2021 Jun 11.

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Background: Hemodialysis (HD) patients are commonly prescribed phosphate binders (PBs) to manage serum phosphorus levels, as hyperphosphatemia is strongly associated with poorer survival. Nonadherence with the PB prescription is associated with elevated serum phosphorus levels. We studied associations between patient satisfaction with their PB and serum phosphorus levels and mortality rates. Read More

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Challenging patient phenotypes in the management of anaemia of chronic kidney disease.

Int J Clin Pract 2021 Nov 12;75(11):e14681. Epub 2021 Aug 12.

Department of Medicine, Division of Nephrology, NYU School of Medicine, New York, New York, USA.

Background: Chronic kidney disease (CKD) is often complicated by anaemia, which is associated with disease progression and increased hospital visits, decreased quality of life, and increased mortality.

Methods: A comprehensive literature search of English language peer-reviewed articles in PubMed/MedLine published between 1998 and 2020 related to the treatment of anaemia of CKD was conducted. The United States Renal Database System and Dialysis Outcomes and Practice Patterns Study (DOPPS) data reports, the Centers for Disease Control and Prevention and the US Food and Drug Administration websites, and published congress abstracts in 2020 were surveyed for relevant information. Read More

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November 2021

Etelcalcetide Utilization, Dosing Titration, and Chronic Kidney Disease-Mineral and Bone Disease (CKD-MBD) Marker Responses in US Hemodialysis Patients.

Am J Kidney Dis 2021 Jul 15. Epub 2021 Jul 15.

Arbor Research Collaborative for Health, Ann Arbor, Michigan.

Rationale & Objective: Clinical trial data have demonstrated the efficacy of etelcalcetide for reducing parathyroid hormone (PTH) levels in hemodialysis (HD) patients. We provide a real-world summary of etelcalcetide utilization, dosing, effectiveness, and discontinuation since its US introduction in April 2017.

Study Design: New-user design within prospective cohort. Read More

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Hyperkalemia excursions are associated with an increased risk of mortality and hospitalizations in hemodialysis patients.

Clin Kidney J 2021 Jul 14;14(7):1760-1769. Epub 2020 Dec 14.

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Background: Hyperkalemia is common among hemodialysis (HD) patients and has been associated with adverse clinical outcomes. Previous studies considered a single serum potassium (K) measurement or time-averaged values, but serum K excursions out of the target range may be more reflective of true hyperkalemia events. We assessed whether hyperkalemia excursions lead to an elevated risk of adverse clinical outcomes. Read More

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Is a treat-to-target approach to lipid-lowering therapy appropriate in patients with chronic kidney disease? A prospective French cohort study.

J Nephrol 2021 10 11;34(5):1467-1477. Epub 2021 Jun 11.

Pharmacology Department, Amiens University Hospital, 80054, Amiens, France.

Background: Whereas European guidelines recommend adjusting lipid-lowering therapy (LLT) to meet prespecified targets ('treat-to-target') for low-density lipoprotein cholesterol (LDL-C), other guidelines do not ('fire and forget'). In a large observational prospective cohort, we sought to evaluate which strategy could be associated with better cardiovascular outcomes in chronic kidney disease (CKD).

Methods: In CKD-REIN, patients (CKD stages 3 and 4) on LLT were categorized according to achievement of LDL-C targets for high and very high cardiovascular risk (< 2. Read More

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October 2021

Secondary hyperparathyroidism, weight loss, and longer term mortality in haemodialysis patients: results from the DOPPS.

J Cachexia Sarcopenia Muscle 2021 08 1;12(4):855-865. Epub 2021 Jun 1.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Background: Wasting is a common complication of kidney failure that leads to weight loss and poor outcomes. Recent experimental data identified parathyroid hormone (PTH) as a driver of adipose tissue browning and wasting, but little is known about the relations among secondary hyperparathyroidism, weight loss, and risk of mortality in dialysis patients.

Methods: We included 42,319 chronic in-centre haemodialysis patients from the Dialysis Outcomes and Practice Patterns Study phases 2-6 (2002-2018). Read More

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Worldwide Early Impact of COVID-19 on Dialysis Patients and Staff and Lessons Learned: A DOPPS Roundtable Discussion.

Kidney Med 2021 Jul-Aug;3(4):619-634. Epub 2021 May 14.

Arbor Research Collaborative for Health, Ann Arbor, MI.

As the worst global pandemic of the past century, coronavirus disease 2019 (COVID-19) has had a disproportionate effect on maintenance dialysis patients and their health care providers. At a virtual roundtable on June 12, 2020, Dialysis Outcomes and Practice Patterns Study (DOPPS) investigators from 15 countries in Asia, Europe, and the Americas described and compared the effects of COVID-19 on dialysis care, with recent updates added. Most striking is the huge difference in risk to dialysis patients and staff across the world. Read More

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Association between Dipeptidyl Peptidase-4 Inhibitor Prescription and Erythropoiesis-Stimulating Agent Hyporesponsiveness in Hemodialysis Patients with Diabetes Mellitus.

Kidney Blood Press Res 2021 22;46(3):352-361. Epub 2021 Apr 22.

Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.

Introduction: Dipeptidyl peptidase-4 (DPP-4) has been hypothesized to improve responsiveness to erythropoiesis-stimulating agent (ESA). We aimed to describe the trend in DPP-4 inhibitor prescription patterns and assess the association between DPP-4 inhibitor prescription and ESA hyporesponsiveness (eHypo) in Japanese hemodialysis (HD) patients with diabetes mellitus (DM).

Methods: We analyzed data from the Japan Dialysis Outcomes and Practice Patterns Study phase 4-6 (2009-2017) on patients with DM who underwent HD thrice per week for at least 4 months. Read More

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Burden of Kidney Disease, Health-Related Quality of Life, and Employment Among Patients Receiving Peritoneal Dialysis and In-Center Hemodialysis: Findings From the DOPPS Program.

Am J Kidney Dis 2021 10 16;78(4):489-500.e1. Epub 2021 Apr 16.

St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Electronic address:

Rationale & Objective: Individuals faced with decisions regarding kidney replacement therapy options need information on how dialysis treatments might affect daily activities and quality of life, and what factors might influence the evolution over time of the impact of dialysis on daily activities and quality of life.

Study Design: Observational cohort study.

Setting & Participants: 7,771 hemodialysis (HD) and peritoneal dialysis (PD) participants from 6 countries participating in the Peritoneal and Dialysis Outcomes and Practice Patterns Studies (PDOPPS/DOPPS). Read More

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October 2021

Serum total indoxyl sulfate and clinical outcomes in hemodialysis patients: results from the Japan Dialysis Outcomes and Practice Patterns Study.

Clin Kidney J 2021 Apr 31;14(4):1236-1243. Epub 2020 Jul 31.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Background: Uremic toxins are associated with various chronic kidney disease-related comorbidities. Indoxyl sulfate (IS), a protein-bound uremic toxin, reacts with vasculature, accelerating atherosclerosis and/or vascular calcification in animal models. Few studies have examined the relationship of IS with clinical outcomes in a large cohort of hemodialysis (HD) patients. Read More

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Medical Director Practice of Advising Increased Dietary Protein Intake in Hemodialysis Patients With Hyperphosphatemia: Associations With Mortality in the Dialysis Outcomes and Practice Patterns Study.

J Ren Nutr 2021 Apr 2. Epub 2021 Apr 2.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Objectives: Patients undergoing hemodialysis (HD) may have poor nutritional status and hyperphosphatemia. Nephrologists sometimes manage hyperphosphatemia by prescribing phosphate binders and/or recommending restriction of dietary phosphate including protein-rich foods; the later may, however, adversely affect nutritional status.

Design And Methods: The analysis includes 8805 HD patients on dialysis ≥ 120 days in 12 countries in Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 4 (2009-2011), from 248 facilities. Read More

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Long-term and large-scale multispecies dataset tracking population changes of common European breeding birds.

Sci Data 2021 03 26;8(1):21. Epub 2021 Mar 26.

DOPPS BirdLife Slovenia, Ljubljana, Slovenia.

Around fifteen thousand fieldworkers annually count breeding birds using standardized protocols in 28 European countries. The observations are collected by using country-specific and standardized protocols, validated, summarized and finally used for the production of continent-wide annual and long-term indices of population size changes of 170 species. Here, we present the database and provide a detailed summary of the methodology used for fieldwork and calculation of the relative population size change estimates. Read More

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The Role of Place in Disparities Affecting Black Men Receiving Hemodialysis.

Kidney Int Rep 2021 Feb 20;6(2):357-365. Epub 2020 Oct 20.

Division of General Internal Medicine and Nephrology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.

Introduction: Black men are over-represented in the end stage kidney disease population and are at disproportionate risk of unfavorable outcomes. There is a paucity of investigation to elucidate the mediators of this risk. This study attempts to identify residential community attributes as a possible contributor. Read More

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February 2021

Self-reported Pruritus and Clinical, Dialysis-Related, and Patient-Reported Outcomes in Hemodialysis Patients.

Kidney Med 2021 Jan-Feb;3(1):42-53.e1. Epub 2020 Nov 21.

Arbor Research Collaborative for Health, Ann Arbor, MI.

Rationale & Objective: Chronic kidney disease (CKD)-associated pruritus, generalized itching related to CKD, affects many aspects of hemodialysis patients' lives. However, information regarding the relationship between pruritus and several key outcomes in hemodialysis patients remains limited.

Study Design: Prospective cohort. Read More

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November 2020

Baseline data report of the China Dialysis Outcomes and Practice Patterns Study (DOPPS).

Sci Rep 2021 01 13;11(1):873. Epub 2021 Jan 13.

Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building, 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.

The number of patients on hemodialysis (HD) is rapidly increasing in China. As an Asian country with a large number of HD patients, understanding the status of Chinese HD patients has a special significance. We reported here the baseline data for China Dialysis Outcomes and Practice Pattern Study Phase 5 (DOPPS5). Read More

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January 2021

Replicating Randomized Trial Results with Observational Data Using the Parametric g-Formula: An Application to Intravenous Iron Treatment in Hemodialysis Patients.

Clin Epidemiol 2020 11;12:1249-1260. Epub 2020 Nov 11.

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Background: Reproducibility of clinical and epidemiologic research is important to generalize findings and has increasingly been scrutinized. A recently published randomized trial, PIVOTAL, evaluated high vs low intravenous iron dosing strategies to manage anemia in hemodialysis patients in the UK. Our objective was to assess the reproducibility of the PIVOTAL trial findings using data from a well-established cohort study, the Dialysis Outcomes and Practice Patterns Study (DOPPS). Read More

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November 2020

Fibroblast Growth Factor 23 and Mortality Among Prevalent Hemodialysis Patients in the Japan Dialysis Outcomes and Practice Patterns Study.

Kidney Int Rep 2020 Nov 20;5(11):1956-1964. Epub 2020 Aug 20.

Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Introduction: Elevated fibroblast growth factor 23 (FGF23) levels have been strongly associated with mortality in the predialysis and incident hemodialysis populations, but few studies have examined this relationship in a large cohort of prevalent hemodialysis patients and in particular among persons with high dialysis vintage. To address this, we analyzed data from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS).

Methods: We included 1122 prevalent hemodialysis patients from the J-DOPPS phase 5 (2012-2015) who had FGF23 measurements. Read More

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November 2020

Forgotten Technology in the COVID-19 Pandemic: Filtration Properties of Cloth and Cloth Masks-A Narrative Review.

Mayo Clin Proc 2020 10 31;95(10):2204-2224. Epub 2020 Jul 31.

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Management of the global crisis of the coronavirus disease 2019 pandemic requires detailed appraisal of evidence to support clear, actionable, and consistent public health messaging. The use of cloth masks for general public use is being debated, and is in flux. We searched the MEDLINE and EMBASE databases and Google for articles reporting the filtration properties of flat cloth or cloth masks. Read More

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October 2020

Benefits of protected areas for nonbreeding waterbirds adjusting their distributions under climate warming.

Conserv Biol 2021 06 21;35(3):834-845. Epub 2021 Jan 21.

Department of Vertebrate Ecology and Zoology, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, Gdańsk, 80-308, Poland.

Climate warming is driving changes in species distributions and community composition. Many species have a so-called climatic debt, that is, shifts in range lag behind shifts in temperature isoclines. Inside protected areas (PAs), community changes in response to climate warming can be facilitated by greater colonization rates by warm-dwelling species, but also mitigated by lowering extirpation rates of cold-dwelling species. Read More

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Low rather than high mean corpuscular volume is associated with mortality in Japanese patients under hemodialysis.

Sci Rep 2020 09 24;10(1):15663. Epub 2020 Sep 24.

Division of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan.

Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Read More

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September 2020

International Comparisons of Native Arteriovenous Fistula Patency and Time to Becoming Catheter-Free: Findings From the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Am J Kidney Dis 2021 02 21;77(2):245-254. Epub 2020 Sep 21.

Arbor Research Collaborative for Health, Ann Arbor, MI.

Rationale & Objective: Optimizing vascular access use is crucial for long-term hemodialysis patient care. Because vascular access use varies internationally, we examined international differences in arteriovenous fistula (AVF) patency and time to becoming catheter-free for patients receiving a new AVF.

Study Design: Prospective cohort study. Read More

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February 2021