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Qualitative research methods and its application in nephrology
Chandana Guha,Andrea K. Viecelli,Germaine Wong,Karine Manera,Allison Tong
doi : 10.1111/nep.13888
Volume 26, Issue 10 p. 755-762
Chronic kidney disease is associated with an increased risk of mortality, comorbidities and life-threatening complications. Invasive treatments including dialysis or transplantation, complex pharmacological therapies, dietary restrictions and the ongoing need to attend follow-up appointments can place a substantial treatment burden on patients and carers and impair quality of life. This highlights the need for care that is responsive to the needs of patients and involves them in decision-making to achieve the most appropriate healthcare outcomes. Shared decision-making and collaborative approaches to care require a deep awareness of the lived experiences and goals of patients. Qualitative research methods can provide insights into patients' experiences, values and priorities and inform practice and policy by uncovering their preferences for care. Qualitative methods are increasingly being used in standalone projects or in mixed methods studies (complementing quantitative studies) to make valuable contributions to patient-centred research. Patient-centred care, collaborations between patient and care provider, and shared decision-making that integrates with the patient's goals are central to quality healthcare. The efficacy of qualitative research lies in its ability to elicit patients' perspectives, values, priorities and goals that underpin shared decision making and care. This article discusses examples of how qualitative research has informed practice and policy in nephrology, provides a summary of qualitative research methods and outlines a guide on how to appraise, interpret and apply qualitative data.
Mean of creatinine clearance and urea clearance examined over 1 h estimates glomerular filtration rate accurately and precisely in children
Yusuke Okuda,Riku Hamada,Osamu Uemura,Tomoyuki Sakai,Toshihiro Sawai,Ryoko Harada,Yuko Hamasaki,Kenji Ishikura,Hiroshi Hataya,Masataka Honda
doi : 10.1111/nep.13911
Volume 26, Issue 10 p. 763-771
Accurate and precise estimation of glomerular filtration rate (GFR) is essential in kidney disease. We evaluated the usefulness of the mean of creatinine clearance (CCr) and urea clearance (CUN) examined over a 1-h urine collection period (1-h (CCr?+?CUN)/2) in a retrospective, cross-sectional study across two centres, as a relatively simple method for estimating GFR in children.
Association between early worsening of kidney function and poor outcomes in patients treated with renin angiotensin system inhibitors: A meta-analysis
Shizhu Yuan,Yueming Liu,Wenfang He,Juan Jin,Lin Liu,Qiang He
doi : 10.1111/nep.13915
Volume 26, Issue 10 p. 772-781
As renin angiotensin system inhibitors (RASi) are widely used in the clinic, early worsening of kidney function (EWKF) after RASi therapy deserves attention, as its clinical significance is unknown. The aim was to evaluate the relationship between EWKF and long-term outcomes including all-cause mortality, kidney and cardiovascular events, in all the patients treated with RASi.
The kinetic estimated glomerular filtration rate ratio predicts acute kidney injury
Daniel Christiadi,Jonathan Erlich,Melissa Levy,Sanjeeva Herath,Jennifer Qian,Sally Boardman,Craig Campbell,Sradha Kotwal,Andrea R. Horvath,Zoltán Endre
doi : 10.1111/nep.13918
Volume 26, Issue 10 p. 782-789
Kinetic estimated Glomerular Filtration Rate (KeGFR) approximates GFR under non-steady-state conditions. We investigated whether the ratio of KeGFR difference to baseline eGFR could predict acute kidney injury (AKI) earlier than a creatinine-based algorithm that triggered an AKI electronic Alert (eAlert).
Muscle power and physical dysfunction: A model for tailoring rehabilitation in chronic kidney disease
Thomas J. Wilkinson,Eleanor F. Gore,Luke A. Baker,Emma L. Watson,Alice C. Smith
doi : 10.1111/nep.13920
Volume 26, Issue 10 p. 790-797
Chronic kidney disease (CKD) is characterized by adverse physical function. Mechanical muscle power describes the product of muscular force and velocity of contraction. In CKD, the role of mechanical muscle power is poorly understood and often overlooked as a target in rehabilitation. The aims of this study were to investigate the association of mechanical power with the ability to complete activities of daily living and physical performance.
Prevalence and risk factors of peripheral artery disease in a population with chronic kidney disease in Australia: A systematic review and meta-analysis
Chau L. B. Ho,Hui J. Chih,Pranav S. Garimella,Kunihiro Matsushita,Shirley Jansen,Christopher M. Reid
doi : 10.1111/nep.13914
Volume 26, Issue 10 p. 798-808
There is a lack of clarity and guidance for screening peripheral artery disease (PAD) in persons with chronic kidney disease (CKD) and end stage kidney disease (ESKD) despite this group being at excess risk of cardiovascular disease (CVD). In this current study, we performed a systematic review and meta-analysis to examine the prevalence and risk factors for PAD in persons with CKD in Australian cohorts. We used the inverse variance heterogeneity meta-analysis with double arcsine transformation to summarize the prevalence of PAD (with 95% CIs). Nine studies and 18 reports from the Australia and New Zealand dialysis and transplant registry with 36 cohorts were included in the review. We found a substantially higher PAD prevalence in cohorts based on an ankle-brachial index (ABI) or toe systolic pressure (TBI) than cohorts based on self-reported history. Higher PAD prevalence was observed in ESKD persons than CKD persons without dialysis (PAD diagnosis based on ABI or TBI: 31% in ESKD persons and 23% in CKD persons, PAD diagnosis based on self-reported history: 17% in ESKD persons and 10% in CKD persons). Older age, Caucasian race, cerebrovascular disease and haemodialysis were associated with the presence of PAD in ESKD persons. Our findings indicated a considerable proportion of PAD in CKD and ESKD persons particularly in those with ESKD. To develop and provide an adequate plan to clinically manage CKD patients with PAD, evidence of cost-effectiveness and clinical benefit of early detection of PAD in persons with CKD in Australia is recommended for future studies.
Assessing urine ammonium concentration by urine osmolal gap in chronic kidney disease
Takuya Fujimaru,Takuya Shuo,Masahiko Nagahama,Fumika Taki,Masaaki Nakayama,Yasuhiro Komatsu
doi : 10.1111/nep.13937
Volume 26, Issue 10 p. 809-813
Acidemia is one of the risk factors for end-stage kidney disease and increases the mortality rate of patients with chronic kidney disease (CKD). Although urinary ammonium (U-NH4+) is the crucial component of renal acid excretion, U-NH4+ concentration is not routinely measured. To estimate U-NH4+, urine osmolal gap (UOG = urine osmolality ? [2(Na+ + K+)?+?urea + glucose]) is calculated and the formula (U-NH4+ = UOG/2) has traditionally been used. However, the usefulness of this formula is controversial in CKD patients. We assessed the relationship between U-NH4+ and UOG in patients with CKD. Blood and spot urine samples were collected in 36 patients who had non-dialysis-dependent CKD. The mean?±?SD age of patients was 72.0?±?14.8?years, and the mean?±?SD serum creatinine and U-NH4+ were 2.7?±?2.3 mg/dl and 9.3?± 9.2?mmol/L, respectively. A significant relationship was found between UOG/2 and U-NH4+ (r = .925, p?<?.0001). U-NH4+ estimated using the UOG was on average higher by 4.7?mmol/L than the measured one. Our results suggested that UOG could be a useful tool in clinical settings, especially in patients with moderate to severe CKD.
Serum phosphate and mortality in incident dialysis patients in Australia and New Zealand
Mark K. Tiong,Shahid Ullah,Stephen P. McDonald,Sven-Jean Tan,Nicole M. Lioufas,Matthew A. Roberts,Nigel D. Toussaint
doi : 10.1111/nep.13904
Volume 26, Issue 10 p. 814-823
Hyperphosphataemia is associated with increased adverse outcomes, including mortality. Re-examining this association using up-to-date data reflecting current and real-world practices, across different global regions and in both haemodialysis and peritoneal dialysis patients, is important.
The impact of anatomical variables on haemodialysis tunnelled catheter replacement without fluoroscopy
Pablo Maggiani-Aguilera,Jonathan S. Chávez-Iñiguez,Joana G. Navarro-Gallardo,Guillermo Navarro-Blackaller,Alondra M. Flores-Llamas,Tania Pelayo-Retano,Erendira A. Arellano-Delgado,Violeta E. González-Montes,Ekatherina Yanowsky-Ortega,Jochen G. Raimann,Guillermo Garcia-Garcia
doi : 10.1111/nep.13909
Volume 26, Issue 10 p. 824-832
Tunnelled haemodialysis (HD) catheters can be used instantly, but there are several anatomical variables that could impact it survival. This study aimed to examine the impact of different novel anatomic variables, with catheter replacement.
Prevalence and impact of HLA and MICA allele mismatching on donor-specific antibodies induction in kidney transplant rejection
Amornrat V. Romphruk,Piyapong Simtong,Jidpinan Suntornnipat,Yupaporn Sudwilai,Siriluk Cheunta,Chitranon Chan-on,Chanvit Leelayuwat
doi : 10.1111/nep.13921
Volume 26, Issue 10 p. 833-841
Donor-recipient antigen mismatching for anti-human leucocyte antigen (HLA) and MICA is one of the risk factors for antibody induction leading to graft rejection. Our aim was to analyze the incidence and specificity of the different DSAs developing and to investigate the impact of HLA and MICA allele mismatches on antibody production in kidney transplant patients experiencing antibody-mediated rejection (AMR).
Light chain deposition disease with low glomerular proteinuria and multiple myeloma: If you search you find
Laura Gobbi,Elena Naso,Luca Dal Santo,Marny Fedrigo,Dorella Del Prete,Annalisa Angelini,Ugo Vertolli,Lorenzo A. Calò
doi : 10.1111/nep.13903
Volume 26, Issue 10 p. 842-843
Very large abscesses of lower limbs by Nocardia farcinica requiring surgical management in patient with minimal change disease under chronic steroid treatment
Carlo Garofalo,Filippo De Stefano,Klodian Gjeloshi,Ilaria De Gregorio,Francesco Masini,Carmen Ricozzi,Ferdinando Carlo Sasso,Antonello Sica,Lucio Selvaggi,Teresa Salvatore
doi : 10.1111/nep.13905
Volume 26, Issue 10 p. 843-844
