Impact of the 2021 Chronic Kidney Disease Epidemiology Collaboration glomerular filtration rate estimating equation on risk of healthcare utilization for hospitalizations for cardiovascular and kidney disease.

Aim Reduced kidney function is a known risk amplifier for atherosclerotic cardiovascular disease (ASCVD) and adverse kidney events. Accurate assessment of kidney function using estimated glomerular filtration rate (eGFR) is therefore essential for evaluating ASCVD risk and kidney prognosis. We aimed to compare the revised 2021 Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) [2021-eGFRcr(AS)] and European Kidney Function Consortium (EKFCcr) with the 2009 CKD-EPI [2009-eGFRcr(ASR)] equations in predicting the risk of hospitalizations for acute myocardial infarction (AMI), acute kidney disease (AKD) and chronic kidney disease (CKD) in a multi-ethnic Asian cohort.

Hospital Readmissions for All-Causes and Fluid Overload in Severely Reduced Kidney Function Not Requiring Dialysis-A Retrospective Cohort Study.

Aim: Chronic kidney disease is associated with frequent readmissions for ambulatory-sensitive conditions such as fluid overload. There is a paucity of literature to identify individuals at high risk of fluid overload or all-cause readmissions.

Methods: We performed a single-centre retrospective cohort study involving 783 patients with an estimated glomerular filtration rate of 11-30 mL/min/1.

Optimizing exit-site care for hospitalized peritoneal dialysis patients with weekly chlorhexidine-impregnated dressing.

IntroductionPeritoneal dialysis (PD) catheter exit site care is crucial to prevent exit site or tunnel tract infection. Daily exit site care for hospitalized PD patients can be time-consuming for nurses. Therefore, an alternative approach with less frequent exit site care is needed.

The Cost and Outcomes of Using Multidisciplinary Care Program in the Care of Adult Patients with Advanced Chronic Kidney Disease.

Objective: The aim of the study was to compare the direct healthcare cost and outcomes of a multidisciplinary care (MDC) program versus usual care for patients with advanced chronic kidney disease (CKD) in Singapore.

Methods: A retrospective study of patients with an estimated glomerular filtration rate (eGFR) less than 20 mL/min/1.73 m2, attending the MDC program or the usual care clinic in a tertiary hospital from 2016 to 2019.

Risk of onset of chronic kidney disease in type 2 diabetes mellitus (ROCK-DM): Development and validation of a 4-variable prediction model.

Aims: The aim of this study was to develop and validate a prediction model for incident chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM), defined as eGFR < 60 ml/min/1.73m2 and/or urine albumin:creatinine ratio (UACR) > 3 mg/mmol in ≥ 2 consecutive readings ≥ 3 months apart.

Methods: Model derivation was performed in the SingHealth Diabetes Registry, including patients aged ≥ 21 years diagnosed with T2DM without pre-existing CKD.

Implementing the Nurse-Led Optimization of Volume and Blood Pressure - Enabling at Multi-Levels Using Technology Program for Chronic Kidney Disease: A Prospective Cohort Study.

Background: Fluid overload is a common manifestation of chronic kidney disease (CKD) and is associated with increased hospitalizations and death. However, severe symptomatic fluid overload is potentially preventable with early recognition of mild fluid overload and timely institution of appropriate pharmacotherapy and fluid restriction. We implemented and evaluated the outcomes of a nurse-led clinic that incorporated objective fluid volume assessment using body impedance analysis (BIA) into structured patient education and action plan coaching to patients with CKD and fluid overload.

Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis.

Background: Published studies have suggested a link between chronic kidney disease (CKD) and sleep disorders, although the exact nature of this association has not been uniformly described. Clarifying this relationship may facilitate evidence-based interventions that address the interplay between these disease entities. Such interventions could prevent obstructive sleep apnea (OSA) from worsening CKD and improve the quality of life for CKD patients by reducing the risk of developing OSA.

Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis.

Introduction: Diabetes mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions.

Effectiveness and sustainability of a multidisciplinary care model for patients with hemodialysis access dysfunction.

Background: A multidisciplinary care model involving the interventional radiologist, vascular surgeon, interventional nephrologist, renal advanced nurse practitioner, and renal coordinators was implemented to improve the care for the patient admitted with dysfunctional hemodialysis access. This study aims to evaluate the effectiveness and sustainability of this multidisciplinary care model.

Method: A dedicated interventional nephrology suite was established to perform endovascular procedures for patients admitted with hemodialysis access dysfunction via the emergency department of the hospital.

The association of sleep duration with the risk of chronic kidney disease: a systematic review and meta-analysis.

Background And Hypothesis: Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease.

Sodium-Glucose Cotransporter-2 Inhibitors Use in Patients with Reduced Kidney Function Hospitalized for Fluid Overload and Heart Failure: An Observational Study.

Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are recommended in kidney disease and heart failure to reduce adverse clinical outcomes, but utilization can vary. To understand potential gaps in clinical practice and identify opportunities for improvement, we aimed to describe the prevalence and factors associated with SGLT2i prescription in patients with reduced kidney function hospitalized for fluid overload and/or heart failure.

Methods: Single-center observational study of patients with reduced kidney function (eGFR 20-59 mL/min/1.

Hospital Readmissions for Fluid Overload among Individuals with Diabetes and Diabetic Kidney Disease: Risk Factors and Multivariable Prediction Models.

Aims: Hospital readmissions due to recurrent fluid overload in diabetes and diabetic kidney disease can be avoided with evidence-based interventions. We aimed to identify at-risk patients who can benefit from these interventions by developing risk prediction models for readmissions for fluid overload in people living with diabetes and diabetic kidney disease.

Methods: This was a single-center retrospective cohort study of 1,531 adults with diabetes and diabetic kidney disease hospitalized for fluid overload, congestive heart failure, pulmonary edema, and generalized edema between 2015 and 2017.

Immune monitoring of prevalent kidney transplant recipients using Torque Teno Virus: Protocol for a single-centre prospective cohort study.

Introduction: Kidney transplant recipients (KTRs) suffer from immunosuppression-related adverse events (iRAEs), such as infections and malignancy from chronic immunosuppression, but are also at risk of graft loss from rejection with underimmunosuppression. Biomarkers that predict both iRAEs and rejection while allowing individualisation of immunosuppression exposure are lacking. Although plasma viral DNA levels of torque teno virus (TTV), a widely prevalent, non-pathogenic virus, have been shown to predict both iRAE and rejection in newly transplanted KTRs within the first year after transplant, its role for prevalent KTRs on stable immunosuppression is less clear.

Efficacy and safety of low dose, weight-based subcutaneous enoxaparin protocol in recurrent arteriovenous access thrombosis.

Background: This study aims to evaluate the safety and efficacy of a short-term, low dose, weight-based subcutaneous enoxaparin protocol (SEP) in maintaining the patency of arteriovenous (AV) access with recurrent thrombosis.

Methods: Prospective follow-up of 25 patients who presented to a tertiary institution with recurrent AV access thrombosis and treated with anticoagulation according to SEP following successful thrombectomy. Patency and safety outcomes of SEP were studied.

Early repeat hospitalization for fluid overload in individuals with cardiovascular disease and risks: a retrospective cohort study.

Aims: Fluid overload is a common manifestation of cardiovascular and kidney disease and a leading cause of hospitalizations. To identify patients at risk of recurrent severe fluid overload, we evaluated the incidence and risk factors associated with early repeat hospitalization for fluid overload among individuals with cardiovascular disease and risks.

Methods: Single-center retrospective cohort study of 3423 consecutive adults with an index hospitalization for fluid overload between January 2015 and December 2017 and had cardiovascular risks (older age, diabetes mellitus, hypertension, dyslipidemia, kidney disease, known cardiovascular disease), but excluded if lost to follow-up or eGFR < 15 ml/min/1.

Exploration of patients' preference for modalities of care among peritoneal dialysis patients in Singapore: a single-center experience.

Introduction: Peritoneal dialysis (PD) is home-based dialysis therapy and therefore a suitable modality for kidney failure patients, particularly, during the COVID-19 pandemic. The present study examined patients' preferences for different PD-related services.

Methods: This was a cross-sectional survey study.

Clinical features, management and outcomes of peritoneal dialysis patients during Delta and Omicron waves of COVID-19 infections.

Introduction: There were discrete outbreaks of SARS-CoV-2 infection in 2021 (Delta wave) and 2022 (Omicron wave) in Singapore, which affected patients receiving peritoneal dialysis (PD).

Methods: This study included all PD patients with COVID-19 infection from a single center between October 2021 and March 2022. The clinical presentation, management and outcomes of patients during the Delta and Omicron outbreaks were compared.

A Descriptive Evaluation of Health Literacy and Determinants of COVID-19 Vaccine Acceptance among Patients with IgA Nephropathy with High Vaccine Uptake.

Aims: Shared decision-making regarding COVID-19 vaccination in IgA nephropathy involves the ability to handle health information regarding potential benefits and risk of flare, but few studies have evaluated health literacy in the context of vaccination. We aimed to evaluate the health literacy and COVID-19 vaccination uptake and acceptance in IgA nephropathy.

Methods: Single-center cross-sectional study of 126 consecutive patients with IgA nephropathy.

Impact of focal segmental glomerulosclerosis over the past decade.

Objective: This is a study on the demographics and clinical outcomes including the response to therapy of patients with focal segmental glomerulosclerosis (FSGS) over the past decade.

Materials And Methods: All histologically proven FSGS cases diagnosed between 2008 and 2018 were analyzed for their clinical, laboratory, and histological characteristics including treatment that could influence the disease progression and renal outcome of these patients. We used the Columbia Classification for FSGS for the renal biopsy.

Satisfaction of patients with diabetic kidney disease with traditional chinese medicine physician visits.

Background: Patient-centred care is an important part of quality healthcare and patient satisfaction has been shown to be associated with improved clinical outcomes. We aim to explore the satisfaction of patients with diabetic kidney disease (DKD) with their visits to the TCM physician and its association with patients' socio-economic characteristics.

Methods: A questionnaire survey was conducted among patients aged >21 years with DKD.

Study protocol for a Prospective, Randomized controlled trial of stEnt graft and Drug-coated bAlloon Treatment for cephalic arch stenOsis in dysfunctional arteRio-venous fistulas (PREDATOR).

Background: Treatment of cephalic arch stenosis (CAS) is associated with high risk of failure and complications. Although stent-graft (SG) placement has improved patency rates, stent edge restenosis has been raised as a potential limiting factor for SG usage in CAS. This study aims to evaluate the safety and efficacy of combining stent graft placement with paclitaxel-coated balloon (PCB) angioplasty versus PCB alone in the treatment of CAS.

Regional citrate anticoagulation vs systemic heparin anticoagulation for double-filtration plasmapheresis.

Introduction: Double-filtration plasmapheresis (DFPP) has been utilized for immunomodulation in kidney transplantation. Anticoagulation is important to maintain circuit patency during DFPP. We aimed to compare the efficacy and safety of regional citrate anticoagulation (RCA) with systemic heparin anticoagulation during DFPP in kidney transplant recipients.