A Gap Analysis to Assess the Implementation of Environmentally Sustainable Kidney Care Strategies in Canada.

Background: There is growing interest in the nephrology community for environmentally sustainable kidney care (ESKC) to alleviate the environmental impact of kidney care services.

Objective: This study aimed to assess the knowledge of Canadian kidney care providers regarding their program's ESKC strategies.

Design Setting Participants Measurements And Methods: An electronic survey, created by the Canadian Society of Nephrology-Sustainable Nephrology Action Planning committee, was distributed to Canadian kidney care providers.

Scoping Review of Kidney Patients and Providers Perspectives on Disaster Management.

Introduction: Patients with kidney disease are uniquely vulnerable to disasters and the need to understand stakeholder experiences to improve disaster preparedness has been highlighted. We aimed to explore the existing literature capturing patient and provider perspectives, identify research gaps, and develop research priorities in disaster management.

Methods: This was a scoping review of the empirical literature that has explored the lived experience and preparedness of patients, caregivers, or healthcare professionals during natural or human-caused disasters.

Self-Reported Burden and Health-Related Quality of Life in Acute Kidney Injury Survivors Compared with Patients with Advanced CKD.

Key Points: Patients recently discharged after a severe AKI episode have a low health-related quality of life. This self-reported quality of life is comparable with that of people living with advanced CKD.

Background: Survivors of severe AKI are at risk of increased morbidity.

Barriers and facilitators to implementing reusable personal protective equipment in hospitals, and their impacts on environment, care safety, costs, and supply chain resilience: a scoping review protocol.

Introduction: Climate degradation poses a significant global health challenge, with healthcare systems paradoxically contributing to this issue while adhering to the principle of 'do no harm'. Notably, the healthcare sector accounts for a considerable share of greenhouse gas emissions in many industrialised countries, primarily due to the supply chain, including pharmaceuticals, disposable medical devices and personal protective equipment (PPE). The COVID-19 pandemic exacerbated this issue, with millions of tons of CO emissions attributed to single-use PPE.

Regional and Gender Disparities in Abstracts Presented at the International Transplant Congresses.

Background: Women and authors from low- and middle-income countries are notably underrepresented in academia. The intersection of these 2 factors is poorly quantified. We aimed to characterize gender disparities by region through analyzing abstracts presented at the Transplantation Society's congresses.

A Roadmap for Disaster Risk Reduction and Management in Kidney Care: A Scoping Review and Content Analysis.

Key Points: Disasters cause significant human suffering, and patients with kidney diseases are uniquely vulnerable. We have developed a roadmap for disaster preparedness, response, and recovery by reviewing and synthesizing existing literature. Our roadmap provides an easily implementable approach for kidney care programs to develop context-specific protocols.

Assessing the role of education level on climate change belief, concern and action: a multinational survey of healthcare professionals in nephrology.

Background: Climate change poses a significant risk to kidney health, and countries with lower national wealth are more vulnerable. Yet, citizens from lower-income countries demonstrate less concern for climate change than those from higher-income countries. Education is a key covariate.

Global structures, practices, and tools for provision of chronic peritoneal dialysis.

Background: Worldwide, the uptake of peritoneal dialysis (PD) compared with hemodialysis remains limited. This study assessed organizational structures, availability, accessibility, affordability and quality of PD worldwide.

Methods: This cross-sectional study relied on data from kidney registries as well as survey data from stakeholders (clinicians, policymakers and advocates for people living with kidney disease) from countries affiliated with the International Society of Nephrology (ISN) from July to September 2022.

Dialysis Outcomes Across Countries and Regions: A Global Perspective From the International Society of Nephrology Global Kidney Health Atlas Study.

Introduction: Kidney failure treated with hemodialysis (HD), or peritoneal dialysis (PD) is a major global health problem that is associated with increased risks of death and hospitalization. This study aimed to compare the incidence and causes of death and hospitalization during the first year of HD or PD among countries.

Methods: The third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) was conducted between June and September 2022.

Peritoneal dialysis versus haemodialysis for people commencing dialysis.

Background: Peritoneal dialysis (PD) and haemodialysis (HD) are two possible modalities for people with kidney failure commencing dialysis. Only a few randomised controlled trials (RCTs) have evaluated PD versus HD. The benefits and harms of the two modalities remain uncertain.

Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care: A Multinational Survey of Health Care Professionals.

Key Points: A multinational survey of health care professionals on the kidney health impacts of climate change and the environmental burden of kidney care was conducted. Most participants reported knowledge gaps and high level of concern on these interconnected issues. Only a minority report personal or organizational initiatives in environmentally sustainable kidney care; this did not vary by country income level.

Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).

The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement, particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplantation, and a 3-fold higher than global median prevalence of dialysis centers.

Home versus in-centre haemodialysis for people with kidney failure.

Background: Home haemodialysis (HHD) may be associated with important clinical, social or economic benefits. However, few randomised controlled trials (RCTs) have evaluated HHD versus in-centre HD (ICHD). The relative benefits and harms of these two HD modalities are uncertain.

Variability in Reporting eGFR at Dialysis Initiation in Canada: A Research Letter.

Background: Estimated glomerular filtration rate (eGFR) at dialysis initiation is increasingly recognized as a key quality indicator (QI) for patients with end-stage kidney disease (ESKD). Specifically, guidelines recommend assessing deferral of dialysis initiation until symptoms arise or if the eGFR is ≤6 mL/min/1.73 m.

ISPD Catheter-related Infection Recommendations: 2023 Update.

Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised and clarified definitions and classifications of exit site infection and tunnel infection. A new target for the overall exit site infection rate should be no more than 0.

Clinical Implementation of NGAL Testing to Improve Diagnostic Assessment of AKI Episodes in a Canadian Center.

Background: The differential diagnosis of acute kidney injury (AKI) episodes is often challenging. Novel AKI biomarkers have shown their utility to improve prognostic prediction and diagnostic assessment in various research populations but their implementation in standard clinical practice is still rarely reported.

Objective: To report the differential diagnostic ability and associated clinical utility of the neutrophil gelatinase-associated lipocalin (NGAL) testing in a real-life setting of a heterogeneous AKI population.

Dialysis modality utilization patterns and mortality in older persons initiating dialysis in Australia and New Zealand.

Aim: The benefits of dialysis in the older population remain highly debated, particularly for certain dialysis modalities. This study aimed to explore the dialysis modality utilization patterns between in-centre haemodialysis (ICHD), peritoneal dialysis (PD) and home haemodialysis (HHD) and their association with outcomes in older persons.

Methods: Older persons (≥75 years) initiating dialysis in Australia and New Zealand from 1999 to 2018 reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry were included.

Burden of kidney failure from atheroembolic disease and association with survival in people receiving dialysis in Australia and New Zealand: a multi-centre registry study.

Background: Cardiovascular disease is a leading cause of mortality in kidney failure (KF). Patients with KF from atheroembolic disease are at higher risk of cardiovascular disease than other causes of KF. This study aimed to determine survival on dialysis for patients with KF from atheroembolic disease compared with other causes of KF.

Quality of Life and Hemodynamic Effects of Switching From Hemodialysis to Hemodiafiltration: A Canadian Controlled Cohort Study.

Background: Recent randomized clinical trials have demonstrated beneficial effects of hemodiafiltration (HDF) compared with hemodialysis (HD) on mortality and hemodynamic stability. Data on quality of life in HDF compared with HD is limited.

Objective: This study aimed to determine whether patients receiving HD experience improvements in quality of life, hemodynamic and laboratory parameters after switching to HDF.

Representativeness of the PDOPPS cohort compared to the Australian PD population.

Background: The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is an international, prospective study following persons treated by peritoneal dialysis (PD) to identify modifiable practices associated with improvements in PD technique and person survival. The aim of this study was to assess the representativeness of the Australian cohort included in PDOPPS compared to the complete Australian PD population, as reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry.

Methods: Adults with at least one PD treatment reported to ANZDATA Registry during the census period of PDOPPS Phase I (November 2014 to April 2018) were compared to the Australian PDOPPS cohort.

Peritoneal Dialysis After Liver Transplantation: A Systematic Review.

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear.

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Oceania and South East Asia.

Oceania and South East Asia (OSEA) is a socioeconomically, culturally, and ethnically diverse region facing a rising epidemic of noncommunicable diseases, including chronic kidney disease (CKD). The second iteration of the International Society of Nephrology Global Kidney Health Atlas aimed to provide a comprehensive evaluation of kidney care in OSEA. Of the 30 countries/territories in OSEA, 15 participated in the survey, representing 98.