Opioid use patterns and persistent use after hemodialysis access surgery.

Objective: We evaluated the risk of persistent opioid use related to opioid pain management for hemodialysis access creation and identify patterns of opioid dosage and use.

Methods: This retrospective cohort study included Medicare-enrolled opioid-naïve patients in the US Renal Data System who initiated hemodialysis for end-stage kidney disease between April 2015 and June 2019. Persistent opioid use was defined as an opioid prescription 90 to 180 days after surgery.

Overweight Status, Obesity, and Progression to ESKD in Patients with Autosomal Dominant Polycystic Kidney Disease.

Key Points: Higher body mass index increased risk of progression to ESKD in patients with early-stage autosomal dominant polycystic kidney disease. Higher body mass index did not increase the risk of progression to ESKD in patients with late-stage autosomal dominant polycystic kidney disease.

Background: Prior research has linked higher body mass index (BMI) and greater visceral adiposity with more rapid progression of early-stage autosomal dominant polycystic kidney disease (ADPKD).

Trends in Timing of Preemptive Kidney Transplantation and Association with Allograft and Survival Outcomes in Children.

Key Points: Preemptive kidney transplant is occurring at higher levels of eGFR in US children over time. Higher level of eGFR at the time of transplant is not associated with patient or allograft survival. Implications of the observed trend of performing preemptive kidney transplant at higher eGFR on the long-term health of children deserve further study.

Preterm Labor and Hypertensive Disorders in Adolescent Pregnancies With Diabetes Between 2006 and 2019.

Objective: We sought to evaluate the risk of preterm labor and hypertensive disorders in adolescent pregnancies with and without diabetes.

Methods: We evaluated 1,843,139 adolescents (≤20 years old) with labor and delivery admissions in the national Kids' Inpatient Database (KID) in years 2006, 2009, 2012, 2016, and 2019. International classification of disease codes was used to identify diabetes and medical factors affecting pregnancy.

Pediatric Nephrology Workforce and Access of Children with Kidney Failure to Transplantation in the United States.

Key Points: Pediatric nephrologists play a critical role in evaluating children with kidney failure for transplant candidacy. Nephrology is one of the pediatric subspecialties with the greatest workforce shortage in the United States. Children residing in states with the highest density of pediatric nephrologists had better access to waitlisting and deceased donor transplantation.

Living Donor Candidates' Self-reported Health and Health Perceptions and Completion of Donor Evaluation: A Cohort Study.

Rationale & Objective: Given the organ shortage in the United States, increasing living donation is vital to improving access to kidney transplantation, but many donor candidates do not complete the donor evaluation. Our objective was to understand potential living donors' perceived health and its association with the likelihood of completing the donor evaluation process.

Study Design: Potential donors' self-reported health was ascertained using the Patient Reported Outcomes Measurement Information System (PROMIS) global physical and mental health and the Davies and Ware Health Perceptions surveys.

Dialysis Facility Staffing Ratios and Kidney Transplant Access Among Adolescents and Young Adults.

Importance: Patient to staff ratios vary across US dialysis facilities and have been associated with patient outcomes in older adults.

Objective: To determine whether patient to nurse or patient to social worker staff ratios are associated with access to kidney transplant for adolescents and young adults.

Design, Setting, And Participants: Retrospective cohort study including patients aged 12 to 30 years who started dialysis between 2005 and 2019 at 8490 US facilities according to the US Renal Data System, the national end-stage kidney disease registry.

Acute Declines in Estimated Glomerular Filtration Rate in Patients Treated With Benazepril and Hydrochlorothiazide Versus Amlodipine and Risk of Cardiovascular Outcomes.

Background: Acute declines in estimated glomerular filtration rate (eGFR) occur commonly after starting angiotensin-converting enzyme inhibitors. Whether declines in eGFR that occur after simultaneously starting angiotensin-converting enzyme inhibitors with other antihypertensive agents modifies the benefits of these agents on cardiovascular outcomes is unclear.

Methods And Results: We identified predictors of acute declines in eGFR (>15% over 3 months) during randomization to benazepril plus amlodipine versus benazepril plus hydrochlorothiazide in the ACCOMPLISH (Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension) trial.

Transient albuminuria in the setting of short-term severe hyperglycemia in type 1 diabetes.

In a cohort of 1817 children with type 1 diabetes (T1D), short-term hyperglycemia was associated with transient albuminuria (11 % during new-onset T1D without diabetic ketoacidosis (DKA), 12 % during/after DKA, 6 % during routine screening). Our findings have implications regarding future risk of diabetic kidney disease and further investigation is needed.

Rurality of patient residence and access to transplantation among children with kidney failure in the United States.

Background: Residence in rural areas is often a barrier to health care access. To date, differences in access to kidney transplantation among children who reside in rural and micropolitan areas of the US have not been explored.

Methods: A retrospective cohort study of children < 18 years who developed kidney failure between 2000 and 2019 according to the United States Renal Data System (USRDS).

Acute Declines in Estimated GFR in Blood Pressure Target Trials and Risk of Adverse Outcomes.

Rationale & Objective: Acute decreases in glomerular filtration rate (GFR) occur commonly during intensive blood pressure (BP) lowering. Our objective was to determine the relationship between acute decreases in estimated GFR and patient outcomes.

Study Design: Retrospective observational study.

Renal Recovery and Mortality Risk among Patients with Hepatorenal Syndrome Receiving Chronic Maintenance Dialysis.

Background: Kidney replacement therapy is controversial for patients with hepatorenal syndrome who may not be liver transplant candidates. Data surrounding the likelihood of recovery of kidney function and mortality after outpatient dialysis initiation in patients with dialysis-requiring hepatorenal syndrome could inform discussions between patients and providers.

Methods: We performed a retrospective cohort study of patients with hepatorenal syndrome who were registered in the United States Renal Data System between 1996 and 2015 (=7830) as receiving maintenance dialysis.

Insulin Pump-related Inpatient Admissions in a National Sample of Youth With Type 1 Diabetes.

Background: Insulin pump use in type 1 diabetes management has significantly increased in recent years, but we have few data on its impact on inpatient admissions for acute diabetes complications.

Methods: We used the 2006, 2009, 2012, and 2019 Kids' Inpatient Database to identify all-cause type 1 diabetes hospital admissions in those with and without documented insulin pump use and insulin pump failure. We described differences in (1) prevalence of acute diabetes complications, (2) severity of illness during hospitalization and disposition after discharge, and (3) length of stay (LOS) and inpatient costs.

Risk of breast cancer in women treated with ovarian stimulation drugs for infertility: a systematic review and meta-analysis.

Objective: To evaluate the evidence addressing the association between the use of ovarian stimulation drugs and the risk of breast cancer.

Design: Systematic review and meta-analysis.

Setting: Not applicable.

National Trends in Pediatric Admissions for Diabetic Ketoacidosis, 2006-2016.

Background And Objectives: Diabetic ketoacidosis (DKA) rates in the United States are rising. Prior studies suggest higher rates in younger populations, but no studies have evaluated national trends in pediatric populations and differences by subgroups. As such, we sought to examine national trends in pediatric DKA.

Insurance status predicts self-reported influenza vaccine coverage among pregnant women in the United States: A cross-sectional analysis of the National Health Interview Study Data from 2012 to 2018.

While the influenza vaccine is recommended for all pregnant women, influenza vaccine coverage among this high-risk population remains inadequate. Factors associated with vaccine coverage among pregnant women, including insurance status, are poorly understood. In a cross-sectional study of the National Health Interview Survey (NHIS) data from 2012 to 2018, we evaluated predictors of self-reported influenza vaccine coverage in pregnant women.