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The incidence and prevalence of end-stage kidney disease (ESKD) in Korea are increasing, and ESKD constitutes a very important medical and social issue. Elderly dialysis patients have the highest risk of early mortality within 3 months after initiating dialysis, and geriatric syndromes such as aging, frailty, functional impairment, and cognitive impairment are crucial for the prognosis of elderly patients. Shared decision-making (SDM) is an approach through which clinicians and patients can achieve informed preferences, thereby yielding better clinical outcomes and quality of life. Through SDM-based, close consultation among patients, families, and healthcare providers, an ESKD Life-Plan for elderly patients should be established. A multidisciplinary approach led by nephrologists can help them to provide proper vascular access for dialysis at the right time, with the right evidence, and to the right patient. Strategies that can improve peritoneal dialysis in elderly patients include assisted peritoneal dialysis, homecare support programs, and automated peritoneal dialysis. In order to enhance the role of kidney transplantation in elderly patients with ESKD, it is necessary to accurately identify patients' clinical conditions before transplantation and to perform active rehabilitation activities and postoperative management to promote recovery after transplantation. With the aging population and the increase in ESKD in the elderly, clinicians must identify factors affecting the mortality and quality of life of elderly dialysis patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10329902 | PMC |
http://dx.doi.org/10.5049/EBP.2023.21.1.1 | DOI Listing |
JAMA Netw Open
September 2025
Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Lübeck, Lübeck, Germany.
Importance: Patients with inflammatory rheumatic diseases (IRDs) frequently experience psychological distress; however, access to psychological support remains limited.
Objective: To investigate the effectiveness of a digital psychological intervention for individuals with IRDs.
Design, Setting, And Participants: Participants aged 18 years or older were recruited across Germany between February 22 and June 4, 2024, if they had been diagnosed with rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus and reported psychological distress and reduced quality of life.
JAMA Netw Open
September 2025
Division of Cardiology, Duke University Hospital, Durham, North Carolina.
Importance: Previous data suggest that the time changes associated with daylight savings time (DST) may be associated with an increased incidence of acute myocardial infarction (AMI).
Objective: To determine whether the incidence of patients presenting with AMI is greater during the weeks during or after DST and compare the in-hospital clinical events between the week before DST and after DST.
Design, Setting, And Participants: This cross-sectional study examined patients enrolled in the Chest Pain MI Registry from 2013 to 2022.
JAMA Netw Open
September 2025
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Importance: As obesity rates rise in the US, managing associated metabolic comorbidities presents a growing burden to the health care system. While bariatric surgery has shown promise in mitigating established metabolic conditions, no large studies have quantified the risk of developing major obesity-related comorbidities after bariatric surgery.
Objective: To identify common metabolic phenotypes for patients eligible for bariatric surgery and to estimate crude and adjusted incidence rates of additional metabolic comorbidities associated with bariatric surgery compared with weight management program (WMP) alone.
JAMA Netw Open
September 2025
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Importance: Patients with advanced cancer frequently receive broad-spectrum antibiotics, but changing use patterns across the end-of-life trajectory remain poorly understood.
Objective: To describe the patterns of broad-spectrum antibiotic use across defined end-of-life intervals in patients with advanced cancer.
Design, Setting, And Participants: This nationwide, population-based, retrospective cohort study used data from the South Korean National Health Insurance Service database to examine broad-spectrum antibiotic use among patients with advanced cancer who died between July 1, 2002, and December 31, 2021.
JAMA Netw Open
September 2025
Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City.
Importance: Advances in diagnostics have enabled the detection of more gastrointestinal pathogens, but misuse of diagnostics can lead to inappropriate antibiotic use and excess financial burdens. Ensuring appropriate use of diagnostics is crucial for optimizing patient care and promoting stewardship of health care resources.
Objective: To elicit parents' and clinicians' perspectives on expectations for care of pediatric diarrhea with a focus on diagnostic testing and to evaluate the potential for an electronic clinical decision support tool (ECDST) to improve appropriate use of diagnostics.