Validation of administrative database codes for acute kidney injury in kidney transplant recipients

The objective of this study is to determine the accuracy of AKI diagnostic codes in kidney transplant recipients. We hypothesized that the sensitivity of diagnostic codes would be significantly greater in the kidney transplant population since these patients are closely followed by nephrologists and are more likely to have serum creatinine measured.DesignThe design is a population-based retrospective cohort study using healthcare administrative and laboratory databases.SettingThe setting is in Southwestern Ontario and Ottawa, Ontario, Canada, from 2003 to 2012.PatientsWe included first-time kidney transplant recipients admitted to hospital for whom serum creatinine was measured in hospital and within 6  months prior (n = 524).MethodsPatients meeting the Acute Kidney Injury Network (AKIN) classification serum creatinine change criteria were classified as having AKI. We determined the sensitivity, specificity, and negative and positive predictive values for theICD-10-CA code for AKI when present as an admission diagnosis, most responsible diagnosis, or any diagnosis compared to a reference standard of AKI defined by the AKIN criteria (stage 1 or greater, stage 2 or greater, or stage 3).ResultsForty-five percent of included kidney transplant patients had a diagnosis of AKI. The most sensitive coding algorithm (reference standard AKIN stage 2 or greater,ICD-10 code present as any diagnosis) had a sensitivity of 42.1  % (95 % CI 31.7, 53.3), a specific...
Source: Canadian Journal of Kidney Health and Disease - Category: Urology & Nephrology Source Type: research

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By ANISH KOKA, MD Bobby It took some doing, but I had finally made it to Bobby’s home. It was a rowhome tucked into one of those little side streets in the city that non-city folks wouldn’t dream of driving down. As I step in, I’m met by the usual set up – wooden steps that hug the right side of the wall leading up to the second floor.  Bobby certainly hasn’t made it up to the second floor in some time. At the moment she is sitting in her hospital bed in the living room. The bed is the focal point to a room stuffed to the gills with all manners of stuff. At least three quarters o...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients Physicians Anish Koka social injustice Source Type: blogs
ConclusionsManagement of delivery in cases of suspected autosomal recessive renal polycystic kidney disease needs to be discussed because of the risk of abdominal dystocia. The route and timing of delivery depend on the size of the fetal abdominal circumference and the gestational age. The rate of kidney growth must also be taken into account.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Medicare may save money by taking on lifetime payments for immunosuppressant drugs after kidney transplantation, rather than the current policy that stops coverage at three years, a new cost-effectiveness analysis suggests.Reuters Health Information
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Nephrology News Source Type: news
A novel endovascular device is a new alternative to surgery for the creation of an arteriovenous fistula for hemodialysis access in those with kidney disease, and has a high level of patient satisfaction.Medscape Medical News
Source: Medscape Transplantation Headlines - Category: Transplant Surgery Tags: Nephrology News Source Type: news
Publication date: Available online 11 December 2019Source: Urology Case ReportsAuthor(s): Mesut Demir, Cumhur Yesildal, Abdullah Hizir Yavuzsan, Sinan Levent Kirecci, Ali Ihsan DokucuAbstract46-year-old wife (donor) and 52-year-old husband (recipient) admitted to our clinic for kidney transplantation. CT angiography of the donor showed us there were bilateral renal double artery and a tortuous aorta that is deviated to the left side. The main artery cannot be reached by laparoscopy because of the upper level of renal artery and deviation of the aorta and an open conversion was performed. Presence of tortuous aorta with mul...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 11 December 2019Source: Urology Case ReportsAuthor(s): Nobufumi Ueda, Hirohito Naito, Mikio SugimotoAbstractWe experienced a case of retroperitoneal hematoma secondary to spontaneous lumbar artery rupture in a kidney transplant patient. A 48-year-old woman underwent kidney transplantation for end-stage renal disease. Fifteen days after transplantation, the patient presented with strong abdominal and back pain on the right side, and blood examination showed severe anemia. Contrast-enhanced computed tomography and emergent angiography was performed, which showed extravasation from the lumba...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 11 December 2019Source: International Journal of Nursing SciencesAuthor(s): Lei Cui, Weixia Chen, Xingxing Yu, Changping JuAbstractPurposePatients undergoing maintenance hemodialysis (MHD) have a higher prevalence of cognitive impairment and inferior cognitive performance than the general population, and those with cognitive impairment are at higher risk of death than those without cognitive impairment. Having diabetes has been associated with an increased risk of cognitive decline in end-stage kidney disease patients treated with peritoneal dialysis or kidney transplant. However, these f...
Source: International Journal of Nursing Sciences - Category: Nursing Source Type: research
Pancreas-kidney transplant extends life expectancy for patients with type 1 diabetes and renal disease more than kidney transplantation alone, according to a study published inDiabetes Care.Healio
Source: Society for Endocrinology - Category: Endocrinology Source Type: news
Every organ in the body is capable, to some extent, of repairing itself after an injury. As part of this process, scar tissue forms and then recedes to make room for normal tissue when healing is complete.However, when healing is disrupted — whether by chronic injury or disease — the cells that make up scar tissue can go rogue, continuously dividing and spreading until the scar eventually strangles the organ it was intended to help heal, which can lead to organ failure.That progressive, out-of-control scarring is called fibrosis, and it can occur in any organ in the body. Fibrosis plays a major role in many dis...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Recent studies demonstrate that the edema index (ECW/TBW) may be a significant predictor of poor outcomes as a composite of overhydration and protein-energy wasting. There is no consensus regarding ECW/TBW cut-off values. We aimed to determine the performance of ECW/TBW in all-cause mortality prediction and to establish certain cut-off values in patients on chronic hemodialysis.
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Original article Source Type: research
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