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Management: Medicare
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Total 21 results found since Jan 2013.

Renal Dysfunction Is Associated With Poststroke Discharge Disposition and In-Hospital Mortality Clinical Sciences
Background and Purpose—Kidney disease is a frequent comorbidity in patients presenting with acute ischemic stroke. We evaluated whether the estimated glomerular filtration rate (eGFR) on admission is associated with poststroke in-hospital mortality or discharge disposition.Methods—In this cohort study, data from ischemic stroke patients in Get With The Guidelines–Stroke linked to fee-for-service Medicare data were analyzed. The Modification of Diet in Renal Disease study equation was used to calculate the eGFR (mL/min/1.73 m2). Dialysis was identified by International Classification of Diseases, Ninth Revision codes....
Source: Stroke - January 22, 2017 Category: Neurology Authors: Nada El Husseini, Gregg C. Fonarow, Eric E. Smith, Christine Ju, Lee H. Schwamm, Adrian F. Hernandez, Phillip J. Schulte, Ying Xian, Larry B. Goldstein Tags: Mortality/Survival, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Relationship between Stroke and Mortality in Dialysis Patients.
CONCLUSIONS: Dialysis recipients have high mortality after a stroke with corresponding decrements in remaining years of life. Poststroke mortality does not differ by race. PMID: 25318759 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - October 15, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Ellerbeck EF, Shireman TI, Rigler SK, Mahnken JD Tags: Clin J Am Soc Nephrol Source Type: research

Race, Ethnicity, and State-by-State Geographic Variation in Hemorrhagic Stroke in Dialysis Patients.
CONCLUSION: Race and ethnicity, or other factors that covary with these, appear to explain a substantial portion of state-by-state geographic variation in hemorrhagic stroke. This finding suggests that the factors underlying the high rate of hemorrhagic strokes in dialysis patients are likely to be system-wide and that further investigations into regional variations in clinical practices are unlikely to identify large opportunities for preventive interventions for this disorder. PMID: 24458073 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - January 23, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Mahnken JD, Ellerbeck EF, Rigler SK, Zhou X, Shireman TI Tags: Clin J Am Soc Nephrol Source Type: research

Atrial fibrillation and risk of stroke in dialysis patients
Abstract: Purpose: Both stroke and chronic atrial fibrillation (AF) are common in dialysis patients, but uncertainty exists in the incidence of new strokes and the risk conferred by chronic AF.Methods: A cohort of dually eligible (Medicare and Medicaid) incident dialysis patients was constructed. Medicare claims were used to determine the onset of chronic AF, which was specifically treated as a time-dependent covariate. Cox proportional hazards models were used to model time to stroke.Results: Of 56,734 patients studied, 5629 (9.9%) developed chronic AF. There were 22.8 ischemic and 5.0 hemorrhagic strokes per 1000 patient...
Source: Annals of Epidemiology - January 18, 2013 Category: Epidemiology Authors: James B. Wetmore, Edward F. Ellerbeck, Jonathan D. Mahnken, Milind Phadnis, Sally K. Rigler, Purna Mukhopadhyay, John A. Spertus, Xinhua Zhou, Qingjiang Hou, Theresa I. Shireman Source Type: research

Relation of Race, Apparent Disability, and Stroke Risk With Warfarin Prescribing for Atrial Fibrillation in Patients Receiving Maintenance Hemodialysis
We examined patterns of warfarin use, and associated factors, after AF diagnosis. This retrospective cohort analysis studied US Medicare patients receiving maintenance dialysis January 1, 2008-June 30, 2010. Demographics, comorbidity, and a durable medical equipment claims-based disability proxy score predicted warfarin prescription after AF diagnosis. The analysis included 8964 patients with non-valvular AF.
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: James B. Wetmore, Yi Peng, David T. Gilbertson, Jiannong Liu Source Type: research

Outcomes Associated with Apixaban Use in End-Stage Kidney Disease Patients with Atrial Fibrillation in the United States.
Conclusions -Among ESKD patients with AF on dialysis, apixaban use may be associated with lower risk of major bleeding compared with warfarin, with a standard 5 mg twice a day dose also associated with reductions in thromboembolic and mortality risk. PMID: 29954737 [PubMed - as supplied by publisher]
Source: Circulation - June 28, 2018 Category: Cardiology Authors: Siontis KC, Zhang X, Eckard A, Bhave N, Schaubel DE, He K, Tilea A, Stack AG, Balkrishnan R, Yao X, Noseworthy PA, Shah ND, Saran R, Nallamothu BK Tags: Circulation Source Type: research

Use and safety of heparin-free maintenance hemodialysis in the USA
Conclusions Patient markers of increased risk of bleeding and facility region associated with heparin-free HD use. Despite the potential benefits of avoiding heparin use, heparin-free HD was not significantly associated with decreased hazards of death, bleeding or thrombosis, suggesting that it may be no safer than HD with heparin.
Source: Nephrology Dialysis Transplantation - June 18, 2013 Category: Urology & Nephrology Authors: Shen, J. I., Mitani, A. A., Chang, T. I., Winkelmayer, W. C. Tags: Intra- and Extracorporeal Treatment of Kidney Failure Source Type: research

Epoetin Alfa and Outcomes in Dialysis amid Regulatory and Payment Reform
Erythropoiesis-stimulating agents (ESAs) are commonly used to treat anemia in patients with CKD, including those receiving dialysis, although clinical trials have identified risks associated with ESA use. We evaluated the effects of changes in dialysis payment policies and product labeling instituted in 2011 on mortality and major cardiovascular events across the United States dialysis population in an open cohort study of patients on dialysis from January 1, 2005, through December 31, 2012, with Medicare as primary payer. We compared observed rates of death and major cardiovascular events in 2011 and 2012 with expected ra...
Source: Journal of the American Society of Nephrology : JASN - September 29, 2016 Category: Urology & Nephrology Authors: Chertow, G. M., Liu, J., Monda, K. L., Gilbertson, D. T., Brookhart, M. A., Beaubrun, A. C., Winkelmayer, W. C., Pollock, A., Herzog, C. A., Ashfaq, A., Sturmer, T., Rothman, K. J., Bradbury, B. D., Collins, A. J. Tags: Clinical Epidemiology Source Type: research

Medicare Bundled Payment Policy on Anemia Care, Major Adverse Cardiovascular Events, and Mortality among Adults Undergoing Hemodialysis
CONCLUSIONS: The Medicare reimbursement policy and Food and Drug Administration-recommended erythropoietin-stimulating agent dosing changes were associated with lower erythropoietin-stimulating agent use and lower hemoglobin levels. These changes in anemia care were associated with lower risks of major adverse cardiovascular event, stroke, mortality, and heart failure but higher risk of acute myocardial infarction among adults receiving hemodialysis.PMID:35589388 | DOI:10.2215/CJN.14361121
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 19, 2022 Category: Urology & Nephrology Authors: Haesuk Park Raj Desai Xinyue Liu Steven M Smith Juan Hincapie-Castillo Linda Henry Amie Goodin Saraswathi Gopal Carl J Pepine Raj Mohandas Source Type: research

Correlates and outcomes of warfarin initiation in kidney transplant recipients newly diagnosed with atrial fibrillation
In the kidney transplant population with atrial fibrillation (AF), evidence regarding the effectiveness and safety of warfarin treatment is lacking. We used fee-for-service Medicare claims to identify kidney transplant recipients with newly diagnosed AF from the United States Renal Data System. Warfarin use within 30 days of AF diagnosis was ascertained from Medicare Part D prescription claims (2007–11) or using a validated algorithm (1997–2011). The study end points were (i) the composite of death, stroke or gastrointestinal bleed, (ii) death and (iii) death-censored graft failure. Warfarin user and non-user g...
Source: Nephrology Dialysis Transplantation - January 28, 2015 Category: Urology & Nephrology Authors: Lenihan, C. R., Montez-Rath, M. E., Shen, J. I., Scandling, J. D., Turakhia, M. P., Chang, T. I., Winkelmayer, W. C. Tags: Renal Transplantation Source Type: research

Longer-term Outcomes of Darbepoetin Alfa Versus Epoetin Alfa in Patients With ESRD Initiating Hemodialysis: A Quasi-experimental Cohort Study
Conclusions In incident hemodialysis patients, mortality and cardiovascular event rates did not differ between patients treated at facilities predominantly using DPO versus EPO.
Source: American Journal of Kidney Diseases - May 2, 2015 Category: Urology & Nephrology Source Type: research

A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients
Conclusions: Greater IDWG is associated with an increased risk of CV morbid events. Strategies that mitigate IDWG may improve CV health and survival among hemodialysis patients.
Source: BMC Nephrology - July 22, 2015 Category: Urology & Nephrology Authors: Claudia CabreraSteven BrunelliDavid RosenbaumEmmanuel AnumKarthik RamakrishnanDonna JensenNils-Olov StålhammarBergur Stefánsson Source Type: research

If you could propose one idea to help improve health care delivery in the United States, what would it be?
Thumbnail: Tags: conversationsphrma conversationslarry hausnermyrl weinbergchris hansennancy brownContributors: 11621161115911631173Contributions: Read Larry Hausner's bio Despite the rapid development of innovative technologies in the health care field, we have yet to discover a panacea that will easily transform our health care system into one that provides high-quality and cost-effective care.  What we have discovered and come to agree on over the last decade is that our sick care system must be reconfigured to a health care system that emphasizes wellness and prevention.  For that reason, I offer ...
Source: PHRMA - June 24, 2013 Category: Pharmaceuticals Authors: rlowe Source Type: news

Risk of intracranial hemorrhage associated with autosomal dominant polycystic kidney disease in patients with end stage renal disease
Conclusions: ADPKD is a significant risk factor for ICH among patients on maintenance dialysis. Our Medicare primary cohort was older than in previous studies of intracranial aneurysm rupture among ADPKD patients. There are also limitations inherent to using the USRDS database.
Source: BioMed Central - February 26, 2014 Category: Journals (General) Authors: David J YooLawrence AgodoaChristina M YuanKevin C AbbottRobert Nee Source Type: research