1,721,291 research outputs found
Putting prevention first in kidney care
No full textThe old adage prevention is better than cure attributed to the Dutch thinker Erasmus, is highly relevant to the treatment of chronic kidney disease (CKD)
An overview of recent advances in treating chronic kidney disease
Full text linkPaul Roderick gives an overview of how the prevention, detection and treatment of chronic kidney disease (CKD) has changed in recent years. He explains why CKD has become a major health problem and the actions required to deal with this life-threatening disease
Assessing the impact of chronic kidney disease on individuals and populations: use of relative and absolute measures
No full textChronic kidney disease (CKD) is now recognized as a global public health problem, contributing substantially to the burden of non-communicable disease (NCD) [1, 2]. CKD is associated with a variety of NCD outcomes, including renal [end-stage renal disease (ESRD)], cardiovascular and non-cardiovascular. It is important to quantify the risks associated with CKD on such disease outcomes in individuals and the impact of CKD on whole populations, and given the high prevalence of CKD and increased risks of most NCDs at older ages, how the impact of CKD varies by age. The paper by Marks et al. is a population-based study using routinely collected data in the Grampian region of Scotland which aimed to determine the effect of CKD (largely Stage 3b–5) on renal replacement therapy (RRT) and all-cause mortality (ACM). The impact of CKD on RRT and ACM was mainly due to CKD in older age groups, a paradox given that the absolute risk of progression to RRT in the CKD cohort and the relative risks of ACM associated with CKD both fell with age. The findings are firstly an illustration of the contrasting information provided by relative and absolute measures of the effects of risk factors, age and CKD on disease outcomes, and secondly highlight the possible interaction between age and CKD. The authors also developed risk prediction tools to determine the absolute risk of RRT and ACM for patients with CKD. This article considers these concepts in more detail<br/
Infusing climate change and sustainability into the medical school curriculum
No full textThe climate emergency is a health emergency. This fact is now indisputable and it is common knowledge that climate change and environmental degradation pose an unprecedented threat to human health. Increasing intensity and frequency of extreme weather events, rising global temperatures and sea levels, pollution, and biodiversity loss contribute to considerable morbidity and mortality. The burden of disease will fall hardest on the most vulnerable people and will widen already existing global health inequalities and gaps in healthcare provision
Public health and nephrology: Contributions of epidemiology to the study, understanding, prevention and treatment of kidney disease
No full textComparison of apparent efficiency of haemodialysis satellite units in England and Wales using data envelopment analysis
No full textObjectives: To expand care for chronic haemodialysis (HD) patients throughout England and Wales by studying two aspects of service delivery that are important: to identify relative performance of haemodialysis satellite units (HDSUs), and understand the factors that influence the performance. As a first step toward these aspects, this work reports a study of apparent comparative efficiency in the delivery of HDSUs and demonstrates the potential of data envelopment analysis (DEA).Methods: DEA was applied to data obtained from a national survey of the organizational structures and processes of delivering care at HDSUs in England and Wales.Results: DEA was found to be a judicious approach for performance assessment of HDSUs, although valid results depend on appropriate model specification and quality of data available. The available data were not of sufficient comprehensiveness or quality to produce definitive results but suggested that overall efficiency could improve; these data suggested by as much as 10% overall (mean efficiency score 90%) and variably within the sample (46 [65%] that HDSUs were potentially inefficient, the lowest unit scoring 38%).Conclusions: Addressing questions raised by comparative inefficiency could help plans to improve capacity to deal with the growing demand for HD delivered in HDSUs. The application was an important start and needs to be followed by further research to establish model validity and obtain authoritative results
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