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- Adverse Drug Events (ADE) (1)
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- Medication: Safety (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedAklilu AM, Kumar S, Yamamoto Y
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
This retrospective study examined the association of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use with patients who have KDIGO-defined acute kidney injury (AKI) during acute heart failure (AHF) hospitalizations and their kidney function recovery at 14 days and 30 days using time-varying multivariable Cox-regression analyses. The study looked at 3305 adults hospitalized across 5 Yale New Haven Health Systems between January 2020 and May 2022 with AHF complicated by KDIGO-defined AKI. Of those individuals hospitalized with AHF and AKI, 356 received SGLT2i following AKI diagnosis either as initiation or continuation. The rate of renal recovery was not significantly different among those exposed and unexposed to SGLT2i following AKI (adjusted HR 0.94). SGLT2i exposure was associated with lower risk of 30-day mortality (adjusted HR 0.45). Rates of renal recovery were similar between the exposed and nonexposed cohorts regardless of the proximity of SGLT2i exposure to AKI diagnosis.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Yamamoto Y .
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
Kidney360 2023 Oct; 4(10):1371-81. doi: 10.34067/kid.0000000000000250..
Keywords: Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Inpatient Care, Medication, Outcomes
Gregg LP, Hedayati SS, Yang H
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
This study looked at whether blood pressure variability (BPV) is associated with cardiovascular outcomes and end-stage kidney disease (ESKD) in patients with chronic kidney disease. The authors studied US veterans with nondialysis chronic kidney disease stages 1-5 and hypertension on nondiuretic antihypertensive monotherapy. This case-control study compared veterans on only one antihypertensive prescription with those who were prescribed a second antihypertensive prescription. Each group had 31,394 participants. BPV was associated with composite cardiovascular events. It was associated with cardiovascular events and death but not ESKD in patients with chronic kidney disease.
AHRQ-funded; HS022418.
Citation: Gregg LP, Hedayati SS, Yang H .
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
Hypertension 2021 Mar 3;77(3):948-59. doi: 10.1161/hypertensionaha.120.16117..
Keywords: Kidney Disease and Health, Blood Pressure, Cardiovascular Conditions, Chronic Conditions
Li K, Ferguson T, Embil J
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Investigators sought to determine how interim lower limb complications modify the subsequent risk of progression to kidney failure, all-cause mortality before kidney failure, and cardiovascular events in a cohort of patients with chronic kidney disease (CKD) stages G3 to G5. Patient-level data obtained from several administrative databases from Manitoba, Canada, were analyzed. They found that interim lower limb complications were associated with an increased risk of kidney failure, all-cause mortality before kidney failure, and cardiovascular-related hospitalization. They stated that clinical trials of screening and treatment strategies for patients with CKD at risk for lower limb complications may help determine optimal strategies to manage this risk.
AHRQ-funded; HS018574.
Citation: Li K, Ferguson T, Embil J .
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Kidney Int Rep 2021 Feb;6(2):381-88. doi: 10.1016/j.ekir.2020.11.010..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Adverse Events, Mortality, Outcomes
Yao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Pokorney SD, Black-Maier E, Hellkamp AS
Oral anticoagulation and cardiovascular outcomes in patients with atrial fibrillation and end-stage renal disease.
The objective of this study was to describe patterns of oral anticoagulant (OAC) use in end-stage renal disease (ESRD) patients with atrial fibrillation (AF) and their associations with cardiovascular outcomes. Medicare fee-for-service 5% claims data from 2007 to 2013 was analyzed in a cohort of patients with ESRD and AF. A cohort of 8,410 patients with AF and ESRD was identified, with a total of 3,043 (36.2%) patients treated with OAC during the study period. Treatment with OAC was not associated with hospitalization for stroke, or death but was associated with increased hospitalization for bleeding and intracranial hemorrhage.
AHRQ-funded; HS021092.
Citation: Pokorney SD, Black-Maier E, Hellkamp AS .
Oral anticoagulation and cardiovascular outcomes in patients with atrial fibrillation and end-stage renal disease.
J Am Coll Cardiol 2020 Mar 24;75(11):1299-308. doi: 10.1016/j.jacc.2020.01.019..
Keywords: Blood Thinners, Medication, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Chronic Conditions, Outcomes
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Brescia AA, Wu X, Paone G
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
Researchers explored whether there a sex-related difference on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. A prospective, observational study was conducted of 17,363 patients not on dialysis undergoing the procedure between 2011 and 2016 across 41 institutions from the Perfusion Measure and Outcomes registry. There was no sex-related differences found for nadir hematocrit or rates of acute kidney injury.
AHRQ-funded; HS026003; HS022535.
Citation: Brescia AA, Wu X, Paone G .
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
J Thorac Cardiovasc Surg 2019 Oct;158(4):1073-80.e4. doi: 10.1016/j.jtcvs.2019.03.042..
Keywords: Injuries and Wounds, Sex Factors, Kidney Disease and Health, Adverse Events, Surgery, Heart Disease and Health, Cardiovascular Conditions
Assimon MM, Brookhart MA, Flythe JE
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
This retrospective cohort study compared cardiac safety of selective serotonin reuptake inhibitors (SSRIs) among individuals receiving maintenance hemodialysis. These individuals may be particularly susceptible to lethal cardiac consequences of drug-induced QT prolongation due to a substantial cardiovascular disease burden and their use of many medications. Data from a cohort of Medicare beneficiaries receiving hemodialysis included in the US Renal Data system registry from 2007-2014 was used. Researchers compared the 1-year risk of death among hemodialysis patients taking different SSRIs. Use of higher QT-prolonging potential SSRIs (citalopram, escitalopram) was associated with a higher risk of sudden cardiac death than patients taking lower risk SSRIs (fluoxetine, fluvoxamine, paroxetine, sertraline). The association was higher among elderly individuals, females, patients with conduction disorders, and those treated with other non-SSRI QT-prolonging medications.
AHRQ-funded; HS026801.
Citation: Assimon MM, Brookhart MA, Flythe JE .
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
J Am Soc Nephrol 2019 Apr;30(4):611-23. doi: 10.1681/asn.2018101032..
Keywords: Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions
Dunn T, Saeed MJ, Shpigel A
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
This study examined whether the use of preoperative cardiac stress testing of patients undergoing kidney transplantation reduced 30-day- death and myocardial infarction post-transplantation. ESRD patients 40 years or older with primary Medicare insurance between 2006 and 2013 were identified using the United States Renal Data System. In a matched cohort of 17,304 patients, there was little difference in 30-day post-transplantation mortality and myocardial infarction between those receiving a stress test and those who did not.
AHRQ-funded; HS019455.
Citation: Dunn T, Saeed MJ, Shpigel A .
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
PLoS One 2019 Feb;14(2):e0211161. doi: 10.1371/journal.pone.0211161..
Keywords: Transplantation, Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Surgery
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Charytan DM, Skali H, Shah NR
Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage.
Microvascular rarefaction is found in experimental uremia, but data from patients with chronic kidney disease (CKD) are limited. The investigators, therefore, quantified absolute myocardial blood flow and coronary flow reserve (the ratio of peak to resting flow) from myocardial perfusion positron emission tomography scans at a single institution and classified individuals into standard CKD categories based on the estimated glomerular filtration rate.
AHRQ-funded; HS022998.
Citation: Charytan DM, Skali H, Shah NR .
Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage.
Kidney Int 2018 Feb;93(2):501-09. doi: 10.1016/j.kint.2017.07.025..
Keywords: Cardiovascular Conditions, Kidney Disease and Health, Mortality
Cooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Amin AP, Bach RG, Caruso ML
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
The purpose of this study was to examine the national variation in acute kidney injury (AKI) incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after percutaneous coronary intervention (PCI). This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for percutaneous coronary intervention (PCI) in the United States.
AHRQ-funded; HS022481.
Citation: Amin AP, Bach RG, Caruso ML .
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
JAMA Cardiol 2017 Sep;2(9):1007-12. doi: 10.1001/jamacardio.2017.2156..
Keywords: Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Patient Safety, Heart Disease and Health, Practice Patterns
Shafi T, Powe NR, Meyer TW
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
This study determined the association of the proatherogenic metabolite trimethylamine N-oxide (TMAO) with cardiovascular outcomes in hemodialysis patients and assessed whether this association differs by race. It found that, compared with blacks in the same quintile, whites in the highest quintile for TMAO (>/=135 muM) had a 4-fold higher risk of cardiac or sudden cardiac death and a 2-fold higher risk of any-cause death.
AHRQ-funded; HS008365.
Citation: Shafi T, Powe NR, Meyer TW .
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
J Am Soc Nephrol 2017 Jan;28(1):321-31. doi: 10.1681/asn.2016030374.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Cardiovascular Conditions
Lee T, Thamer M, Zhang Q
Reduced cardiovascular mortality associated with early vascular access placement in elderly patients with chronic kidney disease.
This study assessed whether there has been a decrease in cardiovascular comorbidity in elderly chronic kidney disease (CKD) patients undergoing predialysis access surgery, and whether this impacted clinical outcomes after access creation and cardiovascular events after hemodialysis initiation. It concluded that a progressive decrease in cardiovascular comorbidities in elderly CKD patients undergoing predialysis vascular access surgery was associated with a decrease in death before hemodialysis and cardiovascular events after starting hemodialysis.
AHRQ-funded; HS022931.
Citation: Lee T, Thamer M, Zhang Q .
Reduced cardiovascular mortality associated with early vascular access placement in elderly patients with chronic kidney disease.
Am J Nephrol 2016;43(5):334-40. doi: 10.1159/000446159.
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Keywords: Cardiovascular Conditions, Elderly, Kidney Disease and Health, Kidney Disease and Health, Mortality
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
Shafi T, Meyer TW, Hostetter TH
Free levels of selected organic solutes and cardiovascular morbidity and mortality in hemodialysis patients: results from the Retained Organic Solutes and Clinical Outcomes (ROSCO) investigators.
This study examined the association of baseline free levels of four organic solutes that are secreted in the native kidney —p-cresol sulfate, indoxyl sulfate, hippurate and phenylacetylglutamine—with outcomes in hemodialysis patients. It found that free levels of uremic solutes that are secreted by the native kidney are associated with a higher risk of cardiovascular morbidity and mortality in incident hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Shafi T, Meyer TW, Hostetter TH .
Free levels of selected organic solutes and cardiovascular morbidity and mortality in hemodialysis patients: results from the Retained Organic Solutes and Clinical Outcomes (ROSCO) investigators.
PLoS One 2015 May 4;10(5):e0126048. doi: 10.1371/journal.pone.0126048..
Keywords: Cardiovascular Conditions, Kidney Disease and Health, Mortality
Tangri N, Miskulin DC, Zhou J
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
The researchers studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. They concluded that a higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.
AHRQ-funded; 290200500341I.
Citation: Tangri N, Miskulin DC, Zhou J .
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
Nephrol Dial Transplant 2015 Apr;30(4):667-75. doi: 10.1093/ndt/gfu349.
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Keywords: Comparative Effectiveness, Hospitalization, Kidney Disease and Health, Cardiovascular Conditions, Treatments