Advances in kidney disease and health最新文献_第5页

Patient-Reported Outcome and Experience Measures as Quality Metrics of Health Care Quality in Patients Receiving Dialysis 患者报告的结果和经验措施作为透析患者医疗保健质量的质量指标

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.09.001

Michelle M. Richardson

{"title":"Patient-Reported Outcome and Experience Measures as Quality Metrics of Health Care Quality in Patients Receiving Dialysis","authors":"Michelle M. Richardson","doi":"10.1053/j.akdh.2025.09.001","DOIUrl":"10.1053/j.akdh.2025.09.001","url":null,"abstract":"<div><div>In dialysis, the inclusion of patient-reported outcomes is relatively new. However, the genesis of patient-reported outcomes as an essential component to measuring the quality of care began over 50 years ago. Although much progress has been made, there are still substantial efforts needed to reach true patient-centeredness in health care quality assessment. Patient-centeredness is an iterative, collaborative process of shared decision-making among stakeholders to identify, address, and resolve issues of importance to patients. This shift to putting patients at the forefront of decision-making requires consideration and implementation of ethical principles. Opportunities for patient participation in quality assessment are broad and representation is necessary to avoid exacerbating health inequities and to achieve varied viewpoints. Many resources exist for selecting instruments that assess patient-reported outcomes and barriers to implementation on all levels must be considered before selecting an instrument for quality assessment. Particular attention needs to be paid to the respondent burden from the patient's point of view. Thoughtful implementation of new initiatives that include patients as equal stakeholders could finally propel quality assessment in kidney disease to meet the vision proposed be Avedis Donabedian over 50 years ago.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"32 5","pages":"Pages 426-436"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The Quality Incentive Program and Patient-Centered Dialysis Care: Mastering the Numbers 质量激励计划和以患者为中心的透析护理：掌握数字

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.05.002

Kathryn S. Taylor , Daniel E. Weiner

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Quality Metrics in Dialysis: It Takes a Village 透析的质量指标：需要一个村庄

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2024.12.001

Abhinav Bhalla , Sri Lekha Tummalapalli , Jeffrey Silberzweig

{"title":"Quality Metrics in Dialysis: It Takes a Village","authors":"Abhinav Bhalla , Sri Lekha Tummalapalli , Jeffrey Silberzweig","doi":"10.1053/j.akdh.2024.12.001","DOIUrl":"10.1053/j.akdh.2024.12.001","url":null,"abstract":"<div><div>Dialysis is a specialized therapy rendered by a team of interdisciplinary professionals. Federal regulations mandate that dialysis facility staff, at minimum, include a registered nurse, physician, social worker, and dietitian. To ensure that patients on dialysis receive high-quality care, the Centers for Medicare and Medicaid Services introduced the first federally mandated pay for performance program in January 2012: the ESRD Quality Incentive Program. Quality metrics in the ESRD Quality Incentive Program have continuously evolved, necessitating greater involvement from the dialysis interdisciplinary team. In this article, we discuss the interdisciplinary nature of dialysis facility staffing and highlight the critical role of all care team members in attaining high performance on dialysis quality metrics. In the context of the coronavirus disease 2019 pandemic, we highlight recent staffing challenges and propose strategies to alleviate workforce shortages. Finally, we review 2 major trends: (1) an increased emphasis on home dialysis and (2) calls to address social determinants of health, which will require the interdisciplinary team to assume an even larger role in achieving high-quality care.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"32 5","pages":"Pages 451-459"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Incremental Peritoneal Dialysis 增量腹膜透析

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.01.004

Agatha Chan , Fredric O. Finkelstein

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Adequacy Measurement for the 21st Century: Revisiting Kt/Vurea 21世纪的充分性度量：重新审视Kt/Vurea

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.05.003

Yoshitsugu Obi , Tariq Shafi

{"title":"Adequacy Measurement for the 21st Century: Revisiting Kt/Vurea","authors":"Yoshitsugu Obi , Tariq Shafi","doi":"10.1053/j.akdh.2025.05.003","DOIUrl":"10.1053/j.akdh.2025.05.003","url":null,"abstract":"<div><div>Congressional legislation extending Medicare to cover end-stage kidney disease mandated quality assurance in dialysis care. The Centers for Medicare & Medicaid Services enforces this mandate by establishing quality standards for dialysis facilities, relying on clinical practice guidelines in selecting specific metrics. For evaluating the adequacy of the delivered dialysis dose, Centers for Medicare & Medicaid Services selected the guideline-recommended minimal single pool Kt/V of urea (Kt/V). In this narrative review, we outline the evolution of Kt/V as an adequacy metric, noting that Kt/V alone is insufficient to ensure the clearance of all uremic solutes in patients receiving dialysis. We highlight that the guideline-recommended Kt/V metrics are based on post hoc observational interpretation of randomized controlled trials and are not generalizable to all patients treated with dialysis, particularly patients with substantial residual kidney function. We emphasize that the results of the recent hemodiafiltration trials suggest that dialysis treatment-related factors beyond Kt/V can change patient outcomes. We recommend discontinuing “dialysis adequacy” synonymously with Kt/V and suggest reducing the emphasis on Kt/V from a single dialysis treatment as a key quality metric.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"32 5","pages":"Pages 411-421"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Patient's Perspective on Quality Metrics in Dialysis 患者对透析质量指标的看法

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.09.003

Glenda V. Roberts

引用次数: 0

The Next Frontier of Kidney Care Quality: Addressing Known Gaps to Transform Care Delivery 肾脏护理质量的下一个前沿：解决已知的差距，以改变护理交付。

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-12-10 DOI: 10.1053/j.akdh.2025.01.009

Mallika L. Mendu , Wingel Xue , Lipika Samal

{"title":"The Next Frontier of Kidney Care Quality: Addressing Known Gaps to Transform Care Delivery","authors":"Mallika L. Mendu , Wingel Xue , Lipika Samal","doi":"10.1053/j.akdh.2025.01.009","DOIUrl":"10.1053/j.akdh.2025.01.009","url":null,"abstract":"<div><div>Over the past decade, quality measurement for patients with kidney disease has been centered on pay-for-performance metrics for kidney failure. From the seminal Centers for Medicare Services ESRD Quality Incentive Program in 2012 to Centers for Medicare Services dialysis start ratings in 2015 to more recent Centers for Medicare and Medicaid Innovation value-based care kidney models, like ESRD Treatment Choices and Kidney Care Choices, there has largely been a focus on care provided in dialysis units. The value of existing kidney-based quality measures has been evaluated, illustrating challenges with validity, attribution, and risk adjustment. Similarly, the current models of incentivization have been questioned with respect to meaningful impacts on improving care. In order to transform kidney care quality, the next phase of quality program development must focus on patient-centeredness, clinical outcomes, and health equity and should be applied across the continuum of kidney care delivery; incorporation of these elements is critical to ensure patients’ perspectives on quality are included, longstanding disparities are addressed, and silos of CKD care are broken down. There is an opportunity to fundamentally shift kidney care quality to a new frontier and drive real improvements in care delivery.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"32 5","pages":"Pages 442-450"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality Metrics: Considerations for a Path Forward 质量度量：前进道路的考虑。

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-11-06 DOI: 10.1053/j.akdh.2025.09.004

Dipal M. Patel , Daniel E. Weiner , Alan S. Kliger

引用次数: 0

Quality Assessment in Dialysis: Adapting to an Evolving World 透析质量评估：适应不断变化的世界。

IF 2.6

Advances in kidney disease and health Pub Date : 2025-09-01 Epub Date: 2025-11-03 DOI: 10.1053/j.akdh.2025.09.002

Dipal M. Patel, Alan S. Kliger, Daniel E. Weiner

引用次数: 0

The Pathology of Tubulointerstitial Kidney Disease: A Clinicopathologic Approach to Narrowing the Differential Diagnosis 肾小管间质性肾病的病理：缩小鉴别诊断的临床病理方法

IF 2.6

Advances in kidney disease and health Pub Date : 2025-07-01 Epub Date: 2025-09-12 DOI: 10.1053/j.akdh.2025.06.003

Leal Herlitz, Michael Kuperman

{"title":"The Pathology of Tubulointerstitial Kidney Disease: A Clinicopathologic Approach to Narrowing the Differential Diagnosis","authors":"Leal Herlitz, Michael Kuperman","doi":"10.1053/j.akdh.2025.06.003","DOIUrl":"10.1053/j.akdh.2025.06.003","url":null,"abstract":"<div><div>Tubulointerstitial kidney disease can be recognized histologically as tubulointerstitial injury that is out of proportion to glomerular or vascular pathology. While recognizable as a histologic entity, determining a more precise underlying etiology for tubulointerstitial disease can be a diagnostic challenge. This review presents a clinicopathologic approach intended to help nephrologists and pathologists narrow the clinical differential diagnosis of tubulointerstitial disease. Inflammatory tubulointerstitial disease can often be subcategorized based on the presence of specific types of inflammatory infiltrates, such as eosinophils, neutrophils or granulomas. Recognition of these inflammatory phenotypes raises and lowers some entities in the differential diagnosis. Broadly speaking, underlying causes of inflammatory tubulointerstitial disease include drug reaction, infection, and autoimmune diseases. The most common causes of acute noninflammatory tubulointerstitial disease are ischemic and toxic tubular injuries. Much of the time there is substantial overlap in the morphology of ischemic and toxic tubular injury, but there are distinctive findings in noninflammatory tubulointerstitial disease, including casts and crystals, that may allow for a more specific histologic diagnosis that maps to a narrower clinical differential diagnosis. Ultimately, understanding the root cause of tubulointerstitial disease requires careful integration of clinical history with histopathologic findings.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"32 4","pages":"Pages 333-340"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0