Clinical Performance Measures & Outcomes in Adolescents

临床表现衡量

• 批准号: 6941195
• 负责人: SUSAN L. FURTH
• 金额: $ 16.35万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6941195
• 关键词: adolescence (12-20); age difference; biomarker; cardiovascular disorder risk; chronic renal failure; clinical research; clinical trials; communicable disease diagnosis; comorbidity; disease /disorder proneness /risk; dosage; hemodialysis; hemoglobin; hospital utilization; human morbidity; human subject; longitudinal human study; medical complication; patient care management; patient oriented research; pediatrics; protein metabolism; septicemia; serum albumin

DESCRIPTION (provided by applicant): In 1999, there were over 7,000 children and adolescents in the U.S. with end stage renal disease (ESRD). Among this group, Medicare payments for pediatric hemodialysis patients exceeded $48,000 per patient year at risk. Fortunately, long-term survival among pediatric dialysis patients (aged 0-19 yrs) is excellent, with 10-year survival probabilities of almost 70% (adjusted for age, gender, race and primary diagnosis) according to the USRDS. However, children and youth who develop ESRD will require some form of renal replacement therapy their entire lives. Recent studies show that despite excellent long-term survival, children with ESRD still require frequent hospitalizations, have abnormal growth, and high rates of complications. Research to define standards for care in pediatric hemodialysis and whether achievement of these standards can improve long-term outcomes and decrease the cost of care for this population is essential. Although these adult standards are frequently applied in assessing the clinical care of children and adolescents maintained on dialysis, little evidence exists to justify the direct application of these standards to children. To our knowledge, no longitudinal study has assessed the health outcomes for children and adolescents on dialysis according to whether or not CPM target hemoglobin, adequacy or serum albumin levels were reached. To address this gap in current knowledge, we propose a longitudinal analysis of prevalent pediatric ESRD in-center hemodialysis patients identified in the 2000 and 2001 CPM project. Linkage of the 2000 (n=433) and 2001 (n=257) CPM data, in which 690 pediatric in-center hemodialysis patients were studied, with outpatient, hospitalization, transplant and survival data from the US Renal Data System will allow an initial assessment of the clinical relevance of adult CPM standards in adolescents and teens with ESRD.

描述（由申请人提供）：1999 年，美国有超过 7,000 名儿童和青少年患有终末期肾病 (ESRD)。在这一群体中，每位处于风险的儿童血液透析患者每年的医疗保险支付金额超过 48,000 美元。幸运的是，根据 USRDS，儿科透析患者（0-19 岁）的长期生存率非常好，10 年生存率接近 70%（根据年龄、性别、种族和初步诊断进行调整）。然而，患有 ESRD 的儿童和青少年一生都需要某种形式的肾脏替代治疗。最近的研究表明，尽管患有 ESRD 的儿童具有出色的长期生存率，但仍然需要频繁住院，生长异常，并且并发症发生率很高。研究确定儿科血液透析的护理标准以及实现这些标准是否可以改善长期结果并降低该人群的护理成本至关重要。 尽管这些成人标准经常用于评估接受透析的儿童和青少年的临床护理，但几乎没有证据证明这些标准直接应用于儿童是合理的。据我们所知，尚无纵向研究根据是否达到 CPM 目标血红蛋白、充足性或血清白蛋白水平来评估接受透析的儿童和青少年的健康结果。为了弥补当前知识中的这一差距，我们建议对 2000 年和 2001 年 CPM 项目中确定的流行儿科 ESRD 中心血液透析患者进行纵向分析。 2000 年 (n=433) 和 2001 年 (n=257) CPM 数据（其中对 690 名儿科中心血液透析患者进行了研究）与来自美国肾脏数据系统的门诊、住院、移植和生存数据的联系将允许初步评估评估成人 CPM 标准在患有 ESRD 的青少年中的临床相关性。

项目成果

Clinical outcomes and dialysis adequacy in adolescent hemodialysis patients.

青少年血液透析患者的临床结果和透析充分性。

• DOI: 10.1053/j.ajkd.2005.10.020
• 发表时间: 2006
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation.
• 作者: Gorman,Gregory;Furth,Susan;Hwang,Wenke;Parekh,Rulan;Astor,Brad;Fivush,Barbara;Frankenfield,Diane;Neu,Alicia
• 通讯作者: Neu,Alicia