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7,000多名儿童和青少年，患有末期肾脏疾病（ESRD）。在该组中，儿科血液透析患者的医疗保险支付超过每年48,000美元的风险。幸运的是，根据USRDS的说法，小儿透析患者（0-19岁）的长期生存非常好，根据USRDS的年龄，性别，性别，种族和初级诊断调整了10年的生存概率。但是，发展ESRD的儿童和青少年一生都需要某种形式的肾脏替代疗法。最近的研究表明，尽管长期生存良好，但ESRD的儿童仍需要频繁住院，异常生长和高速度并发症发生率。定义小儿血液透析标准的研究以及这些标准的成就是否可以改善长期结局并降低该人群的护理成本。 尽管这些成人标准经常用于评估维持透析的儿童和青少年的临床护理，但几乎没有证据证明直接将这些标准应用于儿童的合理性。据我们所知，没有纵向研究根据是否达到CPM靶标血红蛋白，充分性或血清白蛋白水平来评估透析儿童和青少年的健康结果。为了解决当前知识的这一差距，我们提出了对2000年和2001年CPM项目中普遍的小儿ESRD中心血液透析患者的纵向分析。 2000（n = 433）和2001（n = 257）CPM数据的联系，其中研究了690个小儿中心血液透析患者，并使用美国肾脏数据系统的门诊，住院，移植和生存数据进行了门诊，将允许对成人CPM标准cpm cpm cpm intecns and Adenscers and Teensscors和Teenscors and Teenss and Teens and Teens and Teens and Teens and Teens and Teens and Teens and Teens and Teens and Teens and Teens and Teens和Teens cpm cp。

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