Improving Outcomes in Patients Receiving Dialysis: The Peer Kidney Care Initiative

摘要: The past decade has witnessed a marked reduction in mortality rates among patients receiving maintenance dialysis. However, the reasons for this welcome development are uncertain, and greater understanding is needed to translate advances care into additional survival gains. To fill important knowledge gaps enable dialysis provider organizations learn from one another, with aim of advancing patient care, Peer Kidney Care Initiative (Peer) was created 2014 by chief medical officers 14 United States Chronic Disease Research Group. Areas particular clinical importance were targeted help shape public health agenda CKD ESRD. focuses on effect geographic variation outcomes, implications seasonality morbidity mortality, significance understudied disorders affecting patients, debate about how best monitor evaluate progress care. In realm geovariation, provided key observations regional ESRD incidence, hospitalization, pre-ESRD Regarding seasonality, reported both infection-related non-infection-related hospitalizations, suggesting that ambient environmental conditions may affect range outcomes patients. Specific highlights include Clostridium difficile infection, which become strikingly more common year after initiation, chronic obstructive pulmonary disease, treatments have potential contribute sudden cardiac death. Finally, challenges nephrology community consider alternatives standardized ratios assessing positing close scrutiny trends over time be most effective way drive improvements