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01-06-2013 | Original Article

The quality of cardiovascular disease care for adolescents with kidney disease: a Midwest Pediatric Nephrology Consortium study

Authors: David K. Hooper, Jason C. Williams, Adam C. Carle, Sandra Amaral, Deepa H. Chand, Maria E. Ferris, Hiren P. Patel, Christoph Licht, Gina-Marie Barletta, Veronica Zitterman, Mark Mitsnefes, Uptal D. Patel

Published in: Pediatric Nephrology | Issue 6/2013

Abstract

Background

Cardiovascular disease is the leading cause of increased mortality for adolescents with advanced kidney disease. The quality of preventive cardiovascular care may impact long-term outcomes for these patients.

Methods

We reviewed the records of 196 consecutive adolescents from eight centers with pre-dialysis chronic kidney disease, on dialysis or with a kidney transplant, who transferred to adult-focused providers. We compared cardiovascular risk assessment and therapy within and across centers. Predictors of care were assessed using multilevel models.

Results

Overall, 58 % (range 44–86 %; p = 0.08 for variance) of five recommended cardiovascular risk assessments were documented. Recommended therapy for six modifiable cardiovascular risk factors was documented 57 % (26–76 %; p = 0.09) of the time. Of these patients, 30 % (n = 59) were reported to go through formal transition which was independently associated with a 21 % increase in composite cardiovascular risk assessment (p < 0.001). Transfer after 2006 and kidney transplant status were also associated with increased cardiovascular risk assessment (p < 0.01 and p = 0.045, respectively).

Conclusions

Adolescents with kidney disease receive suboptimal preventive cardiovascular care, that may contribute to their high risk of future cardiovascular mortality. A great opportunity exists to improve outcomes for children with kidney disease by improving the reliability of preventive care that may include formal transition programs.

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Title: The quality of cardiovascular disease care for adolescents with kidney disease: a Midwest Pediatric Nephrology Consortium study
Authors: David K. Hooper
Jason C. Williams
Adam C. Carle
Sandra Amaral
Deepa H. Chand
Maria E. Ferris
Hiren P. Patel
Christoph Licht
Gina-Marie Barletta
Veronica Zitterman
Mark Mitsnefes
Uptal D. Patel
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 6/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-013-2419-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The quality of cardiovascular disease care for adolescents with kidney disease: a Midwest Pediatric Nephrology Consortium study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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