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Article ; Online: Ripple Effects: CKD and Physical Function.

Alfaro, Ana Jessica / Liu, Christine K

Kidney medicine

2023 Volume 6, Issue 2, Page(s) 100786

Language	English
Publishing date	2023-12-22
Publishing country	United States
Document type	Editorial
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2023.100786
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Conservative Care for Kidney Failure-The Other Side of the Coin.

Liu, Christine K / Kurella Tamura, Manjula

JAMA network open

2022 Volume 5, Issue 3, Page(s) e222252

MeSH term(s)	Conservative Treatment ; Female ; Humans ; Kidney Failure, Chronic ; Male ; Renal Insufficiency/therapy
Language	English
Publishing date	2022-03-01
Publishing country	United States
Document type	Journal Article ; Comment
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.2252
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Article ; Online: Geriatric Syndromes and Health-Related Quality of Life in Older Adults with Chronic Kidney Disease.

Liu, Christine K / Miao, Shiyuan / Giffuni, Jamie / Katzel, Leslie I / Fielding, Roger A / Seliger, Stephen L / Weiner, Daniel E

Kidney360

2023 Volume 4, Issue 4, Page(s) e457–e465

MeSH term(s)	Humans ; Aged ; Quality of Life ; Syndrome ; Renal Insufficiency, Chronic ; Geriatric Assessment
Language	English
Publishing date	2023-02-14
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0000000000000078
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Article ; Online: Effects of residential socioeconomic polarization on high blood pressure among nursing home residents.

Abdel Magid, Hoda S / Jaros, Samuel / Li, Yongmei / Steinman, Michael A / Lee, Sei / Peralta, Carmen / Jing, Bocheng / Fung, Kathy / Liu, Christine K / Liu, Xiaojuan / Graham, Laura A / Odden, Michelle C

Health & place

2024 Volume 87, Page(s) 103243

Abstract: Objective: Neighborhood concentration of racial, income, education, and housing deprivation is known to be associated with higher rates of hypertension. The objective of this study is to examine the association between tract-level spatial social ... ...

Abstract	Objective: Neighborhood concentration of racial, income, education, and housing deprivation is known to be associated with higher rates of hypertension. The objective of this study is to examine the association between tract-level spatial social polarization and hypertension in a cohort with relatively equal access to health care, a Veterans Affairs nursing home. Methods: 41,973 long-term care residents aged ≥65 years were matched with tract-level Indices of Concentration at the Extremes across four socioeconomic domains. We modeled high blood pressure against these indices controlling for individual-level cardiovascular confounders. Results: We found participants who had resided in the most disadvantaged quintile had a 1.10 (95% 1.01, 1.19) relative risk of high blood pressure compared to those in the other quintiles for the joint measuring race/ethnicity and income domain. Conclusions: We achieved our objective by demonstrating that concentrated deprivation is associated with worse cardiovascular outcomes even in a population with equal access to care. Measures that jointly consider economic and racial/ethnic polarization elucidate larger disparities than single domain measures.
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1262540-1
ISSN	1873-2054 ; 1353-8292
ISSN (online)	1873-2054
ISSN	1353-8292
DOI	10.1016/j.healthplace.2024.103243
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Zs.A 4333: Show issues

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Article ; Online: COVID-19 Infection Risk Among Hemodialysis Patients in Long-term Care Facilities.

Liu, Christine K / Ghai, Sandeep / Waikar, Sushrut S / Weiner, Daniel E

Kidney medicine

2020 Volume 2, Issue 6, Page(s) 810–811

Keywords	covid19
Language	English
Publishing date	2020-09-25
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2020.07.005
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Article ; Online: The Impact of Care Partners on the Mobility of Older Adults Receiving Hemodialysis.

Liu, Christine K / Seo, Janet / Lee, Dayeun / Wright, Kristen / Tamura, Manjula Kurella / Moye, Jennifer / Weiner, Daniel E / Bean, Jonathan F

Kidney medicine

2022 Volume 4, Issue 6, Page(s) 100473

Abstract: Rationale & objective: Many older adults receiving hemodialysis have mobility limitations and rely on care partners, yet data are sparse regarding the support provided by care partners. Our aim was to examine how care partners support the mobility of an ...

Abstract	Rationale & objective: Many older adults receiving hemodialysis have mobility limitations and rely on care partners, yet data are sparse regarding the support provided by care partners. Our aim was to examine how care partners support the mobility of an older adult receiving hemodialysis. Study design: Qualitative study. Setting & participants: Using purposive sampling, we recruited persons aged 60 years or more receiving maintenance hemodialysis and care partners aged 18 years or more who were providing support to an older adult receiving hemodialysis. We conducted in-person semi-structured interviews about mobility with each individual. Analytical approach: We conducted descriptive and focused coding of interview transcripts and employed thematic analysis. Our outcome was to describe perceived mobility supports provided by care partners using qualitative themes. Results: We enrolled 31 older adults receiving hemodialysis (42% women, 68% Black) with a mean age of 73 ± 8 years and a mean dialysis duration of 4.6 ± 3.5 years. Of these, 87% of patients used assistive devices and 90% had care partners. We enrolled 12 care partners (75% women, 33% Black) with a mean age of 54 ± 16 years. From our patient and care partner interviews, we found three themes: (1) what care partners Limitations: Modest sample size; single geographic area. Conclusions: In older adults receiving hemodialysis, care partners observe a decline in mobility and provide support for mobility. They respect the patient's autonomy but worry about future mobility losses. Future research should incorporate care partners in interventions that address mobility in older adults receiving hemodialysis.
Language	English
Publishing date	2022-04-29
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2022.100473
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Article ; Online: Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial.

Weiner, Daniel E / Liu, Christine K / Miao, Shiyuan / Fielding, Roger / Katzel, Leslie I / Giffuni, Jamie / Well, Andrew / Seliger, Stephen L

American journal of kidney diseases : the official journal of the National Kidney Foundation

2022 Volume 81, Issue 1, Page(s) 59–66

Abstract: Rationale & objective: The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain.: Study design: Multicenter, parallel group, randomized controlled trial. ...

Abstract	Rationale & objective: The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain. Study design: Multicenter, parallel group, randomized controlled trial. Settings & participants: Adults 55 years and older with estimated glomerular filtration rate (eGFR) of 15 to <45 mL/min/1.73 m Intervention: Twelve months of in-center supervised exercise training incorporating majority aerobic but also muscle strengthening activities or a group health education control intervention, randomly assigned in 1:1 ratio. Outcome: Primary outcomes were cardiorespiratory fitness and submaximal gait at 6 and 12 months quantified by peak oxygen consumption (Vo Results: Among 99 participants, the mean age was 68 years, 62% were African American, and the mean eGFR was 33 mL/min/1.73 m Limitations: Planned sample size was not reached. Loss to follow-up and dropout were greater than anticipated. Conclusions: Among adults aged ≥55 years with CKD stages 3b-4 and a high level of medical comorbidity, a 12-month program of in-center aerobic and resistance exercise training was safe and associated with improvements in physical functioning. Funding: Government grants (National Institutes of Health). Trial registration: Registered at ClinicalTrials.gov with study number NCT01462097.
MeSH term(s)	Humans ; Aged ; Postural Balance ; Time and Motion Studies ; Exercise/physiology ; Physical Functional Performance ; Renal Insufficiency, Chronic/therapy ; Exercise Therapy
Language	English
Publishing date	2022-08-06
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2022.06.008
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Zs.A 1669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Statins, Mortality, and Major Adverse Cardiovascular Events Among US Veterans With Chronic Kidney Disease.

Barayev, Odeya / Hawley, Chelsea E / Wellman, Helen / Gerlovin, Hanna / Hsu, Whitney / Paik, Julie M / Mandel, Ernest I / Liu, Christine K / Djoussé, Luc / Gaziano, J Michael / Gagnon, David R / Orkaby, Ariela R

JAMA network open

2023 Volume 6, Issue 12, Page(s) e2346373

Abstract: Importance: There are limited data for the utility of statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) and death in adults with chronic kidney disease (CKD).: Objective: To evaluate the association of statin use with ... ...

Abstract	Importance: There are limited data for the utility of statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) and death in adults with chronic kidney disease (CKD). Objective: To evaluate the association of statin use with all-cause mortality and major adverse cardiovascular events (MACE) among US veterans older than 65 years with CKD stages 3 to 4. Design, setting, and participants: This cohort study used a target trial emulation design for statin initiation among veterans with moderate CKD (stages 3 or 4) using nested trials with a propensity weighting approach. Linked Veterans Affairs (VA) Healthcare System, Medicare, and Medicaid data were used. This study considered veterans newly diagnosed with moderate CKD between 2005 and 2015 in the VA, with follow-up through December 31, 2017. Veterans were older than 65 years, within 5 years of CKD diagnosis, had no prior ASCVD or statin use, and had at least 1 clinical visit in the year prior to trial baseline. Eligibility criteria were assessed for each nested trial, and Cox proportional hazards models with bootstrapping were run. Analysis was conducted from July 2021 to October 2023. Exposure: Statin initiation vs none. Main outcomes and measures: Primary outcome was all-cause mortality; secondary outcome was time to first MACE (myocardial infarction, transient ischemic attack, stroke, revascularization, or mortality). Results: Included in the analysis were 14 828 veterans. Mean (SD) age at CKD diagnosis was 76.9 (8.2) years, 14 616 (99%) were men, 10 539 (72%) White, and 2568 (17%) Black. After expanding to person-trials and assessing eligibility at each baseline, there were 151 243 person-trials (14 685 individuals) of nonstatin initiators and 2924 person-trials (2924 individuals) of statin initiators included. Propensity score adjustment via overlap weighting with nonparametric bootstrapping resulted in covariate balance, with mean (SD) follow-up of 3.6 (2.7) years. The hazard ratio for all-cause mortality was 0.91 (95% CI, 0.85-0.97) comparing statin initiators to noninitiators. The hazard ratio for MACE was 0.96 (95% CI, 0.91-1.02). Results remained consistent in prespecified subgroup analyses. Conclusions and relevance: In this target trial emulation of statin initiation in US veterans older than 65 years with CKD stages 3 to 4 and no prior ASCVD, statin initiation was significantly associated with a lower risk of all-cause mortality but not MACE. Results should be confirmed in a randomized clinical trial.
MeSH term(s)	United States/epidemiology ; Adult ; Male ; Aged ; Humans ; Female ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Cohort Studies ; Veterans ; Medicare ; Atherosclerosis/drug therapy ; Renal Insufficiency, Chronic/epidemiology
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2023-12-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.46373
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.

Schmader, Kenneth E / Liu, Christine K / Flannery, Brendan / Rountree, Wes / Auerbach, Heidi / Barnett, Elizabeth D / Schlaudecker, Elizabeth P / Todd, Christopher A / Poniewierski, Marek / Staat, Mary A / Harrington, Theresa / Li, Rongxia / Broder, Karen R / Walter, Emmanuel B

Immunity & ageing : I & A

2023 Volume 20, Issue 1, Page(s) 30

Abstract: Background: Adjuvanted inactivated influenza vaccine (aIIV) and high-dose inactivated influenza vaccine (HD-IIV) are U.S.-licensed for adults aged ≥ 65 years. This study compared serum hemagglutination inhibition (HAI) antibody titers for the A(H3N2) ... ...

Abstract	Background: Adjuvanted inactivated influenza vaccine (aIIV) and high-dose inactivated influenza vaccine (HD-IIV) are U.S.-licensed for adults aged ≥ 65 years. This study compared serum hemagglutination inhibition (HAI) antibody titers for the A(H3N2) and A(H1N1)pdm09 and B strains after trivalent aIIV3 and trivalent HD-IIV3 in an older adult population. Results: The immunogenicity population included 342 participants who received aIIV3 and 338 participants who received HD-IIV3. The proportion of participants that seroconverted to A(H3N2) vaccine strains after allV3 (112 participants [32.8%]) was inferior to the proportion of participants that seroconverted after HD-IIV3 (130 participants [38.5%]) at day 29 after vaccination (difference, - 5.8%; 95%CI, - 12.9% to 1.4%). There were no significant differences between the vaccine groups in percent seroconversion to A(H1N1)pdm09 or B vaccine strains, in percent seropositivity for any of the strains, or in post-vaccination GMT for the A(H1N1)pdm09 strain. The GMTs for the post-vaccination A(H3N2) and B strains were higher after HD-IIV than after aIIV3. Conclusions: Overall immune responses were similar after aIIV3 and HD-IIV3. For the primary outcome, the aIIV3 seroconversion rate for H3N2 did not meet noninferiority criteria compared with HD-IIV3, but the HD-IIV3 seroconversion rate was not statistically superior to the aIIV3 seroconversion rate. Trial registration: ClinicalTrials.gov Identifier: NCT03183908.
Language	English
Publishing date	2023-07-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2168941-6
ISSN	1742-4933
ISSN	1742-4933
DOI	10.1186/s12979-023-00355-7
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Article ; Online: Stakeholder Perspectives on Factors Related to Deprescribing Potentially Inappropriate Medications in Older Adults Receiving Dialysis.

Hall, Rasheeda K / Rutledge, Jeanette / Lucas, Anika / Liu, Christine K / Clair Russell, Jennifer St / Peter, Wendy St / Fish, Laura J / Colón-Emeric, Cathleen

Clinical journal of the American Society of Nephrology : CJASN

2023 Volume 18, Issue 10, Page(s) 1310–1320

Abstract: Background: Potentially inappropriate medications, or medications that generally carry more risk of harm than benefit in older adults, are commonly prescribed to older adults receiving dialysis. Deprescribing, a systematic approach to reducing or ... ...

Abstract	Background: Potentially inappropriate medications, or medications that generally carry more risk of harm than benefit in older adults, are commonly prescribed to older adults receiving dialysis. Deprescribing, a systematic approach to reducing or stopping a medication, is a potential solution to limit potentially inappropriate medications use. Our objective was to identify clinicians and patient perspectives on factors related to deprescribing to inform design of a deprescribing program for dialysis clinics. Methods: We conducted rapid qualitative analysis of semistructured interviews and focus groups with clinicians (dialysis clinicians, primary care providers, and pharmacists) and patients (adults receiving hemodialysis aged 65 years or older and those aged 55-64 years who were prefrail or frail) from March 2019 to December 2020. Results: We interviewed 76 participants (53 clinicians [eight focus groups and 11 interviews] and 23 patients). Among clinicians, 24 worked in dialysis clinics, 18 worked in primary care, and 11 were pharmacists. Among patients, 13 (56%) were aged 65 years or older, 14 (61%) were Black race, and 16 (70%) reported taking at least one potentially inappropriate medication. We identified four themes (and corresponding subthemes) of contextual factors related to deprescribing potentially inappropriate medications: ( 1 ) system-level barriers to deprescribing (limited electronic medical record interoperability, time constraints and competing priorities), ( 2 ) undefined comanagement among clinicians (unclear role delineation, clinician caution about prescriber boundaries), ( 3 ) limited knowledge about potentially inappropriate medications (knowledge limitations among clinicians and patients), and ( 4 ) patients prioritize symptom control over potential harm (clinicians expect resistance to deprescribing, patient weigh risks and benefits). Conclusions: Challenges to integration of deprescribing into dialysis clinics included siloed health systems, time constraints, comanagement behaviors, and clinician and patient knowledge and attitudes toward deprescribing.
MeSH term(s)	Humans ; Aged ; Potentially Inappropriate Medication List ; Deprescriptions ; Renal Dialysis ; Focus Groups ; Pharmacists ; Polypharmacy
Language	English
Publishing date	2023-07-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.0000000000000229
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