American Journal of Kidney Diseases
Volume 56, Issue 1 , Pages 86-94 , July 2010

Dialysis Practices That Distinguish Top- Versus Bottom-Performing Facilities by Hemoglobin Outcomes

  • Brennan M.R. Spiegel, MD, MSHS

      Affiliations

    • Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
    • Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • Corresponding Author InformationAddress correspondence to Brennan M.R. Spiegel, MD, MSHS, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, UCLA/VA Center for Outcomes Research and Education (CORE), 11301 Wilshire Blvd, Bldg 115, Rm 215, Los Angeles, CA 90073
    • ,
  • Roger Bolus, PhD

      Affiliations

    • Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • ,
  • Amar A. Desai, MD, MPH

      Affiliations

    • Department of Medicine, University of California, San Francisco, CA
    • Department of Medicine, Stanford University, Palo Alto, CA
    • ,
  • Philip Zager, MD

      Affiliations

    • Dialysis Clinic Inc (DCI), Nashville, TN
    • ,
  • Tom Parker, MD

      Affiliations

    • Renal Ventures Managements LLC, Lakewood, CO
    • ,
  • John Moran, MD

      Affiliations

    • Satellite Healthcare, Mountain View, CA
    • ,
  • Sally Bolus, MBA

      Affiliations

    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • ,
  • Matthew D. Solomon, MD, PhD

      Affiliations

    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • Department of Medicine, Stanford University, Palo Alto, CA
    • ,
  • Osman Khawar, MD, MPH

      Affiliations

    • Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
    • ,
  • Matthew Gitlin, PharmD

      Affiliations

    • Amgen Inc, Thousand Oaks, CA
    • ,
  • Hack Sul, MD, MPH

      Affiliations

    • Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
    • Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • ,
  • Jennifer Talley, MSPH

      Affiliations

    • Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
    • UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA
    • ,
  • Allen Nissenson, MD

      Affiliations

    • DaVita Inc, Segundo, CA

Received 19 July 2009 ,Accepted 17 February 2010.

References 

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  2. Avram MM, Blaustein D, Fein PA, Goel N, Chattopadhyay J, Mittman N. Hemoglobin predicts long-term survival in dialysis patients: a 15-year single-center longitudinal study and a correlation trend between prealbumin and hemoglobin. Kidney Int Suppl. 2003;87:S6–S11
  3. Collins A, Ellefson J. Association between hematocrit level and mortality in hemodialysis patients (Case study of the anemic patient). Nephrol Nurs J. 2000;27(2):233–236
  4. Collins AJ, Li S, St. Peter W, et al. Death, hospitalization, and economic associations among incident hemodialysis patients with hematocrit values of 36 to 39%. J Am Soc Nephrol. 2001;12(11):2465–2473
  5. Li S, Collins AJ. Association of hematocrit value with cardiovascular morbidity and mortality in incident hemodialysis patients. Kidney Int. 2004;65(2):626–633
  6. Locatelli F, Pisoni RL, Combe C, et al. Anaemia in haemodialysis patients of five European countries: association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2004;19(1):121–132
  7. Messana JM, Chuang CC, Turenne M, et al. Association of quarterly average achieved hematocrit with mortality in dialysis patients: a time-dependent comorbidity-adjusted model. Am J Kidney Dis. 2009;53(3):503–512
  8. CMS. Clinical Performance Measures (CPM) Project. http://www.cms.hhs.gov/CPMProject/01_Overview.aspAccessed January 5, 2009
  9. CMS. 2007 Annual Report (End Stage Renal Disease Clinical Performance Measures Project). Baltimore, MD: CMS; 2007;
  10. Fink JC, Hsu VD, Zhan M, et al. Center effects in anemia management of dialysis patients. J Am Soc Nephrol. 2007;18(2):646–653
  11. McClellan WM, Soucie JM, Flanders WD. Mortality in end-stage renal disease is associated with facility-to-facility differences in adequacy of hemodialysis. J Am Soc Nephrol. 1998;9(10):1940–1947
  12. Goodkin D. Does case mix explain the differences in dialysis mortality rates around the world? (A report from the Dialysis Outcomes and Practice Patterns Study (DOPPS)). iKidney Nephrol Incite. 2005;(13):Spring
  13. Desai AA, Bolus R, Nissenson A, et al. Identifying best practices in dialysis care: results of cognitive interviews and a national survey of dialysis providers. Clin J Am Soc Nephrol. 2008;3(4):1066–1076
  14. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Hemodialysis Adequacy. New York, NY: National Kidney Foundation; 2001;
  15. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Mahwah, NJ: Lawrence Erlbaum Associates Inc; 1988;
  16. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 suppl 1):S1–S266
  17. Spiegel BBR, Desai A, Zagar P, et al. Dialysis practices that distinguish top vs bottom performing facilities by Kt/V [abstract]. J Am Soc Nephrol. 2008;19:931A
  18. Spolter YS, Seliger SL, Zhan M, Hsu VD, Walker LD, Fink JC. The relationship between dialysis performance measures: adequacy and anemia management. Am J Kidney Dis. 2007;50(5):774–781

 Originally published online as doi:10.1053/j.ajkd.2010.02.346 on May 21, 2010.

PII: S0272-6386(10)00598-6

doi: 10.1053/j.ajkd.2010.02.346

American Journal of Kidney Diseases
Volume 56, Issue 1 , Pages 86-94 , July 2010

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