Outcomes research in nutrition and chronic kidney disease: Perspectives, issues in practice, and processes for improvement

TY - JOUR

T1 - Outcomes research in nutrition and chronic kidney disease

T2 - Perspectives, issues in practice, and processes for improvement

AU - Byham-Gray, Laura D.

PY - 2005/1

Y1 - 2005/1

N2 - Despite greater access to health care and advances in medicine and technology, the morbidity and mortality among patients diagnosed with chronic kidney disease (CKD) remain unacceptably high. Discrepancies in patient care outcomes exist between the United States and other industrialized countries and are partly explained by variances reported in clinical practice. Outcomes research (OR) has been the primary methodology used to more fully explore the root causes for the practice variation and to uncover which indicators have the greatest impact. Research has established the relationships between early diagnosis and treatment, cardiovascular disease, quality of life, and malnutrition with morbidity and mortality rates among patients with kidney disease. Although nutrition parameters are predictive of mortality, they are complex to understand and even more difficult to improve, largely because of the effects of the inflammatory process and the lack of a direct measure that defines nutritional status. Future OR projects must focus on specific nutrition-related outcomes and the effectiveness of intervention, as these outcomes can establish clinical guidelines, lead to changes in practice, and create more controlled clinical trials that continue to search for answers to questions on the impact of nutrition and others.

AB - Despite greater access to health care and advances in medicine and technology, the morbidity and mortality among patients diagnosed with chronic kidney disease (CKD) remain unacceptably high. Discrepancies in patient care outcomes exist between the United States and other industrialized countries and are partly explained by variances reported in clinical practice. Outcomes research (OR) has been the primary methodology used to more fully explore the root causes for the practice variation and to uncover which indicators have the greatest impact. Research has established the relationships between early diagnosis and treatment, cardiovascular disease, quality of life, and malnutrition with morbidity and mortality rates among patients with kidney disease. Although nutrition parameters are predictive of mortality, they are complex to understand and even more difficult to improve, largely because of the effects of the inflammatory process and the lack of a direct measure that defines nutritional status. Future OR projects must focus on specific nutrition-related outcomes and the effectiveness of intervention, as these outcomes can establish clinical guidelines, lead to changes in practice, and create more controlled clinical trials that continue to search for answers to questions on the impact of nutrition and others.

KW - Outcomes research

KW - evidence-based medicine

KW - kidney diseases

KW - morbidity

KW - nutrition

UR - http://www.scopus.com/inward/record.url?scp=13844299156&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13844299156&partnerID=8YFLogxK

U2 - https://doi.org/10.1053/j.ackd.2004.10.012

DO - https://doi.org/10.1053/j.ackd.2004.10.012

M3 - Article

C2 - 15719340

SN - 1073-4449

VL - 12

SP - 96

EP - 106

JO - Advances in Renal Replacement Therapy

JF - Advances in Renal Replacement Therapy

IS - 1

ER -