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Articles by L Plantinga
Total Records ( 2 ) for L Plantinga
  M Jhamb , C Argyropoulos , J. L Steel , L Plantinga , A. W Wu , N. E Fink , N. R Powe , K. B Meyer , M. L Unruh and for the Choices for Healthy Outcomes in Caring for End Stage Renal Disease (CHOICE) Study

Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient outcomes. This study examines the correlates of self-reported fatigue at initiation of dialysis and after 1 yr and assesses the extent to which fatigue was associated with health-related quality of life and survival.

Design, setting, participants, & measurements: A longitudinal cohort of 917 incident hemodialysis and peritoneal dialysis patients who completed the CHOICE Health Experience Questionnaire (CHEQ) participated in the study. Fatigue was assessed using the SF-36 vitality scale. Known predictors of fatigue including sociodemographic and psychosocial factors, dialysis-related factors, biochemical variables including inflammatory markers, comorbidities, and medications were used as covariates.

Results: A low vitality score was independently associated with white race, higher Index of Coexistent Disease score, higher body mass index, lack of physical exercise, antidepressant use, and higher C-reactive protein levels (CRP). A lower vitality score was strongly associated with lower SF-36 physical functioning, mental health, bodily pain scores, and decreased sleep quality (all P < 0.001) at baseline. Among surviving participants, higher serum creatinine at baseline was associated with preserved vitality at 1 yr. Patients with the highest baseline vitality scores were associated with longer survival (hazard ratio 0.75; 95% CI 0.58 to 0.96, P = 0.03).

Conclusions: The findings of this study demonstrate that ESRD patients experience profound levels of fatigue and elucidate its correlates. Also, the association of fatigue with survival may have significant implications for this population.

  R Saran , E Hedgeman , L Plantinga , N. R Burrows , B. W Gillespie , E. W Young , J Coresh , M Pavkov , D Williams , N. R Powe and for the CKD Surveillance Team

Despite the recognized importance of chronic kidney disease (CKD), the United States currently lacks a comprehensive, systematic surveillance program that captures and tracks all aspects of CKD in the population. As part of its CKD Initiative, the Centers for Disease Control and Prevention (CDC) funded two teams to jointly initiate the development of a CKD surveillance system. Here, we describe the process and methods used to establish this national CDC CKD Surveillance System. The major CKD components covered include burden (incidence and prevalence), risk factors, awareness, health consequences, processes and quality of care, and health system capacity issues. Goals include regular reporting of the data collected, plus development of a dynamic project web site and periodic issuance of a CKD fact sheet. We anticipate that this system will provide an important foundation for widespread efforts toward primary prevention, earlier detection, and implementation of optimal disease management strategies, with resultant increased awareness of CKD, decreased rates of CKD progression, lowered mortality, and reduced resource utilization. Final success will be measured by usage, impact, and endorsement.

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