Additional file 1: of Preventing Acute Kidney Injury: a qualitative study exploring ‘sick day rules’ implementation in primary care

A ‘sick day rule’ plan for AKI prevention. (DOCX 292 kb

Selected covariates stratified by whether inpatient coronary angiography was performed or not, in 35 881 adults presenting with non-ST-elevation acute coronary syndrome (all data is presented as numbers with column percentage unless otherwise stated).

<p>Abbreviations: IP = inpatient; IMD score = score of deprivation; PVD = peripheral vascular disease; CCF = congestive cardiac failure; MI = myocardial infarction; PCI = percutaneous coronary intervention; CABG = coronary artery bypass graft; eGFR = estimated glomerular filtration rate; IQR = interquartile range; sd = standard deviation.</p

Results of the adjusted logistic regression analysis in 16 645 individuals with non-ST-elevation acute coronary syndrome for the association between inpatient revascularisation and mortality compared with individuals who were medically managed after inpatient coronary angiography stratified by category of renal dysfunction.

<p>*p-interaction (Wald test) between eGFR category and inpatient revascularisation and mortality: 0.744.</p><p>Multivariable Model adjusted for age, ethnicity, gender, IMD score, eGFR, systolic blood pressure, heart rate, haemoglobin, peak troponin, ECG diagnosis, history of angina, hyperlipidaemia, hypertension, peripheral vascular disease, cerebrovascular disease, chronic obstructive airways disease, congestive cardiac failure, previous percutaneous coronary intervention, previous coronary artery bypass graft, previous myocardial infarction, diabetes, current smoking status and hospital.</p><p>Propensity Score estimated using age, ethnicity, gender, IMD score, eGFR, systolic blood pressure, heart rate, haemoglobin, peak troponin ECG diagnosis, history of angina, hyperlipidaemia, hypertension, peripheral vascular disease, cerebrovascular disease, chronic obstructive airways disease, congestive cardiac failure, previous percutaneous coronary intervention, previous coronary artery bypass graft, previous myocardial infarction, diabetes, current smoking status.</p><p>Abbreviations: Medical Mx = medical management; OR = odds ratio; CI = confidence interval; eGFR = estimated glomerular filtration rate.</p

Results of the multivariable logistic regression analysis in 35 881 individuals with non-ST-elevation acute coronary syndrome for the association between inpatient coronary angiography and all-cause death.

<p>*p-interaction (Wald test) between eGFR category and inpatient coronary angiography and mortality: <0.001.</p><p>*Multivariable model adjusted for age, ethnicity, gender, IMD score, systolic blood pressure, heart rate, haemoglobin, peak troponin, ECG diagnosis, history of angina, hyperlipidaemia, hypertension, peripheral vascular disease, cerebrovascular disease, chronic obstructive airways disease, congestive cardiac failure, previous percutaneous coronary intervention, previous coronary artery bypass graft, previous myocardial infarction, diabetes, current smoking status and hospital.</p><p>Abbreviations: OR = odds ratio; CI = confidence interval; eGFR = estimated glomerular filtration rate.</p

Selected covariates stratified by eGFR category at time of presentation in 35 881 adults presenting with non-ST-elevation acute coronary syndrome (all data is presented as numbers with column percentage unless otherwise stated).

<p>Abbreviations: IMD score = score of deprivation; PVD = peripheral vascular disease; CCF = congestive cardiac failure; MI = myocardial infarction; PCI = percutaneous coronary intervention; CABG = coronary artery bypass graft; eGFR = estimated glomerular filtration rate; IP - inpatient; IQR = interquartile range; sd = standard deviation.</p

Effect of the use of different combinations of measures on the risk profile and estimated prevalence of CKD.

<p>Effect of the use of different combinations of measures on the risk profile and estimated prevalence of CKD.</p

Prevalence of eGFR<60ml/min/1.73m² by age grouping and serum creatinine eGFR estimating method.

<p>Prevalence of eGFR<60ml/min/1.73m² by age grouping and serum creatinine eGFR estimating method.</p

Selected covariates stratified by management strategy in 16 646 adults who underwent inpatient coronary angiography presenting with non-ST-elevation acute coronary syndrome.

<p>Abbreviations: PVD = peripheral vascular disease; CCF = congestive cardiac failure; MI = myocardial infarction; PCI = percutaneous coronary intervention; CABG = coronary artery bypass graft; eGFR = estimated glomerular filtration rate; IQR = interquartile range; sd = standard deviation.</p><p>All data is presented as numbers with column percentage unless otherwise stated. Where percentages do not equal 100% this is due to rounding.</p

Results of the adjusted logistic regression analysis in 16 645 individuals with non-ST-elevation acute coronary syndrome for the association between inpatient revascularisation and mortality compared with individuals who were medically managed after inpatient coronary angiography.

<p>*p-interaction (Wald test) between eGFR category and inpatient revascularisation and mortality: 0.744.</p><p>Multivariable Model adjusted for age, ethnicity, gender, IMD score, eGFR, systolic blood pressure, heart rate, haemoglobin, peak troponin, ECG diagnosis, history of angina, hyperlipidaemia, hypertension, peripheral vascular disease, cerebrovascular disease, chronic obstructive airways disease, congestive cardiac failure, previous percutaneous coronary intervention, previous coronary artery bypass graft, previous myocardial infarction, diabetes, current smoking status and hospital.</p><p>Propensity Score estimated using age, ethnicity, gender, IMD score, eGFR, systolic blood pressure, heart rate, haemoglobin, peak troponin ECG diagnosis, history of angina, hyperlipidaemia, hypertension, peripheral vascular disease, cerebrovascular disease, chronic obstructive airways disease, congestive cardiac failure, previous percutaneous coronary intervention, previous coronary artery bypass graft, previous myocardial infarction, diabetes, current smoking status.</p><p>Abbreviations: Medical Mx = medical management; OR = odds ratio; CI = confidence interval; eGFR = estimated glomerular filtration rate.</p

Validation of a patient-reported outcome measure for fatigue in patients receiving hemodialysis: the SONG-HD Fatigue instrument

Background: Fatigue is a very common and debilitating symptom and identified by patients as a critically important core outcome to be included in all trials involving patients receiving hemodialysis. A valid, standardized measure for fatigue is needed to yield meaningful and relevant evidence about this outcome. Objectives: To validate a core patient-reported outcome measure (PROM) for fatigue in hemodialysis. Design: A longitudinal cohort study was conducted to assess the validity and reliability of a new fatigue measure (SONG-HD Fatigue).Eligible and consenting patients completed the measure at three time points: baseline, a week later and twelve days following the second time point. Cronbach’s α and Intraclass correlation coefficient were calculated to assess internal consistency and Spearman’s rho was used to assess convergent validity. Confirmatory factor analysis was also conducted.Setting: Hemodialysis units in the United Kingdom, Australia and Romania participated in this study.Participants: Adult patients aged 18 years and over, English-Speaking, and receiving maintenance hemodialysis were eligible to participate.Measurements: SONG-HD Fatigue, visual analogue scale for fatigue, 12-Item Short Form survey, Functional Assessment of Chronic Illness Therapy-Fatigue were used.Results: In total, 485 participants completed the study across the United Kingdom, Australia, and Romania. Psychometric assessment demonstrated that the SONG-HD Fatigue is internally consistent (Cronbach’s α =0.81- 0.86) and stable over a one-week period (Intraclass correlation coefficient =0.68-74). The measure demonstrated convergence with Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and had moderate correlations with other measures that assessed related but not the same concept (12-Item Short Form Survey and Visual Analogue Scale). Confirmatory factor analysis supported the one-factor model. Conclusions: The SONG-HD Fatigue appears to be a reliable and valid measure to be used in trials involving patients receiving hemodialysis. </div