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Related Concept Videos

Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...

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Updated: May 8, 2026

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

Association between Rurality and Evaluation Start among Referred Patients with End-Stage Kidney Disease.

Angelitta M Britt-Spells1,2, Jade Buford3, Catherine Kelty4

  • 1Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA, anmbritt@iu.edu.

American Journal of Nephrology
|May 6, 2026
PubMed
Summary

Rural residents with end-stage kidney disease face longer waits for kidney transplant evaluations. These disparities in transplant access are present across all regions, necessitating targeted interventions.

Keywords:
EvaluationGeographic variationKidney transplantRegional differencesRural disparities

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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Last Updated: May 8, 2026

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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Published on: April 4, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Area of Science:

  • Nephrology
  • Transplantation Medicine
  • Health Services Research

Background:

  • Rural populations with end-stage kidney disease (ESKD) experience reduced access to kidney transplantation.
  • Disparities in transplant access are particularly pronounced in later stages of kidney disease.

Purpose of the Study:

  • To investigate the impact of rurality on the initiation of kidney transplant evaluations.
  • To determine if the effect of rurality on transplant evaluation initiation varies by geographic region.

Main Methods:

  • Retrospective cohort study of 86,839 adults referred for kidney transplantation (2015-2023).
  • Rurality defined using Rural-Urban Commuting Area codes based on ZIP code.
  • Fine and Gray competing risks models used to estimate time to evaluation initiation, accounting for death and adjusting for covariates and regional interactions.

Main Results:

  • Median time to evaluation was significantly longer for rural patients (166 days) vs. urban patients (106 days).
  • Rural residence was associated with an 11% lower likelihood of evaluation initiation (aSHR 0.89).
  • Strongest disparities observed in New York and New England; consistent patterns across all ESRD Networks.

Conclusions:

  • Rural residents are less likely to initiate kidney transplant evaluations compared to urban counterparts.
  • Significant rural disparities exist in the early stages of the kidney transplant process.
  • Targeted interventions are crucial, particularly in regions with the lowest access to transplant evaluations.