Research Roundup: Kidney Disease; Bariatric Surgery Outcomes; Medicare Wellness Visits
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Surgery:
Association Between Bariatric Surgery And Rates Of Continuation, Discontinuation, Or Initiation Of Antidiabetes Treatment
In this nationwide population-based cohort study of more than 30 000 adults, bariatric surgery was associated with a significantly higher 6-year postoperative antidiabetes treatment discontinuation rate compared with an obese control group, as well as with a low antidiabetes treatment initiation rate, with gastric bypass being the most effective procedure. Patients and physicians should be aware that morbid obesity remains a chronic disease even after bariatric surgery because 50.1% of patients with preexisting antidiabetes treatment remained on treatment 6 years after surgery. (Thereaux, Lesuffleur, Czernichow et. al., 2/14)
JAMA Internal Medicine:
Outcomes Associated With Implantable Cardioverter Defibrillator In Adults With Chronic Kidney Disease
In this cohort study of 5877 community-based patients with heart failure and chronic kidney disease, use of implantable cardioverter defibrillators was not significantly associated with improved survival but was associated with increased risk for subsequent heart failure and all-cause hospitalization. The potential risks and benefits of implantable cardioverter defibrillators should be carefully considered in patients with heart failure and chronic kidney disease. (Bansal, Szpiro, Reynolds et. al., 2/5)
Health Affairs:
Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit
In 2011 Medicare introduced the annual wellness visit to help address the health risks of aging adults. ...Compared to nonadopters, adopters had more stable patient assignment and a slightly healthier patient mix. At the same time, visit rates were lower among practices caring for underserved populations (for example, racial minorities and those dually enrolled in Medicaid), potentially worsening disparities. (Ganguli, Souza, McWilliams et. al., 2/1)
New England Journal of Medicine:
History Of Childhood Kidney Disease And Risk Of Adult End-Stage Renal Disease
A history of clinically evident kidney disease in childhood, even if renal function was apparently normal in adolescence, was associated with a significantly increased risk of ESRD, which suggests that kidney injury or structural abnormality in childhood has long-term consequences. (Calderon-Margalit, Golan, Twig et. al., 2/1)