Topics

A Model of Computer-assisted Prescription of Erythropoiesis-stimulating Agents (ESA) in Patients Under Hemodialysis

2019-12-05 00:03:04 | BioPortfolio

Summary

This is a randomized, double-blind controlled trial to compare AI (model) with the physician on prescribing ESA dose to maintain hemoglobin near the therapeutic target, 11g/dl.

Description

It has been known well for a long time that End stage renal disease (ESRD) patients usually need ESA to maintain their hemoglobin (Hb) to improve both mortality as well as quality of life. Later, several large-scale RCTs showing normalization of Hb in this population increased the risk of thromboembolic event, which leaded current guidelines to recommend the therapeutic goal for anemia in ESRD should be within a range (usually between 10-12 gm/dl) rather than above or below a certain level (or value). In addition to ESA dose, many factors contribute to the severity of anemia in this population, such as iron status, chronic blood loss, adequacy of dialysis, chronic inflammation, renal wasting, et al. To put all these factors together, maintaining the Hb levels within the target level is a challenge to physician. It was reported that only one third of Hb within the target at any given time. Our data showed, for those under maintenance hemodialysis and without any blood transfusion in observation period, near two third of patients' Hb level were within the target range.

For better anemia management, NKF-K/DOQI developed and published guidelines using protocol or algorithm for EPO prescription.6 Recently, artificial intelligence (AI) has been widely applied to medicine in the field of reducing human error, robotic surgical system and decision- making aid. Since then, there were several studies working on decision making programs to set up model of predicting the ESA dose needed for target Hb level. Artificial neural network (ANN) model is most commonly used for ESA dose-response prediction. However, the effectiveness of these kinds of AI is not confirmed clinically and the result not satisfactory. In other words, it is still inconclusive whether contemporary AI has any role in decision making aid when prescribing ESA dose for dialysis patient, a typical trial and error which AI supposed should be very helpful with.

Based on the mentioned above, we are going to conduct this clinical try to test the hypothesis that AI is not inferior to physician in prescribing ESA dose for hemodialysis patients to maintain hemoglobin(Hb) level to meet the target

Study Design

Conditions

End Stage Renal Disease

Intervention

AI (model)

Location

Kaohsiung Medical University Chung-Ho Memorial Hospital (KMUH)
Kaohsiung
TW
Taiwan
807

Status

Recruiting

Source

Kaohsiung Medical University Chung-Ho Memorial Hospital

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-12-05T00:03:04-0500

Clinical Trials [3495 Associated Clinical Trials listed on BioPortfolio]

Registry for End Stage Renal Failure

The rein registry collects case record data from patients with end stage renal disease followed in French Guiana. This allows to generate incidence and rates for terminal renal disease, mo...

Native Kidney Denervation in Patients With End Stage Renal Disease

To investigate the utility of renal denervation in the treatment of patients with End Stage Renal Disease (ESRD).

Prognosis Study of Renal Transplantation in Children

Kidney transplantation is the worldwide recognized best renal replacement treatment for children with end-stage renal disease. Successful kidney transplantation can not only alleviate urem...

Role of Extrarenal 1-Alpha-Hydroxylase in Patients With End Stage Renal Disease

The goal of this study is to evaluate the role of nutritional Vitamin D deficiency as a potential contributor to the morbidity witnessed in patients with end-stage renal disease

Low Potassium Content Vegetables in End-Stage Renal Disease

Hyperkalemia is common in End-Stage Renal Disease on chronic hemodialysis patients. The most common cause of mortality in End-Stage Renal Disease patients is sudden cardiac death caused by...

PubMed Articles [28639 Associated PubMed Articles listed on BioPortfolio]

Proteoglycan/glycosaminoglycan and collagen content in the arterial wall of patients with end-stage renal disease - new indicators for vascular disease.

Cardiovascular (CV) comorbidity is high in chronic kidney disease, particularly in end-stage renal disease (ESRD). Novel biomarkers are of interest.

Thyroid disease in end-stage renal disease.

Hypothyroidism is a highly prevalent endocrine disorder in the end-stage renal disease (ESRD) population, yet many cases may remain latent and undiagnosed.

Comparison of the Functional Outcomes of Lower Limb Amputees with or without End-Stage Renal Disease.

The potential for full rehabilitation following amputation among end-stage renal disease patients is poor.

Evaluation of Electrocardiographic Parameters Predicting Cardiovascular Events in Patients with End-Stage Renal Disease before and after Transplantation.

Cardiovascular (CV) mortality represents the leading cause of death in patients with end-stage renal disease (ESRD). Efficient screening is required to detect CV disease at an early stage, but the bes...

Association of Human Leukocyte Antigen Haplotypes With End-Stage Renal Disease in Vietnamese Patients Prior to First Transplantation.

The prevalence of chronic kidney failure is significantly increasing in Vietnam, causing a burden for health care. This study assessed the relationship of HLA-A, -B, and -DRB1 alleles with end-stage ...

Medical and Biotech [MESH] Definitions

A mutant strain of Rattus norvegicus used in research on renal function and hypertension and as a disease model for diabetes insipidus.

Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)

Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. It is characterized by intense renal vasculature constriction, reduced renal blood flow, OLIGURIA, and sodium retention.

Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.

Final stage of a liver disease when the liver failure is irreversible and LIVER TRANSPLANTATION is needed.

More From BioPortfolio on "A Model of Computer-assisted Prescription of Erythropoiesis-stimulating Agents (ESA) in Patients Under Hemodialysis"

Quick Search

Searches Linking to this Trial