Reinhard Kramar

Publications (85) View all

• Source

  Available from: Oscar Zurriaga

  Article: New primary renal diagnosis codes for the ERA-EDTA.

  Gopalakrishnan Venkat-Raman, Charles R V Tomson, Yongsheng Gao, Ronald Cornet, Benedicte Stengel, Carola Gronhagen-Riska, Chris Reid, Christian Jacquelinet, Elke Schaeffner, Els Boeschoten, Francesco Casino, Frederic Collart, Johan De Meester, Oscar Zurriaga, Reinhard Kramar, Kitty J Jager, Keith Simpson
  [show abstract] [hide abstract]
  ABSTRACT: The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry has produced a new set of primary renal diagnosis (PRD) codes that are intended for use by affiliated registries. It is designed specifically for use in renal centres and registries but is aligned with international coding standards supported by the WHO (International Classification of Diseases) and the International Health Terminology Standards Development Organization (SNOMED Clinical Terms). It is available as supplementary material to this paper and free on the internet for non-commercial, clinical, quality improvement and research use, and by agreement with the ERA-EDTA Registry for use by commercial organizations. Conversion between the old and the new PRD codes is possible. The new codes are very flexible and will be actively managed to keep them up-to-date and to ensure that renal medicine can remain at the forefront of the electronic revolution in medicine, epidemiology research and the use of decision support systems to improve the care of patients.
  Nephrology Dialysis Transplantation 11/2012; · 3.40 Impact Factor
• Source

  Available from: Adrian Covic

  Article: COSMOS: the dialysis scenario of CKD-MBD in Europe.

  José Luis Fernández-Martín, Juan Jesus Carrero, Miha Benedik, Willem-Jan Bos, Adrian Covic, Aníbal Ferreira, Jürgen Floege, David Goldsmith, José Luis Gorriz, Markus Ketteler, [......], Minerva Rodríguez-García, Boleslaw Rutkowski, Vladimir Teplan, Christian Tielemans, Dierik Verbeelen, Rudolf P Wüthrich, Pablo Martínez-Camblor, Iván Cabezas-Rodriguez, José Emilio Sánchez-Alvarez, Jorge B Cannata-Andia
  [show abstract] [hide abstract]
  ABSTRACT: Background Chronic kidney disease-mineral and bone disorders (CKD-MBD) are important complications of CKD5D patients that are associated with mortality.MethodsCOSMOS is a multicentre, open cohort, prospective, observational 3-year study carried out in haemodialysis patients from 20 European countries during 2005-07. The present article describes the main characteristics of the European dialysis population, the current practice for the prevention, diagnosis and treatment of secondary hyperparathyroidism and the differences across different European regions.ResultsThe haemodialysis population in Europe is an aged population (mean age 64.8 ± 14.2 years) with a high prevalence of diabetes (29.5%) and cardiovascular disease (76.0%), and 28.7% of patients have been on haemodialysis more than 5 years. Patients from the former Eastern countries are younger (59.3 ± 14.3 versus 66.0 ± 13.9), having a lower proportion of diabetics (24.1 versus 30.7%). There were relevant differences in the frequency of measurement of the main CKD-MBD biochemical parameters [Ca, P and parathyroid hormone (PTH)] and the Eastern countries showed a poorer control of these biochemical parameters (K/DOQI and K/DIGO targets). Overall, 48.0% of the haemodialysis patients received active vitamin D treatment. Calcitriol use doubled that of alfacalcidiol in the Mediterranean countries, whereas the opposite was found in the non-Mediterranean countries. The criteria followed to perform parathyroidectomy were different across Europe. In the Mediterranean countries, the level of serum PTH considered to perform parathyroidectomy was higher than in non-Mediterranean countries; as a result, in the latter, more parathyroidectomies were performed in the year previous to inclusion to COSMOS.Conclusions The COSMOS baseline results show important differences across Europe in the management of CKD-MBD.
  Nephrology Dialysis Transplantation 11/2012; · 3.40 Impact Factor
• Chapter: Prune-belly syndrome

  Manfred Wallner, Reinhard Kramar
  10/2012;
• Article: Time trend in access to the waiting list and renal transplantation: a comparison of four European countries.

  Vianda S Stel, Reinhard Kramar, Torbjorn Leivestad, Andries J Hoitsma, Wendy Metcalfe, Jacqueline M Smits, Pietro Ravani, Kitty J Jager
  [show abstract] [hide abstract]
  ABSTRACT: To examine the time trend and international differences in access to the waiting list and renal transplantation of patients with end-stage kidney disease. We included all patients (n = 30 961) from Austria, Norway, the Netherlands and Scotland who started renal replacement therapy (RRT) between 1995 and 2003 with their kidney transplant waiting list data (until 31 December 2005) and follow-up data on RRT and mortality (until 31 December 2007). The outcome measure was access to the waiting list within 2 years and to a first renal transplant within 4 years from the start of RRT, expressed as incidence per million age-related population (p.m.a.r.p.) per year. To estimate trends over time, mean percentage annual change (MPAC) and 95% confidence interval (CI) were calculated. In each country, the number of patients starting RRT > 65 years increased significantly over time, whereas the number of renal transplants did not increase to the same extent. Only in Norway were almost all patients on the waiting list transplanted within 4 years of RRT start if they were < 65 years. In patients who started RRT > 65 years, the access to renal transplantation was high in Norway (49 p.m.a.r.p.) and low in Austria ( < 26 p.m.a.r.p.), the Netherlands and Scotland (both < 10 p.m.a.r.p.) but increased significantly in Austria (MPAC = 9.8%; 95% CI = 3.9-16.9) and the Netherlands (MPAC = 9.0%; 95% CI = 3.2-15.0). Only in Norway, virtually all patients on the waiting list < 65 years received a transplant within 4 years after the start of RRT and, remarkably, also most of those > 65 years of age.
  Nephrology Dialysis Transplantation 05/2012; 27(9):3621-31. · 3.40 Impact Factor
• Article: Hemoglobin variability after renal transplantation is associated with mortality.

  Alexander Kainz, Julia Wilflingseder, Reinhold Függer, Reinhard Kramar, Rainer Oberbauer
  [show abstract] [hide abstract]
  ABSTRACT: Anemia is a common problem after renal transplantation. Therefore, the patients are treated with erythropoietin stimulating agents (ESAs). The varying response to treatment contributes to hemoglobin variability, which might be associated with mortality. We conducted a retrospective cohort study of first kidney allograft recipients between 1990 and 2008 represented in the Austrian Transplant Registry. We included 1441 patients of whom 683 received ESAs at any time after transplantation. Cox regression with cubic splines and linear estimates and the purposeful selection algorithm of covariables were used. The measure of variability was the moving standard deviation computed at three monthly intervals for the entire graft life. The hazard ratio (HR) of mortality and graft loss in the spline models increased with hemoglobin variability. The linear HR for mortality was 2.35 (95% confidence interval 1.75-3.17, P<0.001) and functional graft loss 2.45 (1.76-3.40, P<0.001). In an adjusted Cox model (ESA use, hemoglobin, age, diabetes, days on dialysis, eGFR, biopsy confirmed acute rejection and year of transplantation), hemoglobin variability was associated with mortality (HR: 2.11; 1.51-2.94; P<0.001). No association with functional graft loss could be detected (HR: 1.34; 0.93-1.93; P=0.121). These findings suggest that hemoglobin variability is associated with mortality of renal allograft recipients.
  Transplant International 03/2012; 25(3):323-7. · 2.92 Impact Factor