Browsing by Author "Samuel, Susan M."

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    Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience
    (2011-05-26) Grisaru, Silviu; Morgunov, Melissa A.; Samuel, Susan M.; Midgley, Julian P.; Wade, Andrew W.; Tee, James B.; Hamiwka, Lorraine A.
    Acute kidney injury (AKI) is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS) remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT) and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43%) required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD). Most patients, 47 (81%), received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%), peritonitis 11 (20%), and catheter malfunction 5 (9%). Nine patients (16%) needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5) × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.
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    The Canadian Childhood Nephrotic Syndrome (CHILDNEPH) Project: overview of design and methods
    (BioMed Central, 2014-07-22) Samuel, Susan M.; Scott, Shannon; Morgan, Catherine; Dart, Allison; Mammen, Cherry; Parekh, Rulan; Nettel-Aguirre, Alberto; Eddy, Allison; Flynn, Rachel; Pinsk, Maury; Wade, Andrew; Arora, Steven; Benoit, Geneviève; Bitzan, Martin; Erickson, Robin; Feber, Janusz; Filler, Guido; Geier, Pavel; Girardin, Colette; Grisaru, Silviu; Tee, James; Kemp, Kyle; Zappitelli, Michael
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    How Do Transitions Within End-Stage Renal Disease Impact Health-Related Quality of Life?
    (2018-08-31) Dumaine, Chance Skylar; MacRae, Jennifer; Ravani, Pietro; Santana, Maria Jose; Samuel, Susan M.
    Dialysis is used to sustain life for patients with end-stage renal disease (ESRD). While dialysis prolongs length of life, numerous studies have shown that dialysis patients have significantly reduced health-related quality of life (HRQoL). The degree of impairment seems to be partially related to dialysis modality [in-centre hemodialysis (IHD), peritoneal dialysis (PD), or home hemodialysis (HHD)], as patients on PD/HHD often have higher HRQoL scores than IHD patients. Patients may change dialysis modalities a number of times during their life. Each change is accompanied by a “transition period” (period of time in which patients adapt to life on their new modality). These transition periods are often marked by high rates of anxiety, depression, morbidity, and mortality, and are periods when HRQoL may change rapidly. However, few studies have examined the magnitude of change in HRQoL during transition periods or what the drivers of change are. Such studies are necessary to ensure that patients are provided with the necessary supports during their modality transition to prevent declines in HRQoL. In this pilot project, we tested the methodology of combining kidney disease-specific HRQoL questionnaires (Kidney Disease Quality of Life surveys) with semi-structured interviews in patients undergoing dialysis modality transitions. Patients completed KDQOL surveys prior to and 3 months after initiating a new dialysis modality and participated in semi-structured interviews to describe changes in HRQoL that occurred during the transition period. Regardless of dialysis modality being initiated, mean HRQoL scores as measured by the five domains of the KDQOL-36 improved over the initial 3 months of the transition period. Scores in additional domains of the KDQOL-Short Form were more variable, with improvements in some domains but reductions in others. Patient interviews highlighted many factors that negatively impacted HRQoL which may be amenable to intervention. Overall, combining the KDQOL tools with semi-structured patient interviews proved to be an effective method of studying changes in HRQoL that occur during modality transitions. Future studies may consider implementation of this model on a larger scale in order to better understand transition periods and to test interventions to prevent declines in HRQoL.
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    Overview of the Canadian pediatric end-stage renal disease database
    (BioMed Central, 2010-08-26) Samuel, Susan M.; Tonelli, Marcello A.; Foster, Bethany J.; Nettel-Aguirre, Alberto; Na, Yingbo; Williams, Robert; Soo, Andrea
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    Trajectories of Kidney Function in Children with Reduced Kidney Function
    (2018-05-18) Kahlon, Bhavneet Kaur; Samuel, Susan M.; James, Matthew T.; Pacaud, Danièle Le; Ronksley, Paul Everett; Hagel, Brent Edward
    Little is known about the progression of chronic kidney disease (CKD) during the emerging adulthood period in patients with pediatric onset CKD cared for in primary care. We performed a retrospective cohort study using administrative data from The Health Improvement Network Database to determine the natural history of CKD, the impact of the emerging adulthood period, and the effects of comorbidities including mental health disorders, substance use, and pregnancy on CKD progression. We identified 15,679 patients who met cohort inclusion criteria. We found that kidney function measured using the estimated glomerular filtration rate (eGFR) increased with increasing age. Emerging adulthood was associated with an attenuation in this increase in eGFR. Finally, the presence of mental health disorders, substance use, and pregnancy modified the relationship between age and eGFR resulting in a small, but statistically significant acceleration in the eGFR increase over age, but were associated with lower baseline eGFR.