Mean 24-hour ambulatory systolic blood pressure decreased by-4.2 (95% CI,-13.3 to 5.8) mm Hg in group-based care patients compared with usual care at 6 months but this was not statistically significant. Similarly, we did not detect significant differences in health-related behaviors (such as medication adherence, sodium intake, and physical activity) or quality-of-life measures between the 2 groups. Among the adolescents, attendance was very poor; self-reported satisfaction, although high, did not change from baseline compared with the 6-month follow-up. Small study size, missing data. Group-based care is feasible and acceptable among adults with hypertension and CKD. However, a larger trial is needed to determine the effect on blood pressure and health-related behaviors. Patient participation may limit the effectiveness of group-based care models in adolescents. National Institutes of Health R34 DK102174. https//clinicaltrials.gov/show/NCT02467894.https//clinicaltrials.gov/show/NCT02467894. High pill burden associates with reduced phosphate-binder adherence among dialysis patients, contributing to elevated serum phosphorus levels. We compared the real-world effectiveness of sucroferric oxyhydroxide (SO) versus other phosphate binders in hemodialysis patients over 2 years. Retrospective cohort study. Adult in-center hemodialysis patients prescribed 2 years of uninterrupted SO therapy (maintenance SO; n=222) compared with patients who discontinued SO therapy (discontinued SO; n=596) within 90 days of first prescription and switched to other phosphate binder(s) for 2 years. Phosphate binders. Achievement of serum phosphorus levels≤5.5mg/dL, pill burden, and hospitalizations. Comparisons were made quarterly (Q1-Q8) between maintenance SO and discontinued SO using Poisson and mixed-effects linear regression. Patients achieving serum phosphorus levels≤5.5mg/dL increased from baseline in maintenance SO (46 [20.7%] to a maximum of 104 [46.8%; <0.001]) and discontinued SO (96 [16.1%] tPatients maintained on SO therapy were more likely to achieve target serum phosphorus levels, use 50% fewer phosphate-binder pills per day, and have fewer hospital admissions than patients switched to treatment with other binders.Patients maintained on SO therapy were more likely to achieve target serum phosphorus levels, use 50% fewer phosphate-binder pills per day, and have fewer hospital admissions than patients switched to treatment with other binders. Recent data demonstrate that center volume is not a factor in the outcomes of adult kidney transplant recipients. This study assessed whether center volume affects graft survival in pediatric patients who received a kidney transplant. Case-cohort study. Kidney transplantation centers, recipients younger than 18 years. Data were retrieved from the Scientific Registry of Transplant Recipients for transplantations performed July 1, 2010, to June 30, 2015, and the Organ Procurement and Transplantation Network for transplantations performed January 1, 2010, to December 30, 2015. Center volume was divided into 3 groups low (<4 per year), intermediate (4-8 per year), and high (>8 per year). The primary outcome was 3-year graft survival rate. Outcomes were reviewed in 115 centers that performed 3,762 transplantations. There were no substantive differences in sex, age, ethnicity, diagnosis, and kidney donor profile index score in the 3 transplantation center volume categories. During the 5-year period (Jatric patients treated at lower-volume centers. The difference was more pronounced for patients receiving living versus deceased donor kidneys. The distribution of household income in pediatric transplant recipients may also be a factor that contributes to lower 3-year graft survival in low-volume centers. Previous studies of inflammation and anemia management in hemodialysis (HD) patients may be biased due to patient differences. A922500 We used a self-matched longitudinal design to test whether new inflammation, defined as an acute increase in C-reactive protein (CRP) level, reduces hemoglobin response to erythropoiesis-stimulating agent (ESA) treatment. Self-matched longitudinal design. 3,568 new inflammation events, defined as CRP level>10mg/L following a 3-month period with CRP level≤5mg/L, were identified from 12,389 HD patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases 4 to 6 (2009-2018) in 10 countries in which CRP is routinely measured. "After" (vs "before") observing a high CRP level. Within-patient changes in hemoglobin level, ESA dose, and ESA hyporesponsiveness (hemoglobin<10g/dL and ESA dose>6,000 [Japan] or>8,000 [Europe] U/wk). Linear mixed models and modified Poisson regression. Comparing before with after periods, mean hemoglobin level decreased fromfter HD patients experienced an increase in CRP levels, hemoglobin levels declined quickly, ESA doses increased, and the prevalence of ESA hyporesponsiveness increased appreciably. Routine CRP measurement could identify inflammation as a cause of worsened anemia. In turn, these findings speak to a potentially important role for anemia therapies that are less susceptible to the effects of inflammation. Most new patients with end-stage renal disease (ESRD) initiate hemodialysis (HD) with a central venous catheter (CVC) and later transition to a permanent vascular access with lower infection risk. The benefit of early fistula use in preventing severe infections is incompletely understood. We examined patients' first access and subsequent transitions between accesses during the first year of HD to estimate the risk for bloodstream infection (BSI) associated with incident and time-dependent use of HD access. A retrospective cohort study using enhanced 5% Medicare claims data. New patients with ESRD initiating HD between January 1, 2011, and December 31, 2012, and having complete pre-ESRD Medicare fee-for-service coverage for 2 years. The incident and prevalent use of CVC, graft, or fistula as determined from monthly reports to the Centers for Medicare & Medicaid Services by HD providers. Incident hospitalization with a primary/secondary diagnosis of BSI ( code 038.xx or 790.7). Extended survival analysis accounting for patient confounders.