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Early-Stage Chronic Kidney Disease Linked to Significant Health Care Spending Increase Over 5 Years, Study Finds

Cohort study of nearly 80,000 participants reveals the economic impact of early-stage CKD on health care utilization.

A new study conducted in Japan involving 79,988 participants sheds light on the substantial health care spending associated with early-stage chronic kidney disease (CKD). The research, utilizing nationwide health checkup and medical claims data, indicates a strong correlation between mild reductions in estimated glomerular filtration rates (eGFR), proteinuria, and health care spending over a 5-year period.

Key Findings:

  1. Excess Health Care Spending: The study, conducted from April 2021 to October 2023, reveals that early-stage CKD is linked to greater excess health care spending. Participants with mildly reduced eGFR, proteinuria, or a combination of both consistently exhibited higher health care spending over the examined 5-year period.
  2. Association Beyond Traditional Risk Factors: Even after adjusting for common risk factors such as hypertension and diabetes, mild reductions in eGFR and the presence of proteinuria were independently associated with excess health care spending.
  3. Longitudinal Impact: The research not only assessed the cross-sectional impact but also examined the longitudinal effects over 5 years. The findings suggest a constant need for excess health care spending in individuals with early-stage CKD, with the combination of proteinuria and mildly reduced eGFR showing an increasing trend over time.
  4. Preventive Measures Urged: The study concludes by emphasizing the importance of designing actions to prevent the occurrence and progression of CKD. It suggests that interventions aimed at reducing the economic burden associated with early-stage CKD are crucial for sustaining a healthcare system.


Chronic kidney disease affects a significant portion of the global population and is a known risk factor for end-stage kidney disease and cardiovascular disease. The study emphasizes that while advanced-stage CKD has been linked to higher health care utilization, evidence regarding the economic burden of early-stage CKD has been limited.


The study’s findings highlight the need for targeted interventions and preventive measures to address early-stage CKD, considering its impact on health care spending. Identifying and addressing CKD-related practices could help reduce excess health care utilization and contribute to a more sustainable healthcare system.

Note: The information presented is based on the provided study results and abstract.

Credit: JAMA Network Open, Naomi Sakoi

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Groundbreaking Study Proposes Guiding Principles to Tackle Algorithm Bias and Promote Health Equity

Panel of Experts Offers Framework to Address Racial and Ethnic Disparities in Health Care Algorithms

Date: December 17, 2023

In a significant stride toward combating algorithmic bias and fostering health equity, a diverse panel of experts assembled by the Agency for Healthcare Research and Quality (AHRQ) and the National Institute for Minority Health and Health Disparities (NIMHD) has put forth guiding principles. These principles aim to mitigate and prevent bias in health care algorithms, particularly in relation to racial and ethnic disparities.

Study Overview:

The comprehensive study, titled “Guiding Principles to Address the Impact of Algorithm Bias on Racial and Ethnic Disparities in Health and Health Care,” sheds light on the crucial role algorithms play in healthcare, from diagnosis and treatment to resource allocation. The study emphasizes that biased algorithms can lead to adverse outcomes, especially for minoritized groups and historically marginalized populations.

Key Findings:

The panel’s findings resulted in the development of a conceptual framework and five guiding principles applicable across the life cycle of health care algorithms. The principles are strategically designed to promote health and health care equity, ensuring transparency, authentic community engagement, and accountability for fairness.

Five Guiding Principles:

  1. Promote Health and Health Care Equity: The study advocates for the integration of health equity goals throughout the algorithm’s life cycle, emphasizing the importance of problem formulation, data selection, algorithm development, deployment, and monitoring.
  2. Ensure Transparency and Explainability: Stakeholders, including developers, institutions, users, and regulators, are urged to make algorithms transparent, explainable, and interpretable to diverse audiences, fostering informed decision-making.
  3. Authentically Engage Patients and Communities: The study stresses the ethical imperative of involving patients and communities in all phases of the algorithm life cycle, earning trustworthiness through transparency, ethical practices, and timely disclosures.
  4. Identify Algorithmic Fairness Issues and Trade-offs: Recognizing that fairness issues arise from ethical choices and technical decisions, the study advocates for explicit identification, transparency, and explainability of health care algorithmic fairness issues and trade-offs.
  5. Establish Accountability for Equity and Fairness: Model developers and users are called upon to accept responsibility for achieving equity and fairness in algorithm outcomes, with organizations urged to establish processes and accountability metrics throughout the algorithm life cycle.


The study concludes by highlighting the need for collaborative efforts among stakeholders to create systems, regulations, and policies that effectively mitigate and prevent algorithm bias in health care. It underscores the importance of dedicated resources, public support, and a commitment to avoiding the mistakes of the past in algorithm usage.

This groundbreaking study represents a pivotal step toward ensuring that health care algorithms prioritize equity, transparency, and fairness, ultimately benefiting patients and communities alike.

Credit: JAMA Network Open, Marshall H. Chin

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How to measure blood pressure yourself.

Measuring your blood pressure yourself can be done using a device called a sphygmomanometer, commonly known as a blood pressure monitor. There are two types of blood pressure monitors available: manual and digital. Here’s a step-by-step guide on how to measure your blood pressure using a digital blood pressure monitor, which is the more convenient and widely used option:

  1. Purchase a reliable digital blood pressure monitor: Look for a quality device from a reputable brand. You can find them at pharmacies, medical supply stores, or online retailers.
  2. Choose the right cuff size: Most digital blood pressure monitors come with a cuff that wraps around your upper arm. Ensure that the cuff fits properly and is the right size for your arm. The cuff should encircle your upper arm snugly but not too tight.
  3. Prepare for the measurement: Find a quiet and comfortable place where you can sit and relax for a few minutes. It’s recommended to measure your blood pressure in a seated position with your feet flat on the floor and your arm resting on a table or armrest.
  4. Familiarize yourself with the device: Read the instruction manual provided with your blood pressure monitor to understand its specific operation and features. Different models may have slightly different instructions.
  5. Apply the cuff: Roll up your sleeve and slide your arm through the cuff, making sure the bottom edge of the cuff is about an inch above the bend of your elbow. Position the cuff so that the artery marker (usually indicated with an arrow) is aligned with your brachial artery, which is located on the inside of your arm.
  6. Take the measurement: Once the cuff is properly positioned, press the start button on the monitor. The cuff will begin to inflate automatically, tightening around your arm. Remain still and avoid talking or moving during the measurement.
  7. Wait for the results: As the cuff deflates, the monitor will display your systolic and diastolic blood pressure readings. It may also show your heart rate. Take note of the readings displayed on the screen.
  8. Record your blood pressure: Keep a record of your blood pressure readings, including the date and time. This will allow you to track changes over time and share the information with your healthcare provider if needed.
  9. Repeat for accuracy: For accuracy, it’s recommended to measure your blood pressure at the same time each day, following any specific instructions provided by your healthcare professional. Taking multiple measurements over time will provide a better understanding of your average blood pressure.

Remember, while self-measurement can be helpful for monitoring your blood pressure, it’s essential to regularly consult with a healthcare professional for a comprehensive assessment and interpretation of your blood pressure readings.