J Formos Med Assoc
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The effect of exact classes of lipid-lowering drugs (LLDs) on preventing major adverse cardiovascular events (MACEs) and poor renal outcomes is not well characterized in the chronic kidney disease (CKD) population. ⋯ In patients with non-dialysis CKD, there is sufficient evidence to show that rosuvastatin and atorvastatin were statistically significantly more effective and preferable in reducing the risk of MACE and increasing the mean eGFR compared with the control group.
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In this study, using Taiwan's National Health Insurance (NHI) as an example of a single-payer system, we examined the extent of pharmaceutical procurement profits (PPP) and evaluated their impact on the financial performance of healthcare institutions. ⋯ Average PPP increased during the study period, increasingly affecting hospitals' financial stability across all strata. The gap between TOP and HSP in medical centers has gradually widened, suggesting an increase in non-health service profits. In this study, we propose a payment policy reform that fosters sustainability of the healthcare and financing system under universal health coverage and corrects the potential distortions caused by PPP.
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Certain patient subpopulations requiring dialysis initiation show varied survival rates and chances of ending renal replacement therapy (RRT). Consensus clustering can help identify these subgroups and their dialysis outcomes. ⋯ Among critical patients undergoing RRT due to systemic demand-capacity imbalance, more than half of the patients died. We identified distinct phenotypes in demand-capacity imbalance in a heterogeneous cohort of patients initializing RRT. Additionally, we found that pre-dialysis UCR as a novel predictor for mortality and the likelihood of being dialysis-free.
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Hypophosphatemic rickets is a rare metabolic bone disease caused by renal phosphate wasting, leading to impaired bone mineralization. We present a case of a boy with fibroblast growth factor 23 (FGF23)-related hypophosphatemic rickets who did not achieve callus consolidation after six months of conventional therapy with phosphate and active vitamin D following corrective osteotomy. ⋯ This report is the first to address the short-term use of burosumab therapy to promote bone healing after orthopedic surgery. Our findings further emphasize the clinical advantages and short-term applications of burosumab in FGF23-related hypophosphatemic diseases, especially for patients undergoing orthopedic surgery.