Journal ArticleDOI
Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis
Garabed Eknoyan,Gerald J. Beck,Alfred K. Cheung,John T. Daugirdas,Tom Greene,John W. Kusek,Michael Allon,James L. Bailey,James A. Delmez,Thomas A. Depner,Johanna T. Dwyer,Andrew S. Levey,Nathan W. Levin,Edgar L. Milford,Daniel B. Ornt,Michael V. Rocco,Gerald Schulman,Steve J. Schwab,Brendan P. Teehan,Robert D. Toto +19 more
TLDR
Patients undergoing hemodialysis thrice weekly appear to have no major benefit from a higher dialysis dose than that recommended by current U.S. guidelines or from the use of a high-flux membrane.Abstract:
Background The effects of the dose of dialysis and the level of flux of the dialyzer membrane on mortality and morbidity among patients undergoing maintenance hemodialysis are uncertain. Methods We undertook a randomized clinical trial in 1846 patients undergoing thrice-weekly dialysis, using a two-by-two factorial design to assign patients randomly to a standard or high dose of dialysis and to a low-flux or high-flux dialyzer. Results In the standard-dose group, the mean (±SD) urea-reduction ratio was 66.3±2.5 percent, the single-pool Kt/V was 1.32±0.09, and the equilibrated Kt/V was 1.16±0.08; in the high-dose group, the values were 75.2±2.5 percent, 1.71±0.11, and 1.53±0.09, respectively. Flux, estimated on the basis of beta2-microglobulin clearance, was 3±7 ml per minute in the low-flux group and 34±11 ml per minute in the high-flux group. The primary outcome, death from any cause, was not significantly influenced by the dose or flux assignment: the relative risk of death in the high-dose group as com...read more
Citations
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Journal ArticleDOI
Incremental dialysis for preserving residual kidney function-Does one size fit all when initiating dialysis?
Anna T. Mathew,Yoshitsugu Obi,Connie M. Rhee,Jason A. Chou,Kamyar Kalantar-Zadeh,Kamyar Kalantar-Zadeh,Kamyar Kalantar-Zadeh +6 more
TL;DR: Patients are suggested which may predict favorable outcomes with an incremental approach to hemodialysis, including substantial RKF, adequate volume control, lack of significant anemia/electrolyte imbalance, satisfactory health‐related quality of life, low comorbid disease burden, and good nutritional status without evidence of hypercatabolism.
Journal ArticleDOI
From cooperative to uncorrelated clogging in cross-flow microfluidic membranes.
TL;DR: This study uses a microfluidic filtration model to probe the kinetics and mechanisms of clogging in crossflow, and exposes two findings: the primary clogging rate of individual pores depends only on the trans-membrane flux, and a transition from correlated to uncorrelated clogging of the membrane is explained qualitatively by deriving a dimensionless number.
Journal ArticleDOI
Angiotensin-converting enzyme inhibitors and cardiovascular outcomes in patients on maintenance hemodialysis
Tara I. Chang,David Shilane,Steven M. Brunelli,Alfred K. Cheung,Alfred K. Cheung,Glenn M. Chertow,Wolfgang C. Winkelmayer +6 more
TL;DR: In this article, the authors conducted a secondary analysis of results of the HEMO study, a randomized trial of dialysis dose and membrane flux in patients on maintenance hemodialysis.
Journal ArticleDOI
Prevalence and determinants of hypertension in chronic hemodialysis patients in Japan.
Kunitoshi Iseki,Shigeru Nakai,Takahiro Shinzato,Osamu Morita,Toshio Shinoda,Kenjiro Kikuchi,Atsushi Wada,Naoki Kimata,Takashi Akiba +8 more
TL;DR: The prevalence of hypertension was significantly associated with volume excess and serum levels of albumin, calcium, and phosphorous in chronic HD patients and despite the high prescription rate of antihypertensive drugs, control of blood pressure remains unsatisfied.
Journal ArticleDOI
Dialysis dose and risk factors for death among ESRD patients treated with twice-weekly hemodialysis: a prospective cohort study.
Thanachai Panaput,Bandit Thinkhamrop,Somnuek Domrongkitchaiporn,Dhavee Sirivongs,Laksamon Praderm,Jirasak Anukulanantachai,Chavasak Kanokkantapong,Pakorn Tungkasereerak,Cholatip Pongskul,Sirirat Anutrakulchai,Thathsalang Keobounma,Surapong Narenpitak,Pisith Intarawongchot,Ammrit Suwattanasin,Sajja Tatiyanupanwong,Kannika Niwattayakul +15 more
TL;DR: The effect of spKt/V on short-term mortality was not obvious in twice-weekly dialysis patients, and attention should be paid to patients who smoke, have hypoalbuminemia, are elderly, or have a high ICED.
References
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Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
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TL;DR: A class of statistical models that generalizes classical linear models-extending them to include many other models useful in statistical analysis, of particular interest for statisticians in medicine, biology, agriculture, social science, and engineering.
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