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
Secondary Immunodeficiency Related to Kidney Disease (SIDKD)—Definition, Unmet Need, and Mechanisms
TL;DR: In this paper , the authors proposed a definition of SIDKD and discussed the pathogenic mechanisms of secondary immunodeficiency related to kidney disease, including unexpected immunoregulatory roles of elevated levels of FGF23 and hyperuricemia and shifts in the secretome of the intestinal microbiota in kidney disease.
Journal ArticleDOI
Slowing the progression of diabetic nephropathy and its cardiovascular consequences
TL;DR: The goal of an ideal clinical trial would be ESRD prevention; however, pragmatic objectives such as a greater understanding of therapeutic toxicities should also be explored in this population.
Journal ArticleDOI
Independent Community House Hemodialysis as a Novel Dialysis Setting: An Observational Cohort Study
Mark R. Marshall,Mark R. Marshall,Nora van der Schrieck,David Lilley,Sharen K. Supershad,Alvin Ng,Rachael C. Walker,Joanna L. Dunlop +7 more
TL;DR: Within limits, this study shows community house HD to be both safe and effective and provides an option to improve the uptake of home HD.
Journal ArticleDOI
All-cause and cause-specific mortality associated with diabetes in prevalent hemodialysis patients
Abdus Sattar,Christos Argyropoulos,Lisa A. Weissfeld,Nizar Younas,Linda F. Fried,John A. Kellum,Mark Unruh +6 more
TL;DR: Risk of death associated with diabetes in ESRD increases over time and suggests that an increasing risk of death among diabetes may be underappreciated when using conventional survival models.
Journal ArticleDOI
Chronic maintenance hemodialysis: making sense of the terminology.
TL;DR: This paper seeks to explore the use and sometimes confusing application of many commonly used terms in dialysis, and proposes a number of possible deletions, and offers a descriptive data set that it believes should be used for all HD‐related papers.
References
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Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
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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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