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
More filters
Journal ArticleDOI
The influence of patient- and facility-specific factors on nutritional status and survival in hemodialysis.
TL;DR: Whereas lower serum albumin concentrations consistently were associated with an increased risk of death, the differences were attenuated among older patients and accentuated among patients of longer vintage.
Journal ArticleDOI
Membrane innovation: closer to native kidneys.
Markus Storr,Richard A. Ward +1 more
TL;DR: Tighter control of the molecular characteristics of the polymers used for membrane fabrication, along with the introduction of additives and improvements in the manufacturing process, has led to membranes with a tighter pore size distribution that allows the use of an increased absolute poresize without leaking substantial amounts of albumin.
Journal ArticleDOI
The future of critical care: renal support in 2027
William R. Clark,Mauro Neri,Francesco Garzotto,Zaccaria Ricci,Stuart L. Goldstein,Xiaoqiang Ding,Jiarui Xu,Claudio Ronco +7 more
TL;DR: Current limitations of CRRT and potential solutions over the next decade from both a patient management and a technology perspective are discussed and the issue of sustainability forCRRT and related therapies beyond 2027 is addressed.
Journal ArticleDOI
Why assistive technology is needed for probing of dry weight.
TL;DR: Assistive technologies offer an opportunity to improve on the subjective clinical exam for the setting of dry weight, but well designed and adequately powered clinical trials are needed.
Journal ArticleDOI
Haemodiafiltration: promise for the future?
Neelke C. van der Weerd,Neelke C. van der Weerd,E. Lars Penne,E. Lars Penne,Marinus A. van den Dorpel,Muriel P.C. Grooteman,Menso J. Nubé,Michiel L. Bots,Piet M. ter Wee,P.J. Blankestijn +9 more
TL;DR: Fluvastatin treatment prevents progressive kidney inflammation and fibrosis in stroke-prone rats and also suppresses oxidative stress and Fibrosis in the interstitium of mouse kidneys with unilateral ureteral obstruction.
References
More filters
Book ChapterDOI
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).
Book ChapterDOI
Regression Models and Life-Tables
TL;DR: The analysis of censored failure times is considered in this paper, where the hazard function is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time.
Book
Generalized Linear Models
Peter McCullagh,John A. Nelder +1 more
TL;DR: In this paper, a generalization of the analysis of variance is given for these models using log- likelihoods, illustrated by examples relating to four distributions; the Normal, Binomial (probit analysis, etc.), Poisson (contingency tables), and gamma (variance components).
Journal ArticleDOI
Generalized linear models. 2nd ed.
Peter McCullagh,John A. Nelder +1 more
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.
Related Papers (5)
A mechanistic analysis of the National Cooperative Dialysis Study (NCDS).
Frank A. Gotch,John A. Sargent +1 more
Effect of the hemodialysis prescription of patient morbidity: report from the national cooperative dialysis study
In-center hemodialysis six times per week versus three times per week.
Glenn M. Chertow,Nathan W. Levin,Gerald J. Beck,Thomas A. Depner,Paul W. Eggers,Jennifer J. Gassman,Irina Gorodetskaya,Tom Greene,Sam James,Brett Larive,Robert M. Lindsay,Ravindra L. Mehta,Brent W. Miller,Daniel B. Ornt,Sanjay Rajagopalan,Anjay Rastogi,Michael V. Rocco,Brigitte Schiller,Olga Sergeyeva,Gerald Schulman,George Ting,Mark Unruh,Robert A. Star,Alan S. Kliger +23 more