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
Lymphocyte apoptosis: role of uremia and permeability of dialysis membrane.
Sagrario Soriano,Alejandro Martin-Malo,Julia Carracedo,Rafael Ramírez,Mariano Rodriguez,Pedro Aljama +5 more
TL;DR: It is suggested that in dialysis patients lymphocyte apoptosis is influenced not only by the biocompatibility but also by the permeability of the dialysis membrane.
Journal ArticleDOI
Frequent hemodialysis: a critical review.
TL;DR: An in‐depth summary of current data comparing the effects of frequent and CHD modalities on survival, hospitalizations, vascular access complications, burden of therapy, quality of life, residual renal function, cardiovascular parameters, bone mineral metabolism, and anemia is provided.
Journal ArticleDOI
Effect of haemodiafiltration vs conventional haemodialysis on growth and cardiovascular outcomes in children – the HDF, heart and height (3H) study
Rukshana Shroff,Aysun Karabay Bayazit,Constantinos J. Stefanidis,Varvara Askiti,Karolis Azukaitis,Nur Canpolat,Ayşe Ağbaş,Ali Anarat,Bilal Aoun,Sevcan A. Bakkaloglu,Devina Bhowruth,Dagmara Borzych-Duzalka,Ipek Kaplan Bulut,Rainer Büscher,Claire Dempster,Ali Duzova,Sandra Habbig,Wesley Hayes,Shivram Hegde,Saoussen Krid,Christoph Licht,Mieczysław Litwin,Mark Mayes,Sevgi Mir,Rose Nemec,Lukasz Obrycki,Fabio Paglialonga,Stefano Picca,Bruno Ranchin,Charlotte Samaille,Mohan Shenoy,Manish D. Sinha,Colette Smith,Brankica Spasojevic,Enrico Vidal,Karel Vondrak,Alev Yilmaz,Ariane Zaloszyc,Michel Fischbach,Franz Schaefer,Claus Peter Schmitt +40 more
TL;DR: This is the largest study on dialysis outcomes in children that involves deep phenotyping across a wide range of cardiovascular, anthropometric, nutritional and health-related quality of life measures, to test the hypothesis that HDF leads to improved cardiovascular and growth outcomes compared to conventional HD.
Journal ArticleDOI
The Controversies of Diagnosing and Treating Hypertension among Hemodialysis Patients
TL;DR: Evaluating home BP in every dialysis patient, evaluating volume status on a regular basis, and treating hypertension predominantly with nonpharmacological strategies are worthwhile.
Journal ArticleDOI
Enhanced solute removal with intermittent, in-center, 8-hour nocturnal hemodialysis.
TL;DR: It is shown that serum phosphorus levels are significantly lowered in patients maintained on thrice‐weekly, in‐center, 8‐hour nocturnal HD performed at a blood flow rate of 400 mL/min and the kinetics of this modality were examined.
References
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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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