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 Article
On-line hemodiafiltration: technique and efficiency.
TL;DR: A new mode of infusion in on-line HDF--the mixed infusion mode--is here described, which is able to achieve and maintain the maximum possible water and solute removal during the sessions through a feedback control of the transmembrane pressure.
Journal ArticleDOI
Dialysis session length (“t”) as a determinant of the adequacy of dialysis
Manjula Kurella,Glenn M. Chertow +1 more
TL;DR: Future studies should evaluate hemodialysis session length independent of efficiency, and should consider the evaluation of dose by using other clearance parameters and the adequacy of ultrafiltration in addition to solute kinetics.
Journal ArticleDOI
ESHOL study reanalysis: All-cause mortality considered by competing risks and time-dependent covariates for renal transplantation.
Francisco Maduell,Francesc Moreso,Josep Mora-Macià,Mercedes Pons,Rosa Ramos,Jordi Carreras,Jordi Vallespir Soler,Ferran Torres +7 more
TL;DR: The original results of the ESHOL study, which censored patients discontinuing the study for any reason, were confirmed in the present ITT population without censures and when all-cause mortality was considered by time-dependent and competing risks for transplantation.
Haemodialysis treatment monitored on-line by ultra violet absorbance
TL;DR: An optical method utilizing ultra violet (UV) absorbance for on-line monitoring of haemodialysis treatment for increased efficiency is described and evaluated.
Journal ArticleDOI
Incremental Hemodialysis: How I Do It
TL;DR: I have had a long and successful experience performing incremental dialysis (both peritoneal and hemodialysis) and share here my practice strategies and approaches for incrHD.
References
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