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
The trend toward geriatric nephrology.
Fasika Tedla,Eli A. Friedman +1 more
TL;DR: The evolving epidemiology of renal disorders among the elderly is reviewed and evidence put forward to explain this phenomenon is summarized.
Journal ArticleDOI
Optimal blood pressure for the minimum all-cause mortality in Chinese ESRD patients on maintenance hemodialysis
TL;DR: It is revealed that BP worked in a time-dependent way among a Chinese MHD cohort and a U-shaped association between the pre-dialysis systolic BP and all-cause mortality is highlighted.
Journal ArticleDOI
Hemoglobin normalization results in lower dialysis dose, despite high dialysate flow. Single needle offers inadequate dialysis.
Dimosthenis Vlassopoulos,D K Hadjiyannakos,K G Koutala,A N Iliopoulos,N V Diamantopoulou,S I Marioli +5 more
TL;DR: Hb correction to normality is associated with a decrease in dialysis efficiency and the use of high dialysate flow does not compensate for this loss, and SN delivers inadequate dialysis independently of dialysATE flow or hemoglobin concentration.
Journal Article
Predictors of Clinical Outcomes in Hemodialysis Patients: a Multicenter Observational Study.
Tayebeh Soleymanian,Hossein Niyazi,Shaghayegh Noorbakhsh Jafari Dehkordi,Shokoufeh Savaj,Hassan Argani,Iraj Najafi +5 more
TL;DR: In this article, a multivariable Cox proportional hazard model was used to predict death adjusting for case-mix variables, nutrition variables, bone mineral variables, Kt/V, vascular access, and Charlson comorbidities index.
Journal ArticleDOI
Initial Session Duration and Mortality Among Incident Hemodialysis Patients
Shailender Swaminathan,Shailender Swaminathan,Vincent Mor,Vincent Mor,Rajnish Mehrotra,Amal N. Trivedi,Amal N. Trivedi +6 more
TL;DR: Patients in facilities routinely initiating hemodialysis therapy for ≥ 4 hours may have substantially lower mortality as compared with patients in facilities initiating for only 3 hours of treatment.
References
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