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
Effects of dietary intake, appetite, and eating habits on dialysis and non-dialysis treatment days in hemodialysis patients: cross-sectional results from the HEMO study.
Jerrilynn D. Burrowes,Brett Larive,David B. Cockram,Johanna T. Dwyer,John W. Kusek,Sandra McLeroy,Diane Poole,Michael V. Rocco +7 more
TL;DR: People receiving maintenance hemodialysis should be counseled to consume adequate amounts of energy and protein daily, especially on DD, and practitioners should monitor closely those patients who report poor appetite and should intervene appropriately.
Journal ArticleDOI
Mortality Associated with Low Serum Sodium Concentration in Maintenance Hemodialysis
TL;DR: In this paper, the authors examined the association between predialysis serum sodium concentration and mortality in patients undergoing hemodialysis for end-stage renal disease, a condition in which arginine vasopressin does not affect water excretion and osmoregulation.
Book ChapterDOI
Obesity paradox in patients on maintenance dialysis.
TL;DR: Examining the causes and consequences of the obesity paradox in dialysis patients can improve the understanding of similar paradoxes observed both for other conventional risk factors in chronicdialysis patients, and in other populations, such as patients with heart failure, cancer or AIDS or geriatric populations.
Journal ArticleDOI
Long-Term Outcome of Chronic Dialysis in Children
Rukshana Shroff,Sarah Ledermann +1 more
TL;DR: The available outcome data for children on chronic dialysis as well as extrapolating data from the larger adult dialysis experience to inform paediatric practice are reviewed.
Journal ArticleDOI
Associations of hemodialysis dose and session length with mortality risk in Australian and New Zealand patients.
TL;DR: The optimal combination of hemodialysis (HD) dose and session length remains uncertain, and previous studies have not conclusively shown session length to be an important independent determinant of patient mortality.
References
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