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
Low Vitamin D and High Fibroblast Growth Factor 23 Serum Levels Associate with Infectious and Cardiac Deaths in the HEMO Study
TL;DR: Disordered mineral metabolism may affect outcomes in chronic hemodialysis patients using repeated yearly measures and fixed-covariate Cox models with only baseline values after controlling for important clinical covariates in the HEMO study.
Journal ArticleDOI
Rationale - Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT): Evolving the management of cardiovascular risk in patients with chronic kidney disease
T. Christian H. Mix,Robert M. Brenner,Mark E. Cooper,Dick de Zeeuw,Peter Ivanovich,Andrew S. Levey,Janet B. McGill,John J.V. McMurray,Patrick S. Parfrey,Hans-Henrik Parving,Brian J.G. Pereira,Giuseppe Remuzzi,Ajay K. Singh,Scott D. Solomon,Catherine Stehman-Breen,Robert D. Toto,Marc A. Pfeffer +16 more
TL;DR: TREAT will provide data that are critical to evolution of the management of cardiovascular risk in this high-risk population and has a composite primary end point comprising time to mortality and nonfatal cardiovascular events, including myocardial infarction, myocardia, stroke, and heart failure.
Journal ArticleDOI
Which Targets in Clinical Practice Guidelines Are Associated with Improved Survival in a Large Dialysis Organization
Francesca Tentori,William C. Hunt,Mark Rohrscheib,Min Zhu,Christine A. Stidley,Karen S. Servilla,Dana C. Miskulin,Klemens B. Meyer,Edward J. Bedrick,H. Keith Johnson,Philip G. Zager +10 more
TL;DR: It was postulated that having multiple parameters that satisfy the current guidelines, except for BP, is associated with improved survival among HD patients, and a randomized, controlled trial is needed to identify the optimal BP for HD patients.
Journal ArticleDOI
Associates of Mortality and Hospitalization in Hemodialysis: Potentially Actionable Laboratory Variables and Vascular Access
TL;DR: The top 5 potentially actionable variables are readily identifiable, with albumin level and catheter use the most prominent, and all 5 are appropriate targets for improvement.
Journal ArticleDOI
Prognostic value of myocardial perfusion imaging in predicting outcome after renal transplantation
Amar D Patel,Wael S. Abo-Auda,Jonathan M Davis,Gilbert J. Zoghbi,Mark H. Deierhoi,Jaekyeong Heo,Ami E. Iskandrian +6 more
TL;DR: In high-risk patients (most of whom had diabetes) with preoperative stress perfusion imaging, those with normal images had significantly lower cardiac events than those with abnormal images, which have important implications in patient screening and postoperative management.
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