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 clinical epidemiology of cardiovascular disease in chronic kidney disease.
John Shik,Patrick S. Parfrey +1 more
TL;DR: To determine whether these uraemia-related factors are markers of cardiovascular disease risk or are actually cardiotoxic requires additional randomized controlled trials.
Journal ArticleDOI
Superior dialytic clearance of β2-microglobulin and p-cresol by high-flux hemodialysis as compared to peritoneal dialysis
TL;DR: In this article, the authors performed a single-center cross-sectional observational study including 70 unselected patients treated with either high-flux HD ( n =20) or peritoneal dialysis (n =50) as compared to hemodialysis (HD).
Journal ArticleDOI
The impact of selecting a high hemoglobin target level on health-related quality of life for patients with chronic kidney disease: a systematic review and meta-analysis
TL;DR: This study suggests that targeting hemoglobin levels in excess of 12.0 g/dL leads to small and not clinically meaningful improvements in HQOL, in addition to significant safety concerns, suggesting that targeting treatment to hemoglobinlevels that are in the range of 9.0 to 12.
Journal ArticleDOI
Pediatric acute renal failure in southwestern Nigeria
Wasiu A Olowu,Kayode A Adelusola +1 more
TL;DR: The results show that many of the causes of ARF in patients are preventable; it should be possible to reduce morbidity due to ARF through purposive preventive measures.
Journal ArticleDOI
High dialysis dose is associated with lower mortality among women but not among men
Friedrich K. Port,Robert A. Wolfe,Tempie E. Hulbert-Shearon,Keith McCullough,Valarie B. Ashby,Philip J. Held +5 more
TL;DR: In this article, the secondary randomized Hemodialysis (HEMO) Study finding that greater dialysis dose may benefit women, but not men, was evaluated by using Cox proportional hazards models.
References
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