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
Urea-induced ROS cause endothelial dysfunction in chronic renal failure
Maria D'Apolito,Xueliang Du,Daniela Pisanelli,Massimo Pettoello-Mantovani,Angelo Campanozzi,Ferdinando Giacco,Angela Bruna Maffione,Anna Laura Colia,Michael Brownlee,Ida Giardino +9 more
TL;DR: Data show that urea itself, at levels common in patients with CRF, causes endothelial dysfunction and activation of proatherogenic pathways.
Journal ArticleDOI
Relative Survival of Peritoneal Dialysis and Haemodialysis Patients: Effect of Cohort and Mode of Dialysis Initiation
James G. Heaf,Sonja Wehberg +1 more
TL;DR: Dialysis survival has increased during the past 20 years, and PD survival since 2000 has been better than HD, overall and for all subgroups.
Journal ArticleDOI
On-line mixed hemodiafiltration with a feedback for ultrafiltration control: effect on middle-molecule removal.
TL;DR: The mixed infusion mode in hemodiafiltration, controlled by the TMP-ultrafiltration feedback, seems to improve the efficiency of hemodialysisfiltration by fully exploiting the convective mechanism of solute removal.
Journal ArticleDOI
Hemodialysis vascular access monitoring: current concepts.
Michael Allon,Michelle L. Robbin +1 more
TL;DR: Routine surveillance for graft stenosis, with preemptive angioplasty, cannot be recommended for reduction of graft thrombosis, and future research should be directed at pharmacologic interventions to prevent graft stenotic disease.
Journal ArticleDOI
Impact of Kidney Bone Disease and Its Management on Survival of Patients on Dialysis
TL;DR: Subgroup analyses are presented that show that administration of any dose of paricalcitol, when compared with no paricalCitol, is associated with better likelihood of survival in virtually all subgroups of patients on hemodialysis, and may be the most promising option for improving CKD outcomes.
References
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