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
An incident cohort study comparing survival on home hemodialysis and peritoneal dialysis (australia and new zealand dialysis and transplantation registry)
Annie-Claire Nadeau-Fredette,Carmel M. Hawley,Elaine M. Pascoe,Christopher T. Chan,Philip A. Clayton,Kevan R. Polkinghorne,Neil Boudville,Martine Leblanc,David W. Johnson,David W. Johnson +9 more
TL;DR: Home hemodialysis was associated with superior patient and technique survival compared with peritoneal dialysis and competing risks models and different definitions for technique failure and lag period after modality switch.
Journal ArticleDOI
Cognitive function and dialysis adequacy: no clear relationship.
Lena M. Giang,Daniel E. Weiner,Brian T. Agganis,Tammy Scott,Eric P. Sorensen,Hocine Tighiouart,Mark J. Sarnak +6 more
TL;DR: There is no association between lower Kt/V and worse cognitive performance in the current era of increased dialysis dose, in contrast to several older studies.
Journal Article
Validity and reliability of short form-12 questionnaire in iranian hemodialysis patients
TL;DR: The SF-12 has good psychometric properties and can be used as a shorter version of the SF-36 questionnaire in future studies involving Iranian patients undergoing hemodialysis.
Journal ArticleDOI
Kt/V (and especially its modifications) remains a useful measure of hemodialysis dose
TL;DR: Intensive, extended dialysis may cause adverse effects to residual kidney function, and more information needs to be collected to better understand how urine volume modifies dose requirements, and how to maximize the chances of preserving residual kidneys function.
Journal ArticleDOI
How strong are patients’ preferences in choices between dialysis modalities and doses?
Eric B Bass,Stacey Wills,Nancy E. Fink,Nancy E. Fink,Mollie W. Jenckes,John H. Sadler,Andrew S. Levey,Klemens B. Meyer,Neil R. Powe,Neil R. Powe +9 more
TL;DR: Dialysis patients have strong preferences for their current modality and are more likely to accept a higher dose of dialysis than switch modality to increase survival, and Physicians should talk with patients about the modalityand dose they prefer.
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