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
Uremic Toxins: Do We Know Enough to Explain Uremia?
TL;DR: Uremic retention is a complex phenomenon and the most toxic compounds are difficult to remove by dialysis, and the knowledge of the responsible pathways is still incomplete, and needs to be extended to develop new and more efficient treatment strategies.
Journal ArticleDOI
Home dialysis as a first option: a new paradigm
TL;DR: The advantages of the home-based dialysis methods and the arguments for this simple but vital change in the process of choosing the method of dialysis are reviewed.
Journal Article
Dialysis strategies in critically ill acute renal failure patients
TL;DR: In this article, the authors reviewed recent publications that shed light on several specific topics, like optimal treatment modality, dose of dialysis, type of kidney dialysis membrane, and new developments such as slow extended daily dialysis.
Journal ArticleDOI
High-Performance Membrane Dialyzers and Mortality in Hemodialysis Patients: A 2-Year Cohort Study from the Annual Survey of the Japanese Renal Data Registry.
TL;DR: The use of different membrane types may affect mortality, and further long-term prospective studies are needed to clarify whether the PES and PMMA membranes can improve prognosis.
Journal ArticleDOI
Home-based preventative care in high-risk dialysis patients: a pilot study.
Steven J. Berman,Cherisse Wada,Dayna E. Minatodani,Timothy J. Halliday,Robin Miyamoto,Jaclyn Lindo,Patricia J. Jordan +6 more
TL;DR: The results suggest that remote telehealth technology can play an important role in improving health outcomes and the cost of care of patients with end-stage renal disease who have complex healthcare needs.
References
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Nonparametric Estimation from Incomplete Observations
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