Journal ArticleDOI
Effect of the hemodialysis prescription of patient morbidity: report from the national cooperative dialysis study
TLDR
Increased morbidity appears to accompany prescriptions associated with a relatively high BUN, and morbidity may be decreased by prescriptionsassociated with more efficient removal of urea if the dietary intake of protein and other nutrients is adequate.Abstract:
This report summarizes morbidity in 151 patients in a cooperative trial designed to evaluate the clinical effects of different dialysis prescriptions. Four treatment groups were divided along two dimensions: dialysis treatment time (long or short), and blood urea nitrogen (BUN) concentration averaged with respect to time (TACurea) (high or low). Dietary protein was not restricted. There was no difference in mortality between the groups. Withdrawal of patients from the high-BUN groups for medical reasons was significantly greater than withdrawal from the low-BUN groups. Hospitalization was also greater in the high-BUN groups, but dialysis treatment time had no significant effects. The data indicate that the occurrence of morbid events is affected by the dialysis prescription. Increased morbidity appears to accompany prescriptions associated with a relatively high BUN. Conversely, morbidity may be decreased by prescriptions associated with more efficient removal of urea if the dietary intake of protein and other nutrients is adequate.read more
Citations
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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
TL;DR: 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.
Journal ArticleDOI
Survival of Patients Undergoing Hemodialysis with Paricalcitol or Calcitriol Therapy
TL;DR: Patients who receive paricalcitol while undergoing long-term hemodialysis appear to have a significant survival advantage over those who receive calcitriol.
Journal ArticleDOI
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
TL;DR: Frequent hemodialysis, as compared with conventional hemodIALysis, was associated with favorable results with respect to the composite outcomes of death or change in left ventricular mass and death orchange in a physical-health composite score but prompted more frequent interventions related to vascular access.
Journal ArticleDOI
KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update
Michael Rocco,John T. Daugirdas,Thomas A. Depner,Jula K. Inrig,Rajnish Mehrotra,Michael V. Rocco,Rita S. Suri,Daniel E. Weiner,Nancy Greer,Areef Ishani,Roderick MacDonald,Carin M Olson,Indulis Rutks,Yelena Slinin,Timothy J Wilt,Holly J. Kramer,Michael J. Choi,Milagros Samaniego-Picota,Paul J. Scheel,Kerry Willis,Jessica Joseph,Laura Brereton +21 more
TL;DR: The 2015 update of the KDOQI Clinical Practice Guideline for Hemodialysis Adequacy is intended to assist practitioners caring for patients in preparation for and during hemodialysis.
Journal ArticleDOI
Immunologic function and survival in hemodialysis patients
Paul L. Kimmel,Terry M. Phillips,Terry M. Phillips,Terry M. Phillips,Samuel J. Simmens,Samuel J. Simmens,Samuel J. Simmens,Rolf A. Peterson,Rolf A. Peterson,Rolf A. Peterson,Karen L. Weihs,Karen L. Weihs,Karen L. Weihs,Sylvan Alleyne,Sylvan Alleyne,Sylvan Alleyne,Illuminado Cruz,Illuminado Cruz,Illuminado Cruz,Jack A. Yanovski,Jack A. Yanovski,Jack A. Yanovski,Judith H. Veis,Judith H. Veis,Judith H. Veis +24 more
TL;DR: Higher levels of circulating proinflammatory cytokines areassociated with mortality, while immune parameters reflecting improved T-cell function are associated with survival in ESRD patients treated with HD, independent of other medical risk factors.
References
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Journal ArticleDOI
Nitrogen balance during intermittent dialysis therapy of uremia
Michael F. Borah,Patricia Y. Schoenfeld,Frank A. Gotch,John A. Sargent,Marsha Wolfson,Michael H. Humphreys +5 more
TL;DR: It is demonstrated that nitrogen balance is negative on Dialysis days regardless of protein intake, and that Gu is higher on dialysis days, and this relationship agreed well with previous observations made in nondialyzed uremic patients under more steady-state conditions.
Journal ArticleDOI
The analysis of rates and of survivorship using log-linear models.
TL;DR: It is shown that the estimation of parameters involves the solution of identical systems of equations for data from either a Poisson process, an exponential distribution, a survival model or a generalized log-linear model that enables one to use algorithms for fitting log- linear models, such as iterative proportional fitting (IPF), for the analysis of rates or survivorship.
Journal Article
The genesis of the square meter-hour hypothesis.
Book ChapterDOI
Principles and Biophysics of Dialysis
John A. Sargent,Frank A. Gotch +1 more
TL;DR: This chapter is organized as shown in Figure 1 and consists of two basic lines of development: consideration of the dialyzer and its operating principles and application of mass balance principles to various solute systems and the effect of Dialyzer use on solute control during intermittent dialysis therapy.
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A mechanistic analysis of the National Cooperative Dialysis Study (NCDS).
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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