Abstract:
PURPOSE OF REVIEW:This review examines recent advances in understanding of how clinical outcomes for hemodialysis patients may be improved by achieving longer or more frequent treatment times, lower ultrafiltration rates (UFRs), improving nutritional status, and individualizing dialysate composition. This review also discusses the controversy related to timing of dialysis initiation. RECENT FINDINGS:Many observational studies and several randomized controlled trials indicate longer dialysis treatment times, particularly nocturnal dialysis, and/or more frequent dialysis improve morbidity and mortality. Recent evidence also suggests that lower UFR and more consistent achievement of 'dry weight' may help minimize the damage from myocardial stunning and chronic volume overload that occurs in the majority of patients who receive conventional hemodialysis during the day with a standard schedule of 3-5 h, 3 times a week. Other aspects of the dialysis procedure such as appropriate estimated glomerular filtration rate for dialysis initiation and individualizing dialysate composition may also minimize cardiovascular risk. Finally, several studies have highlighted the benefits of oral nutritional supplementation (ONS) during dialysis. SUMMARY:Greater treatment times per week with slower UFR, consistent attainment of 'dry weight', individualized dialysate prescriptions, and administration of ONS to malnourished patients are likely to reduce hospitalizations and improve survival in this high-risk population of end-stage renal disease patients.
journal_name
Curr Opin Nephrol Hypertensjournal_title
Current opinion in nephrology and hypertensionauthors
Fissell R,Hakim RMdoi
10.1097/MNH.0b013e328365b34csubject
Has Abstractpub_date
2013-11-01 00:00:00pages
675-80issue
6eissn
1062-4821issn
1473-6543journal_volume
22pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Potassium channels in the distal nephron are precisely controlled to regulate potassium secretion in accord with physiological demands. In recent years, it has become evident that membrane trafficking processes play a fundamental role. This short review highlights recent developments in elucidating th...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328363ff76
更新日期:2013-09-01 00:00:00
abstract:PURPOSE OF REVIEW:While treating high blood pressure in middle age is beneficial in terms of reducing the occurrence of cardiovascular disease, treated and well controlled hypertensive adults still have a substantial excess mortality and reduced survival compared with normotensives. Therefore, identification of the mea...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000165893.13620.2b
更新日期:2005-05-01 00:00:00
abstract::The recognition that cell death in the myocardium is not only necrotic in nature but is also mediated by activation of the suicide program of myocytes has raised several questions concerning the magnitude of this phenomenon, and whether these two distinct forms of cell death are disease-dependent or coexist in the pat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199703000-00011
更新日期:1997-03-01 00:00:00
abstract::Vascular endothelial growth factor is a diffusible endothelial cell-specific mitogen and angiogenic factor that can also increase vascular permeability. The vascular endothelial growth factor receptors are specifically expressed on the cell surface of vascular endothelial cells. Recent studies point to vascular endoth...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199601000-00008
更新日期:1996-01-01 00:00:00
abstract::The chemical identification and functional characterization of endothelium-derived hyperpolarizing factors varies depending on vascular size, vascular bed and species. Three major candidates are the epoxyeicosatrienoic acids, cytochrome P450 metabolites of arachidonic acid, potassium ion and hydrogen peroxide. Additio...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200203000-00008
更新日期:2002-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Dialysis has been the prevailing treatment paradigm in advanced chronic kidney disease (CKD) for patients ineligible for or unlikely to receive kidney transplantation. As dialysis may neither offer survival benefit nor improved quality of life in certain groups, there has been increasing interest in c...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章
doi:10.1097/MNH.0000000000000573
更新日期:2020-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Inadequately controlled blood pressure is considered an important risk factor for both chronic kidney disease (CKD) progression and cardiovascular disease progression in CKD patients. Patients with CKD and hypertension are typically followed in primary care practice settings and blood pressure is not ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834902c8
更新日期:2011-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia that increases both short-term and long-term mortality. Historically, managing hyperkalemia has relied upon dietary modifications, augmentation of urinary potassium excretion and enhanced enteral potassium elimination. T...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000320
更新日期:2017-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The renin-angiotensin system plays an important role in cardiovascular disease via the production of angiotensin II. Over the past decades, however, more and more evidence has accumulated suggesting an important role for another angiotensin: Angiotensin-(1-7) [Ang-(1-7)]. In this review, we discuss th...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000050
更新日期:2014-09-01 00:00:00
abstract::In spite of the popular belief that "nervous tension," "stress," and hypertension are causally related, it has been difficult to prove a role of autonomic dysfunction in the genesis of essential hypertension. There are three major reasons for this: 1) autonomic function cannot be assessed with one simple test, 2) the ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199212000-00016
更新日期:1992-12-01 00:00:00
abstract::Proteinuria (protein excretion > 300 mg/d) is an independent risk factor for the development of cardiovascular disease and renal failure. The finding of persistent proteinuria in otherwise asymptomatic patients often precedes the development of arterial hypertension and renal failure. When proteinuria is accompanied b...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199311000-00017
更新日期:1993-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The direct oral anticoagulants (DOACs) have emerged as an effective and safe alternative to vitamin K antagonists (VKAs) for stroke and venous thromboembolism (VTE) prevention. However, patients with chronic kidney disease (CKD) experience an increase in the risk of both thromboembolism and bleeding, ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000493
更新日期:2019-05-01 00:00:00
abstract:PURPOSE OF REVIEW:There is currently a major debate on the mechanisms of albuminuria, and this review appraises recent studies in this area. RECENT FINDINGS:The traditional view of albuminuria is that it is the result of damage to an essentially impermeable glomerular barrier. However, over the years, critical evidenc...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32832cb96a
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we will discuss (i) how the recent advancements in digital technology and computational engineering are currently applied to nephropathology in the setting of clinical research, trials, and practice; (ii) the benefits of the new digital environment; (iii) how recognizing its challenges...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000360
更新日期:2017-11-01 00:00:00
abstract::This review focuses on the role of two cytokines, platelet-derived growth factor and transforming growth factor-beta, in glomerular injury. The most recent in vitro and in vivo evidence for the role of platelet-derived growth factor and transforming growth factor-beta in glomerular hypercellularity and matrix expansio...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199405000-00015
更新日期:1994-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The renal distal tubule has been considered for a long time as the main cellular target of aldosterone, where the hormone enhances sodium reabsorption and potassium secretion. However, other cell types in nonepithelial tissues, such as the heart, the vessels, adipose tissue, and macrophages, are now a...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834fb25b
更新日期:2012-03-01 00:00:00
abstract:PURPOSE OF REVIEW:African-Americans are more likely than Caucasians to develop hypertension-related end-stage renal disease. Elevations in blood pressure levels clearly potentiate pre-existing renal disease and also contribute to kidney injury independently of other primary renal diseases in this cohort. Until recently...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200301000-00013
更新日期:2003-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this mini-review is to highlight some unresolved questions and controversies in the evolving story of apolipoprotein L1 (APOL1) nephropathy. RECENT FINDINGS:We highlight studies that introduce complexity in unraveling the mechanisms whereby APOL1 risk variant alleles cause disease. The...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000462
更新日期:2019-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review addresses the recent literature demonstrating important differences in the rate of progression of kidney function decline between transplant recipients and patients with native kidney disease. It also highlights the need for prospective studies to determine the importance of nonimmu...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200411000-00005
更新日期:2004-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Phosphate homeostasis is tightly controlled by the coordinated activity of bone, kidney, intestine, and parathyroid gland. The renal phosphate transporters have emerged as key regulators of both total body phosphate homeostasis and serum phosphate concentration. This review focuses on the latest updat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000053
更新日期:2014-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Insulin resistance is a known complication of end-stage renal disease that also appears to be present in earlier stages of chronic kidney disease (CKD). It is a risk factor for cardiovascular disease and an important potential therapeutic target in this population. Measurement of insulin resistance is...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834b23c1
更新日期:2011-11-01 00:00:00
abstract::Renal synthesis of the active form of vitamin D, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], is a pivotal step in calcium and phosphate homeostasis. Production of 1,25(OH)2D3 is catalyzed by the mitchondrial cytochrome P450, 25-hydroxyvitamin D3-1alpha-hydroxylase (1alpha-HYD). As a consequence of the tight regulation of ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200001000-00004
更新日期:2000-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Glucose 6-phosphate dehydrogenase (G6PD) is the rate-limiting enzyme of the pentose phosphate pathway. G6PD is the main source of the essential cellular reductant, NADPH. The purpose of this review is to describe the biochemistry of G6PD and NADPH, cellular factors that regulate G6PD, normal physiolog...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000294
更新日期:2017-01-01 00:00:00
abstract::Sodium restriction is the most commonly used lifestyle modification for control of hypertension. Nevertheless, there is no consensus on the relative importance of salt in the development of hypertension, nor is the physiological mechanism(s) responsible for salt-induced elevations of blood pressure clearly understood....
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199603000-00012
更新日期:1996-03-01 00:00:00
abstract::The vasculature wall is an active, integrated organ composed of endothelial cells and vascular smooth muscle cells, as well as other cell types depending on the specific vascular segment (e.g. fibroblasts in many vascular regions). The vascular wall is not static; the vascular components (cells and extracellular matri...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199701000-00016
更新日期:1997-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Sodium-glucose cotransporter 2 (SGLT2) inhibitors are antihyperglycemic drugs that act by inhibiting renal sodium-glucose cotransport. Here we present new insights into 'off target', or indirect, effects of SGLT2 inhibitors. RECENT FINDINGS:SGLT2 inhibition causes an acute increase in urinary glucose...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章
doi:10.1097/MNH.0000000000000632
更新日期:2020-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear receptors activated by nutrient molecules and their derivatives. Their role has been increasingly recognized to be important in hypertension, metabolic disorders and cardiovascular disease, including atherosclerosis. Control o...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328325803b
更新日期:2009-03-01 00:00:00
abstract:PURPOSE OF REVIEW:In the present review, we aim to describe the state of knowledge concerning antibody-mediated rejection (ABMR) spectrum and diagnosis criteria before analyzing the present and future promising leads regarding ABMR prognosis markers and treatment. RECENT FINDINGS:Recent studies regarding complement-bi...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000069
更新日期:2014-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Hypertension is an important risk factor for adverse cardiovascular and renal outcomes particularly in patients with chronic kidney disease. This review compares blood pressure measurements obtained in the clinic with those obtained outside the clinic to predict cardiovascular and renal injury and out...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000222700.14960.18
更新日期:2006-05-01 00:00:00
abstract::It is well known that hyperparathyroidism begins early in renal failure and progresses, probably not linearly, throughout the natural course of renal diseases and dialysis therapy. Recent progress in basic medical science has improved our understanding of the mechanisms by which the classically known stimuli for parat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199607000-00007
更新日期:1996-07-01 00:00:00