Abstract:
:Anabolic steroids have been used for the treatment of the anemia of chronic renal failure for more than 25 years. Due to concerns over adverse effects, their use historically has been limited to nandrolone decanoate given to men, usually over age 50, who have intact kidneys. The introduction of epoetin alfa in 1989 has led to reduced androgen use for the treatment of anemia. Nevertheless, there continues to be scientific investigation into the possible role that androgens may play in combination with or as an alternative to erythropoietin. Whether combination therapy will prove to be useful remains to be determined in a large, prospective, randomized trial. There is little likelihood, based on present literature, that androgen therapy alone will replace epoetin alfa in U.S. dialysis units. This topic was addressed recently by the Anemia Work Group of the National Kidney Foundation Dialysis Outcomes Quality Initiative (27). While acknowledging androgen treatment may be less expensive than epoetin alfa, the group stated that the potential risks of primary androgen therapy alone make this form of treatment "unacceptable." The work group did not offer any recommendations on the combined use of erythropoietin and androgens, stating that published data are inconclusive. If future reimbursement policies are changed to include epoetin alfa within a capitated rate, economic incentives may lead to increased use of androgens to achieve targeted hematocrit values. The potential value of anabolic steroids for treating malnutrition in dialysis patients is an intriguing idea. Very little has been done to explore this issue, and this clinical practice has not become widespread nor universally recommended (28). Prospective clinical trials in this area may be warranted as well.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Johnson CAdoi
10.1046/j.1525-139x.2000.00011.xsubject
Has Abstractpub_date
2000-01-01 00:00:00pages
36-9issue
1eissn
0894-0959issn
1525-139Xjournal_volume
13pub_type
杂志文章,评审abstract::The bone disease associated with end-stage renal failure (ESRD) and treatment are complex and multifactorial, and has changed in both clinical and imaging features over the past three decades. Whereas previously features of vitamin D deficiency (rickets/osteomalacia) and intense, and prolonged, secondary hyperparathyr...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2002.00073.x
更新日期:2002-07-01 00:00:00
abstract::Percutaneous peritoneal catheter insertion can be performed by trained nephrologists. The objective of this study was to compare the outcome of peritoneal dialysis (PD) catheters percutaneous inserted with the traditional surgical technique. One hundred twenty-one PD catheters were placed in 121 stage-5 Chronic kidney...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12147
更新日期:2014-05-01 00:00:00
abstract::Malnutrition is a frequent complication in hemodialysis patients and is associated with increased mortality and morbidity. Interventions such as oral or intravenous nutritional supplements have often failed to improve nutritional status. We report here the effect that daily dialysis, practiced in our center since 1997...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.0894-0959.2004.17205.x
更新日期:2004-03-01 00:00:00
abstract::Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological tre...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12132
更新日期:2013-11-01 00:00:00
abstract::Few prospective studies have looked at the incidence of hyperkalemia in outpatient hemodialysis access procedures. Our study prospectively evaluated 167 procedures using a preadmit venous blood gas (VBG) and found that 14.3% had moderate or severe hyperkalemia. When the individual procedures were analyzed it was found...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12243
更新日期:2015-01-01 00:00:00
abstract::Recombinant human erythropoietin (rHuEPO, epoetin) revolutionized the treatment of anemia in patients with chronic kidney disease (CKD) when it was approved for use in the United States in 1989. Among dialysis patients, the mean hemoglobin (Hb) in patients undergoing dialysis rose from 7-8 g/dl prior to 1989 to 11-12 ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18105.x
更新日期:2005-01-01 00:00:00
abstract::Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12280
更新日期:2015-01-01 00:00:00
abstract::The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness a...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12901
更新日期:2020-09-01 00:00:00
abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12668
更新日期:2018-03-01 00:00:00
abstract::The control of serum phosphorus by dialysis is made difficult by the fact that intradialytic blood levels tend to be low, and because phosphorus is removed almost exclusively from the plasma during its passage through the dialyzer. The most practical way to increase phosphorus removal is to extend dialysis time, altho...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12439
更新日期:2015-11-01 00:00:00
abstract::We present a case of arteriovenous graft pseudoaneurysms treated endovascularly with stent grafts and make suggestions regarding the technique of evaluating the pseudoaneurysms and choosing the proper location to deploy the stent grafts to maximize the outcomes and minimize the length of the graft covered by the stent...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12142
更新日期:2014-03-01 00:00:00
abstract::Calciphylaxis, a disorder of dermal arteriolar calcification with a distinct predilection for patients with advanced kidney disease, remains an enigmatic condition that challenges clinicians. Observations regarding positive associations between levels of circulating parathyroid hormone (PTH) and the risk of calciphyla...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12502
更新日期:2016-07-01 00:00:00
abstract::Renal osteodystrophy (ROD) represents a spectrum of bone lesions ranging from a high-turnover to a low-turnover state. The expression of the histologic bone lesions is modulated by parathyroid hormone (PTH), vitamin D, calcium, phosphorus, and aluminum that act as major regulators of osteoblastic activity and bone for...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18404.x
更新日期:2005-07-01 00:00:00
abstract::For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12691
更新日期:2018-05-01 00:00:00
abstract::Baclofen is an oral derivative of gamma-aminobutyric acid (GABA) used to treat muscular spasticity from disorders of the central nervous system. However, it is also being used for a variety of other conditions such as musculoskeletal pain, myoclonus, and alcohol withdrawal. The elimination of baclofen is heavily depen...
journal_title:Seminars in dialysis
pub_type: 信件
doi:10.1111/sdi.12400
更新日期:2015-09-01 00:00:00
abstract::Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant inter...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/sdi.12712
更新日期:2018-09-01 00:00:00
abstract::The elderly represent the fastest growing segment of incident patients entering end-stage renal disease (ESRD). Increasingly, social scientists and caregivers are faced with changing models of care, which will challenge traditional patterns of patient acceptance into costly medical therapies. This paper analyzes the o...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12015
更新日期:2012-11-01 00:00:00
abstract::With the current understanding that atherosclerosis is an inflammatory disorder, markers of the associated systemic inflammatory response have been extensively studied as predictors of cardiovascular disease. Recently the use of high-sensitivity C-reactive protein (hsCRP) has been proposed for risk assessment in indiv...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2006.00138.x
更新日期:2006-03-01 00:00:00
abstract::Withdrawal from dialysis is an appropriate decision for situations in which the burdens of treatment outweigh the benefits. Alternately, it can be viewed as a public health problem and suicide equivalent that contributes to the high mortality of end-stage renal disease (ESRD). More than one in five deaths of patients ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18201.x
更新日期:2005-03-01 00:00:00
abstract::Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12741
更新日期:2018-11-01 00:00:00
abstract::In healthy individuals, vitamin D produced in the skin or derived from nutritional sources is converted to 25-hydroxyvitamin D (25[OH]D) in the liver, and then 1,25-dihydroxyvitamin D (1,25[OH](2)D) by 1 alpha-hydroxylase in the kidney. Chronic kidney disease (CKD) is accompanied by a progressive decline in the abilit...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2010.00751.x
更新日期:2010-07-01 00:00:00
abstract::Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, exces...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12527
更新日期:2016-11-01 00:00:00
abstract::Hemodialysis patients are susceptible to coronavirus disease 2019 (COVID-19). The aim of this study was to describe the epidemiological, clinical characteristics, and mortality-related risk factors for those who undergoing hemodialysis with COVID-19. We conducted a retrospective study. A total of 49 hemodialysis patie...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12928
更新日期:2020-10-29 00:00:00
abstract::Determining dry weight and assessing extracellular fluid volume in hemodialysis (HD) patients is one of the greatest challenges to practicing nephrologists. The clinical examination has limited accuracy, so different strategies have been investigated to aid in this evaluation. Biochemical markers of volume overload (A...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139x.2004.17112.x
更新日期:2004-01-01 00:00:00
abstract::Dialysis patients are at high risk for fracture, with published rates in excess of a 20% probability of fracture over the next 10 years of dialysis. Unfortunately, there is no accepted methodology for quantifying this risk in advance of the first fracture; conventional bone densitometry performs unreliably in this rol...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2010.00817.x
更新日期:2011-01-01 00:00:00
abstract::Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opini...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12679
更新日期:2018-05-01 00:00:00
abstract::Antibiotic prophylaxis has been employed to reduce the risk of infection. Many reports have documented the role of prophylactic antibiotics on the subsequent development of infection in patients undergoing surgical as well as a variety of percutaneous interventions including cardiac, vascular, biliary, genitourinary, ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2009.00607.x
更新日期:2009-05-01 00:00:00
abstract::Central vein catheters for dialysis have become an integral and unavoidable access modality for providing hemodialysis therapy despite all their major drawbacks. We report a clinical decision dilemma that every nephrologist will encounter while considering an ideal dialysis access for the steadily aging dialysis popul...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00475.x
更新日期:2009-09-01 00:00:00
abstract::Both the morbidity of the uremic syndrome and the generation of uremic toxins are attributed to malnutrition. If protein intake and catabolism result in the generation of solutes, then nutritional intake should be related directly to toxicity. On the other hand, inadequate nutrition has been linked to inflammation and...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1046/j.1525-139x.2002.00076.x
更新日期:2002-09-01 00:00:00
abstract::Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, th...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.00956.x
更新日期:2011-09-01 00:00:00