Abstract:
:Evidence-based medicine provides tools to evaluate dialysis outcomes by integrating knowledge obtained from interventional and observational studies. This is illustrated in relation to three important topics: dialysis membranes, dialysis dose and anemia. Clinical trials and observational evidence support each other in indicating a decrease in dialysis-related amyloidosis morbidity when high-flux dialysis is used, whereas the impact of dialysis membranes on mortality is still controversial. Two clinical trials are currently investigating this issue: the American Hemodialysis (HEMO) Study and the European Membrane Permeability and ESRD Patient Outcome (MPO) Study. As indicated by the National Cooperative Dialysis Study (NCDS), dialysis dose is an important determinant of patient outcome. Although Gotch's analysis of the NCDS showed no further benefits for Kt/V>0.9, the analysis by Keshaviah showed a progressive benefit as Kt/V increased beyond 0.9. This finding has been confirmed by observational studies, of which the Dialysis Outcome and Practice Patterns Study (DOPPS) is the most recent and interesting. Further information is also expected from the HEMO study. The findings of observational and interventional studies are consistent in indicating anemia as a major determinant of morbidity and mortality in dialysis patients. American and European guidelines advise hemoglobin levels of 11-12 g/dl and hematocrit levels of 33-36%. The real benefit of completely correcting anemia is not so clear. In conclusion, far from being in opposition, clinical trials and observational studies can provide an integrated contribution to the analysis of dialysis outcomes.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Locatelli F,Andrulli S,D'Amico Msubject
Has Abstractpub_date
2001-11-01 00:00:00pages
S101-8eissn
1121-8428issn
1724-6059journal_volume
14 Suppl 4pub_type
杂志文章,评审abstract::Despite substantial progress in dialysis patients' management, cardiovascular disease remains the major cause of death. Nearly half of deaths on dialysis are secondary to myocardial infarction, cardiac arrest, malignant arrhythmias and other cardiac causes. The high prevalence of diabetes, anemia, hyperparathyroidism ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2009-11-01 00:00:00
abstract::Cutaneous periarteritis nodosa (PAN) is a clinical feature characterized by chronic, benign course; its pathogenesis is unknown. In patients submitted to renal transplantation cutaneous PAN is a rare complication. We report a case of cutaneous PAN associated with the reappearance of hepatitis B antigen 16 years after ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::Clinically apparent venous thromboembolism (VTE) occurs in approximately 7% of patients with membranous nephropathy. Hypoalbuminemia at diagnosis is an independent risk factor for VTE, and risk increases significantly as albumin falls. Optimal prophylactic and treatment anticoagulation regimens in the nephrotic syndro...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0552-9
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Arterial stiffness is a risk factor for chronic kidney disease progression (CKD). Pulse pressure is a surrogate marker of arterial stiffness. It is unclear if pulse pressure predicts CKD progression in type 2 diabetes mellitus. METHODS:This was prospective study involving 1494 patients with estimat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-020-00954-3
更新日期:2021-01-25 00:00:00
abstract::The hallmark of IgA nephropathy (IgAN) is macroscopic hematuria coinciding with, or immediately following, a mucosal infection, usually of the upper respiratory airways. The role of mucosal pathogens has been proven in different experimental models. Mucosal (or innate) immunity acts through the recognition of pathogen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:In biopsy-proven idiopathic nephrotic syndrome (INS), immunoglobulin M (IgM) and C1q are occasionally deposited in the mesangium. In pediatric nephrology, the significance of mesangial IgM or C1q deposits is controversial, based on previous reports. The aim of this study was to explore the clinical significa...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000133
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Patients (pts) with primary Membranous nephropathy (MN) have an autoimmune disease caused by autoantibodies against podocyte antigens and 60-80% of them have antibodies directed against the M-type phospholipase A2 receptor (PLA2R). Immunosuppressive treatment is recommended in high-medium risk pts. Recently ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-020-00781-6
更新日期:2020-06-27 00:00:00
abstract:BACKGROUND:Uremic pruritus as a symptom that affects hemodialysis (HD) patients can decrease the quality of life and increase morbidity in these patients. The aim of this study was to evaluate the effects of turmeric on uremic pruritus in HD patients. SUBJECTS AND METHODS:This was a double-blind placebo-controlled tri...
journal_title:Journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40620-014-0039-2
更新日期:2014-04-01 00:00:00
abstract::The pathogenesis of calcium-oxalate (CaOx) renal stones is still debated and a number of issues needs to be clarified. In particular, it is difficult to combine the intraluminal physical-chemical imbalance and fixed particle theory with the evidence that CaOx stones actually form and grow on Randall's plaque in the re...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2004-11-01 00:00:00
abstract::Kidney remodeling is a response to intrinsic or extrinsic triggers of kidney injury. Injury initiates a set of universal response programs that were positively selected through evolution to control potentially life-threatening dangers and to regain homeostasis, including tissue repair. These danger control programs ar...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000247
更新日期:2013-05-01 00:00:00
abstract::The analysis of the urinary proteome is a potential source of information regarding the kidney's physiopathology. A clear knowledge of the protein composition of normal urine is an essential prerequisite to looking at its pathology. Technological evolution in the field of proteomics (2-dimensional [2D] electrophoresis...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000233
更新日期:2013-07-01 00:00:00
abstract::Emphysematous pyelonephritis is a rare life-threatening infection of the renal parenchyma. It usually affects unilateral kidney and occurs mostly in diabetic patients. It is characterized by the presence of gas within the renal parenchyma and requires prompt diagnosis and early aggressive therapy. Bilateral emphysemat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:We measured serum creatinine concentrations in 17 male athletes of the Italian national rugby team. METHODS:Blood was obtained before the start of training and during the competitive season. Serum creatinine level was measured by Jaffé reaction at 4 time points during the season, with a formal measure of ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000094
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The relationship between malnutrition in hemodialysis (HD) patients with a chronic inflammatory condition and the expression levels of leukocyte integrins and their adhesiveness to fibronectin was investigated. METHODS:Subjective global assessment, albumin and body mass index were used as nutritional marker...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-03-01 00:00:00
abstract::Survival analysis is the statistical method for studying the time between entry to a study and a subsequent event. Survival is often the most important outcome in both observational and intervention studies. The analysis of survival, however, is not simple because of a number of factors. The time between entry to a st...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:The response of proximal convoluted tubules (PCTs) to angiotensin II is mediated by specific type 1 receptors found on both apical and basolateral surface membrane cells. After ligand association with type 1 receptors, different signaling pathways are triggered and determine changes in fluid absorption (Jv)....
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::Cyclosporine (CsA) is among the most widely used immunosuppressants for preventing graft rejection and autoimmune diseases. However, its clinical use is hampered by its significant nephrotoxicity and effects as a cause of hypertension. The proximal tubular Na+-H+ exchanger (NHE3) is responsible for transcellular reabs...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract:AIMS:In recent years, treatment options for secondary hyperparathyroidism (SHPT) have increased (e.g., paricalcitol, calcimimetics). To determine the impact these new treatments have on achieving K/DOQI targets, an observational, prospective survey was undertaken. METHODS:Four 6-month time-spaced surveys of 2,637 pati...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.5301/jn.2010.6193
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Improved responsiveness to erythropoiesis stimulating agents (ESAs) in patients on on-line post-dilution hemodiafiltration (Post-HDF) compared with conventional hemodialysis (HD) was reported by some authors but challenged by others. This prospective, cross-over randomized study tested the hypothesis that an...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-020-00709-0
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND METHODS:Smoking is associated with hyperparathyroidism in the elderly general population and nicotine, the main component of tobacco smoke, stimulates PTH release in experimental models. Although smoking is a persisting problem in patients with end-stage renal disease (ESRD), the association between smok...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/JN.2011.7740
更新日期:2012-01-01 00:00:00
abstract::Page kidney was first described in animal experiments in 1939. In the 1950s and 1960s the human counterpart became evident. In this review we examine the modest literature on this rare but important renal/urological complication, summarize the clinical features, and discuss the best approach to diagnosis and managemen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2003-05-01 00:00:00
abstract::Icodextrin, a glucose polymer, is widely used as an alternative to glucose as the osmotic agent in peritoneal dialysis (PD). We describe a case of a continuous ambulatory peritoneal dialysis patient who developed severe cutaneous hypersensitivity after initiation of icodextrin PD solution. Erythematous skin lesions gr...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2006-09-01 00:00:00
abstract::Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndro...
journal_title:Journal of nephrology
pub_type: 杂志文章,实务指引,评审
doi:10.1007/s40620-017-0390-1
更新日期:2017-06-01 00:00:00
abstract::There have been dramatic increases in the understanding of the molecular mechanisms involved in membranous nephropathy (MN) over the past 2 decades. Most of these have come directly from studies carried out in the Heymann nephritis models of MN in rats, which closely simulate the clinical and pathologic features of th...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The recent multicenter, randomized, open-label INDEPENDENT study demonstrated that sevelamer improves survival in new to hemodialysis (HD) patients compared with calcium carbonate. The objective of this study was to determine the cost-effectiveness of sevelamer versus calcium carbonate for patients new to HD...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s40620-014-0122-8
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Causes of hypertension and cardiac hypertrophy in hemodialysis (HD) patients are multiple, but the role of fluid overload appears to be crucial. Short daily HD (sDHD = 2 hr x 6/week) seems to allow reductions in left ventricular mass (LVM) through the reduction of extracellular water (ECW). Better cardiovasc...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedu...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2009-05-01 00:00:00
abstract::To determine the clinical impact of conversion from C0 to C2 Neoral monitoring, we conducted a 6-month prospective study in 62 stable renal transplant recipients. Neoral was given alone (19%), with steroids (31%), combined with azathioprine (Aza) or mycophenolate mofetil (MMF) (50%). C0 and C2 target ranges were, resp...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2004-03-01 00:00:00
abstract:INTRODUCTION:We analyzed renal histologic and immunohistologic findings in children with nephrotic syndrome (NS) who did (n=5) or did not (n=17) develop cyclosporine A (CyA) nephropathy despite appropriately low serum CyA concentrations being maintained over 2 years. METHODS:To discriminate embryonic-type from mature ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/JN.2010.5793
更新日期:2011-07-01 00:00:00
abstract::The Liber medicine orinalibus (codex 69 Montecassino) of Hermogenes is the first known manuscript to have a Latin translation from the original Greek work of Magnus of Emesa (or Nisibis). The particular text here translated, from the so-called Commentatio, mentions direct transliteration of Greek concepts such as chym...
journal_title:Journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.5301/JN.2011.6461
更新日期:2011-05-01 00:00:00