Abstract：
:In an attempt to improve patient outcomes in peritoneal dialysis (PD), national organizations (such as the National Kidney Foundation Dialysis Outcomes Quality Initiative [NKF-DOQI] process) have formulated clinical practice guidelines based on clinical evidence available at the time of development. For "adequacy" of PD it was acknowledged that there was no prospective randomized interventional clinical trial that evaluated the effect of an increase in peritoneal clearance on outcome. The ADEMEX study is the first such study designed to do this. It was well done and adequately powered for the primary analysis. The study findings indicate that over the range of solute clearances studied, an increase in peritoneal clearance is not associated with an incremental improvement in patient outcome. However, it is noted that the cause of dropout was different between groups, with more dropout for "uremia" in the control group. There are also some limitations in the generalizability of the results. First, the exclusion criteria were likely to exclude patients who were small in body size or were high transporters, patients with the highest relative risk of death. Second, although there was an increase in small solute clearance between control and intervention groups, there was not likely to be an increase in clearance of other potential uremic solutes such as middle molecules. Third, the study did not examine outcomes for patients on cycler therapy. Nevertheless it was a provocative, well-run clinical study which does have implications for clinical practice. It confirms that one prescription does not fit all patients, that many patients below current NKF-DOQI targets for small solute clearance are likely to be adequately dialyzed, and provides evidence-based clinical information for national societies to consider when preparing for the next revision of their guidelines.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Burkart JMdoi
10.1046/j.1525-139x.2003.03001.xsubject
Has Abstractpub_date
2003-01-01 00:00:00pages
1-4issue
1eissn
0894-0959issn
1525-139Xpii
3001journal_volume
16pub_type
评论,社论abstract：:Most recent randomized controlled trials (RCTs) have found that hemodialysis graft surveillance combined with preemptive correction of stenosis does not prolong graft survival. Nevertheless, such programs may be justified if they reduce other adverse outcomes or decrease the cost of care. This study tested this hypoth...
journal_title：Seminars in dialysis
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1525-139X.2005.00102.x
更新日期：2005-11-01 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：:With the increased number of renal transplants being performed in the United States, there are also increasing numbers of early and long-term allograft failures. Patients with failed allografts require reentry into the end-stage renal disease (ESRD) system. If an allograft is producing little in the way of morbidity, ...
journal_title：Seminars in dialysis
pub_type： 社论,评审
doi：10.1111/j.1525-139X.2005.18306.x
更新日期：2005-05-01 00:00:00
abstract：:Cancer and kidney disease are linked by causality and comorbidities. Observational data show an increased risk of malignancy as renal function declines. Erythropoietin stimulating agents (ESAs), which are the cornerstone therapy for anemia patients with chronic kidney disease and cancer, are associated with increased ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12841
更新日期：2019-11-01 00:00:00
abstract：:Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective ana...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12358
更新日期：2015-07-01 00:00:00
abstract：:Extracorporeal elimination of drugs and toxins is a critical component in the management of poisonings, though specific techniques and indications remain a matter of debate. Conventional hemodialysis is frequently the treatment of choice because of its widespread availability and proven effectiveness for certain drugs...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2006.00194.x
更新日期：2006-09-01 00:00:00
abstract：:The National Kidney Foundation (NKF) has recently published clinical practice guidelines for bone metabolism and disease in chronic kidney disease (CKD) patients (the Kidney Disease Outcomes Quality Initiative [K/DOQI]). Data from the literature show that the majority of dialysis patients treated with traditional calc...
journal_title：Seminars in dialysis
pub_type： 社论,指南,实务指引
doi：10.1111/j.0894-0959.2004.17354.x
更新日期：2004-09-01 00:00:00
abstract：:Arteriovenous fistula (AVF) nonmaturation is currently a significant clinical problem; however, the mechanisms responsible for this have remained unanswered. Previous work by our group and others has suggested that anatomical configuration and the corresponding hemodynamic endpoints could have an important role in AVF...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.1525-139X.2012.01112.x
更新日期：2013-03-01 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：:Bacteremia is a common infectious complication in hemodialysis patients. Metastatic sites of infection including infective endocarditis, vertebral osteomyelitis, spinal epidural abscess, and septic arthritis occur relatively frequently. These complications are associated with increased morbidity and mortality in hemod...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12031
更新日期：2013-01-01 00:00:00
abstract：:Peritoneal dialysis (PD) is a simple, safe, gentle, and efficient renal replacement therapy (RRT) method. It is able to correct acute kidney injury (AKI)-induced metabolic, electrolytic, and acid-base disorders and volume overload both in and out the intensive care unit setting. Some PD modalities, such as high-volume...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2011.00868.x
更新日期：2011-03-01 00:00:00
abstract：:Computed tomographic (CT) peritoneography has been widely used as reference standard to evaluate continuous ambulatory peritoneal dialysis-related complications. However, given the varying CT peritoneography approaches used across different institutions, there is no standard value for non-ionic iodinated contrast medi...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12867
更新日期：2020-03-01 00:00:00
abstract：:Pregnancy occurs uncommonly in women with chronic kidney disease (CKD) and fetal outcome tends to be poor, with high rates of prematurity and mortality. Dialysis, by complementing residual renal function, may improve fetal outcome in pregnant women with CKD. Although there are no prospective or randomized trials that ...
journal_title：Seminars in dialysis
pub_type： 社论,评审
doi：10.1046/j.1525-139x.2003.16084_1.x
更新日期：2003-09-01 00:00:00
abstract：:Leptin is mainly produced by adipocytes and metabolized in the kidney. Leptin is taken up into the central nervous system by a saturable transport system, and controls appetite in rodents and in healthy subjects. Leptin acts on peripheral tissue and increases the inflammatory response by stimulating the production of ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2007.00334.x
更新日期：2007-11-01 00:00:00
abstract：:It has been nearly 100 years since the first published report of advanced glycation end products (AGEs) by the French chemist Maillard. Since then, our understanding of AGEs in diseased states has dramatically changed. Especially in the last 25 years, AGEs have been implicated in complications related to aging, neurod...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2012.01081.x
更新日期：2012-09-01 00:00:00
abstract：:Parathyroidectomy (PTX) remains an important intervention for dialysis patients with poorly controlled secondary hyperparathyroidism (SHPT), though there are only retrospective and observational data that show a mortality benefit to this procedure. Potential consequences that we seek to avoid after PTX include persist...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12833
更新日期：2019-11-01 00:00:00
abstract：:While patients with sickle cell disease currently constitute a very small minority of the US dialysis population (0.1%), there is anticipated growth of this group as the life expectancy of those with sickle cell disease (SCD) increases. SCD patients suffer a high burden of morbidity, which is enhanced by the presence ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12403
更新日期：2016-01-01 00:00:00
abstract：:Home dialysis (home HD or home PD) remains underutilized in most jurisdictions. Physicians, advanced-practice nurses, and policy makers working with chronic kidney disease populations can provide insights into patient, healthcare professional, and system-level barriers to home dialysis selection by suitable patients. ...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12183
更新日期：2014-03-01 00:00:00
abstract：:The use of stents has been steadily increasing in the management of dialysis access dysfunction. The purpose of this report was to review the use of covered stents in failed forearm fistulas and describe a case of the use of a small caliber forearm covered stent in a early failed forearm fistula that allowed dialysis ...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.1525-139X.2008.00473.x
更新日期：2009-01-01 00:00:00
abstract：:National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12334
更新日期：2015-03-01 00:00:00
abstract：:This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. Th...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12538
更新日期：2017-01-01 00:00:00
abstract：:Secondary hyperparathyroidism almost universally accompanies end-stage renal disease (ESRD). In some, but not all studies, elevated serum parathyroid hormone (PTH) concentrations are associated with increased fracture rates, cardiovascular disease, and mortality in ESRD. The serum concentration of PTH required for opt...
journal_title：Seminars in dialysis
pub_type： 社论
doi：10.1111/sdi.12457
更新日期：2016-05-01 00:00:00
abstract：:There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end-stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12368
更新日期：2015-07-01 00:00:00
abstract：:Nephrologists offer renal replacement therapy (RRT) to patients who are unlikely to benefit in part because of our discomfort discussing goals of care in the setting of an uncertain prognosis for a given individual. Permanent neurological impairment, terminal illness (life expectancy <6 months), medical conditions pre...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12492
更新日期：2016-07-01 00:00:00
abstract：:In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12658
更新日期：2018-05-01 00:00:00
abstract：:With the recent focus on the benefits of more frequent dialysis, the Baxter Aurora dialysis system provides maximum flexibility for therapy prescription, including short daily treatments, long nocturnal treatments, hemodialysis, hemofiltration, and online hemodiafiltration, all in a compact, reliable, easy to use syst...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.0894-0959.2004.17215.x
更新日期：2004-03-01 00:00:00
abstract：:The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.0894-0959.2004.17329.x
更新日期：2004-07-01 00:00:00
abstract：:The increased frequency of cardiovascular disease observed in hemodialysis patients is secondary to the combination of many traditional (age, male sex, hypertension, smoking, diabetes mellitus, and dyslipidemia) and novel and uremia-related (inflammation, uremic toxins, adipokine imbalance, coagulation disorders, prot...
journal_title：Seminars in dialysis
pub_type： 社论,评审
doi：10.1111/sdi.12345
更新日期：2015-05-01 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
abstract：:Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can infl...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12045
更新日期：2013-07-01 00:00:00
