Abstract:
BACKGROUND:The Determinants of the prescribed dialysis dose have not been well studied in a large patient population. Few studies have examined survival rates after adjusting for dose determinants. METHODS:Data were obtained from a cohort of chronic hemodialysis patients for the period January 1991 through December 2000. The prescribed dialysis dose was calculated as the dialyzer membrane area (m2) times session hours, and was expressed as m2h per week. Determinants of the prescribed dialysis dose were examined by multivariate logistic regression analysis of baseline clinical and laboratory variables. Survival curves for each prescribed dose were calculated by the Kaplan-Meier method. Cox proportional hazards analysis was used to evaluate differences in the survival curves after adjusting for confounding variables. The delivered dose of dialysis, Kt/V, was calculated in a subgroup of the cohort. RESULTS:For 1041 patients receiving thrice-weekly dialysis, the mean (SD) dialysis dose was 19.8 (5.8) m2h/week (range, 6.3 to 33.0 m2h/week). The significant and independent determinants of prescribed dialysis dose were sex, age, diabetes mellitus (DM), body mass index (BMI), serum albumin, diastolic blood pressure, serum creatinine, duration of dialysis, and comorbidity. The dialysis dose received by women and patients with DM was relatively low, even when adjusted for BMI ( P < 0.01 for both). During the follow-up period, 463 patients died, 60 underwent renal transplant, and 10 were transferred away from Okinawa. The hazard ratio (95% confidence interval) for death was 1.016 (0.995-1.037; not significant) for the dialysis dose (m2h/week) after adjustment for multiple confounding factors. The mean (SD) Kt/V was 1.31 (0.28). The hazard ratio (95% confidence interval) for Kt/V > or = 1.31 vs Kt/V < or = 1.30 was 0.706 (0.553-0.900; P = 0.0049). CONCLUSIONS:The prescribed dialysis dose did not significantly influence mortality in our cohort. Empirically based prescription practice, such as increasing the prescribed dialysis dose in male patients, when the BMI is large, or when serum creatinine or diastolic blood pressure is high may explain the relatively good prognosis of chronic hemodialysis patients in Japan.
journal_name
Clin Exp Nephroljournal_title
Clinical and experimental nephrologyauthors
Iseki K,Tozawa M,Takishita Sdoi
10.1007/s10157-003-0242-2subject
Has Abstractpub_date
2003-09-01 00:00:00pages
231-7issue
3eissn
1342-1751issn
1437-7799journal_volume
7pub_type
杂志文章abstract::We report a 58-year-old Japanese man with primary systemic AL amyloidosis who achieved disappearance of proteinuria including Bence-Jones protein (lambda-type) after two courses of VAD therapy (vincristine, doxorubicin, and dexamethasone) and subsequent high-dose melphalan, followed by autologous peripheral blood stem...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
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abstract::Waldenström's macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström's macroglobulinemia present in 8-18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with ri...
journal_title:Clinical and experimental nephrology
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doi:10.1007/s10157-007-0015-4
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
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abstract:BACKGROUND:Dotinurad is a novel selective urate reabsorption inhibitor (SURI) that selectively inhibits the reabsorption of uric acid in renal tubules and promotes the excretion of uric acid into urine. In this study, the effects of age and gender on the pharmacokinetics (PK), pharmacodynamics (PD), and safety of dotin...
journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:Edaravone, a drug for treating acute ischemic stroke, has been reported to provoke acute renal disorders. In the previous study, the author evaluated the role of edaravone in the development of renal disorders in 207 patients reported as having developed them in the post-marketing survey of the drug. The ove...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0108-8
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:School urinary screening has been performed in Japan. METHODS:Ikeda City and Toyono Town introduced, in 2012 and 2013, urinary protein/creatinine (Cr) ratio measurement into the urine-screening protocols designed for students aged between 4 and 15 years. For each student whose urinary protein/Cr ratio was ≥...
journal_title:Clinical and experimental nephrology
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,评审
doi:10.1007/s10157-013-0891-8
更新日期:2014-04-01 00:00:00
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journal_title:Clinical and experimental nephrology
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更新日期:2008-04-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s10157-019-01818-2
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
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journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章
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更新日期:2006-12-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-014-0967-0
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pub_type: 杂志文章,评审
doi:10.1007/s10157-011-0493-2
更新日期:2012-02-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-011-0566-2
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journal_title:Clinical and experimental nephrology
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doi:10.1007/s10157-003-0267-6
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Darbepoetin alfa (DA) is an attractive alternative to recombinant human erythropoietin (rHuEPO) in managing renal anemia. Since DA has not been approved by the appropriate Japanese drug regulatory agencies for the indication of renal anemia in children in Japan, we have conducted a multicenter prospective st...
journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2018-10-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-009-0207-1
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Although a high prevalence of macrovascular disease (MVD) has been reported in patients with stage 3 chronic kidney disease (CKD), few studies have reported its risk with respect to the underlying cause of kidney disease. This study investigated the prevalence of MVD in type 2 diabetic patients with CKD stra...
journal_title:Clinical and experimental nephrology
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doi:10.1007/s10157-011-0420-6
更新日期:2011-06-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-013-0842-4
更新日期:2014-06-01 00:00:00
abstract::A 78-year old woman with complicating solitary kidney had nephrotic syndrome. Renal biopsy specimens showed focal segmental glomerulosclerosis (FSGS). First, the patient was treated with angiotensin receptor blocker (ARB) and angiotensin converting enzyme inhibitor (ACEI). Proteinuria decreased from 10 to 6 g/day, but...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0076-z
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a significant public health problem. Strategy for its early detection is still controversial. This study aims to assess the cost-effectiveness of population strategy, i.e. mass screening, and Japan's health checkup reform. METHODS:Cost-effectiveness analysis was carried out t...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-011-0567-1
更新日期:2012-04-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-018-1666-z
更新日期:2019-04-01 00:00:00
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journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-014-1058-y
更新日期:2015-08-01 00:00:00
abstract::A 69-year-old woman presented with unusual electron microscopic findings. The patient was admitted to ascertain the cause of her persistent proteinuria, and kidney biopsy was performed. While light microscopic findings and immunofluorescence study suggested membranous nephropathy, electron microscopic study showed mic...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0089-7
更新日期:2008-12-01 00:00:00
abstract::The case of a 63-year-old woman with a relatively rapidly growing angiomyolipoma (AML) originating from the right renal sinus is presented. The tumor had enlarged to more than fivefold in volume (7.4 × 6.7 × 10.1 cm) in the 7 years following its detection (5.6 × 3.4 × 4.6 cm) and had significantly pushed aside the duo...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-011-0519-9
更新日期:2011-12-01 00:00:00