Abstract:
:During the past few years, it has become increasingly evident that residual renal function (RRF) is an important and independent predictor of poor outcome in patients with chronic kidney disease (CKD). Although the causes of this observation are not fully understood, it appears that the loss of RRF impairs both fluid removal and clearance of solutes, which in turn leads to uremic toxicity and increased morbidity and mortality. There is increasing evidence that patients with CKD develop signs of fluid overload already in the early phases of the disease, and this may be a stimulus for inflammatory activation. Recently, an inflammatory component was identified in uremic atherosclerotic and non-atherosclerotic cardiovascular disease (CVD), which have been consistently associated with poor clinical outcome in patients with CKD. Signs of systemic inflammation occur in parallel to the impairment in renal function, and the pathophysiology is most likely multifactorial, including a decrease in cytokine clearance, advanced glycation end-product accumulation, oxidative stress, and principal fluid overload. Additionally, inflammation seems to be a predictor of accelerated loss of renal function. In this article, we discuss the evidence showing that patients with CKD generally have fluid overload, the mechanisms by which impaired renal function may lead to a chronic inflammatory state, and the available information linking fluid overload to accelerated loss of renal function and CVD through inflammation. Inflammation may lead to the development of complications of CKD, in particular CVD, but on the other hand may also lead to a faster progression of renal disease. Strategies aiming to reduce fluid overload may be useful to reduce cardiovascular morbidity and mortality, but also preserve RRF.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Pecoits-Filho R,Gonçalves S,Barberato SH,Bignelli A,Lindholm B,Riella MC,Stenvinkel Pdoi
10.1159/000078699subject
Has Abstractpub_date
2004-01-01 00:00:00pages
285-92issue
3eissn
0253-5068issn
1421-9735pii
78699journal_volume
22pub_type
杂志文章,评审abstract::For human beings trace elements are essential nutrients with a gamut of functions. They are for instance indispensable components of many enzymes, so they have some regulatory functions and they may affect immune reactions and free radical generation. Altered blood levels of different trace elements have been describe...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000014394
更新日期:1999-01-01 00:00:00
abstract::Heart failure results in significant morbidity and mortality in the United States. Chronic heart failure is often complicated by renal insufficiency. Further, acute decompensated heart failure is often complicated by worsening renal function or the development of diuretic resistance. Heart failure complicated by renal...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000207198
更新日期:2009-01-01 00:00:00
abstract::In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169411
更新日期:1985-01-01 00:00:00
abstract::The effects of pulsatile perfusion on microcirculation and renal function in high-risk patients were evaluated in this study. Pulsatile roller pumps with a pulsatile control module and membrane oxygenator were used in a clinical setting. 40 patients undergoing elective cardiac surgery with a high risk of either having...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000085174
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND AND AIM:Elevated low-density lipoprotein cholesterol and/or lipoprotein(a) are established risk factors for cardiovascular disease (CVD). Management of hypercholesterolemia consists of drug therapies, including statins and proprotein convertase subtilisin/kexin type 9 inhibitors. In patients with familial hy...
journal_title:Blood purification
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000497447
更新日期:2019-01-01 00:00:00
abstract::The recent Kidney Disease Outcomes Quality Initiative (K/DOQI) classification of chronic kidney disease (CKD) includes transplant recipients. Although there are important differences between kidney transplant recipients (KTRs) and patients with native kidney disease, the inclusion of KTRs along with other CKD patients...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000067871
更新日期:2003-01-01 00:00:00
abstract::Clinical trials using very low protein supply supplemented with amino acid or keto acid preparations have shown the possibility of slowing the rate of decline of renal function in patients with advanced chronic renal failure together with preservation of nutritional status. The possible mechanisms by which this effect...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,评审
doi:10.1159/000169557
更新日期:1988-01-01 00:00:00
abstract::Dialysis dependence at hospital discharge after acute kidney injury (AKI) requiring renal replacement therapy (RRT) in the intensive care unit (ICU) is found in 10-15% of survivors. In case of severe AKI in the ICU, it is necessary to reconcile two objectives: the creation of an adequate temporary angioaccess for RRT ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000341721
更新日期:2012-01-01 00:00:00
abstract::Doubt has remained as to whether or not the K/DOQI recommended targets for adequacy of dialysis for peritoneal dialysis patients is appropriate (weekly Kt/V 2 + creatinine clearance 50-60 l/1.73 m(2)). The ADEMEX trial can be interpreted as indicating that lower targets might be acceptable. The HEMO trial, not yet pub...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000067869
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Dialysate fluid connection to the membrane in continuous dialysis may affect solute clearance. Although circuit connections are routinely made counter-current to blood flow in intermittent dialysis, no study has assessed the effect of this dialysate fluid flow direction on removal of small solutes creatinine...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000441270
更新日期:2016-01-01 00:00:00
abstract::Issues in biocompatibility have traditionally focused on the interaction of membranes or materials with the activation of complement, red blood cell destruction, clotting dysfunctions, and platelet activation. Other studies are concerned with the replacement fluid formulations and host responses. Recent attention has ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000169968
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The relationship between predialysis blood pressure (BP) and hemodialysis (HD) patient outcomes is controversial. We report the evolution of predialysis BP in incident patients treated with the dry weight method and its relationship with patients' outcomes. METHODS:Between January 2000 and 2009, 308 patient...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000337101
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:We have reported that vitamin D deficiency may be implicated in the pathogenesis of hypoalbuminemia observed in patients with end-stage renal disease, but the mechanism remains to be clarified. The aim of the present study was to determine whether supplementation with alfacalcidol might increase protein inta...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000076855
更新日期:2004-01-01 00:00:00
abstract::The recent recognition that hyperphosphatemia is a strong predictor of survival on dialysis has rekindled interest in the regulation and control of serum phosphate. In incipient renal failure hyperphosphatemia is prevented by increased fractional renal phosphate excretion mediated via an increase in parathyroid hormon...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000082004
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients. METHOD:A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defi...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000335256
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:We studied the influence of acute renal failure (ARF) on the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and hemodynamic parameters. METHODS:The echocardiographic parameters and NT-proBNP levels were compared between 26 mechanically ventilated patients with ARF requiring conti...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000322259
更新日期:2011-01-01 00:00:00
abstract::Along with the numerous technological improvements in molecular biology, polymerase chain reaction, which permits analysis of sequences of a very small amount of biological material, enables evaluation of hemodialysis-induced gene transcription of inflammatory cytokines. Blood samples drawn from 22 hemodialysis patien...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014310
更新日期:1998-01-01 00:00:00
abstract::Dialysis fluid is produced by the blending of treated water with electrolytes at the patients bed side. Its preparation and composition are important elements of treatment optimisation since many of the constituents play a role in patient well-being. Ideally the composition of the dialysis fluid should match that of p...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096400
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:We estimated the flow of endotoxins (ET) from dialysates into the blood of patients on hemodialysis (HD) using limulus amebocyte lysate (LAL) assays and endotoxin activity (EA) determined by neutrophil respiratory burst activity. METHODS:A cross-sectional study compared groups given ultrapure bicarbonate (n...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000322622
更新日期:2011-01-01 00:00:00
abstract::Malnutrition, which is common in maintenance hemodialysis (HD) patients, is strongly associated with increased morbidity and mortality. Protein requirements in HD patients are increased twice or more compared to those of healthy subjects. Underdialysis leads to anorexia with low protein and energy intake in relation t...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170072
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:We proposed a new method to estimate dry weight (DW) using single frequency bioimpedance. METHODS:We hypothesized that the change in whole body resistance at 50 kHz (R(50)) was proportional to the ultrafiltration volume (UFV) during a hemodialysis (HD) session. When the targeted resistance estimated in heal...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000330337
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Sedative-hypnotic medication is widely used among continuous ambulatory peritoneal dialysis (CAPD) patients with sleep disorders; however, its effect on mortality has rarely been investigated. METHODS:Logistic regression was employed to identify factors associated with sedative-hypnotic medication, whose ef...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000484922
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:We explored whether biocompatible dialyzer membranes modulate the inflammatory response during blood contact in patients with systemic inflammation. METHODS:15 patients with end-stage renal disease and systemic inflammation (mean serum C-reactive protein 86 +/- 4 mg/l) were randomly treated with Cuprophan (...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000083941
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Critically ill patients with acute kidney injury (AKI) are at high risk for death and frequently require initiation of renal replacement therapy (RRT). There is wide variation in clinical practice on the indications for and timing of initiation and discontinuation of RRT. Numerous clinical and biochemical fa...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000157325
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:This study evaluated the mechanism of hemodynamic improvement in polymyxin B-immobilized fiber (PMX) treatment. METHODS:Fifteen septic patients with endotoxemia and/or gram negative infection were treated with PMX. Plasma concentrations of calcitonin gene-related peptide (CGRP) and nitric oxide metabol...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000070696
更新日期:2003-01-01 00:00:00
abstract::The biological effect of oxygen-reactive species controlled by antioxidant mechanisms are exerted on the basis of antioxidant enzymes and substrates. In this study, the activities of antioxidant enzymes-superoxide dismutase (SOD) and glutathione peroxidase (GPx)-were determined in the erythrocytes of patients on regul...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170269
更新日期:1996-01-01 00:00:00
abstract::Although cis-diamminedichloroplatinum (cisplatin) is widely used in the treatment of malignant tumors, the dose administered is limited because of side effects such as nephrotoxicity. The plasma levels of non-protein-bound platinum, which can be removed by dialysis, play an important role in the antitumor effects and ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000170256
更新日期:1996-01-01 00:00:00
abstract::The evidence concerning online hemodiafiltration (HDF) includes the following: (1) the increase of removal of uremic toxin, (2) the prevention of dialysis rerated hypotension, (3) the recovery of survival, and (4) the recovery of dialysis related uncertain symptoms. Although clinical evidence has been noted, the hypot...
journal_title:Blood purification
pub_type: 社论
doi:10.1159/000487917
更新日期:2018-01-01 00:00:00
abstract::Cardiovascular disease (CVD) remains the major cause of morbidity and mortality in end-stage renal disease (ESRD) patients. As traditional risk factors cannot alone explain the unacceptable high prevalence and incidence of CVD in this population, inflammation (a common phenomenon in ESRD), and other non-traditional ri...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000082014
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/AIMS:Carpal tunnel syndrome (CTS) is a common clinical presentation of dialysis-related amyloidosis. It was determined whether β(2)-microglobulin (β2M) and advanced glycation end products in serum are predictors of CTS in dialysis patients. METHODS:A total of 385 hemodialysis patients were screened for CTS....
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000338923
更新日期:2012-01-01 00:00:00