Abstract:
:Guidelines have been developed in nephrology and medicine developed to assist practitioners and patients in making decisions about healthcare for specific clinical circumstances. There has been a proliferation of guidelines over the last decade in all areas of medicine, including nephrology. Many of the nephrology guidelines are based on a less robust evidentiary base than guidelines in cardiology or diabetes. There continues to be a debate in medicine as to whether guidelines and their development process actually impact patient outcomes. This article describes the ways in which guidelines may impact patient outcomes in nephrology and emphasizes the role of guidelines in education, research and health policy development such that there is an indirect benefit on medical practice and thus patient outcomes. Our failure to be able to directly attribute any specific guideline to a change in patient outcomes speaks to the complexity of CKD patients, and the difficult in measuring hard outcomes versus process outcomes. Examples of the activities stimulated by guidelines in key areas of nephrology are given. Guidelines are an important component of the application of medical knowledge to medical practice, and need to be contextualized as such. Rigorous evaluation of current implementation techniques and resultant impacts should be undertaken.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Levin Adoi
10.1159/000110568subject
Has Abstractpub_date
2008-01-01 00:00:00pages
67-72issue
1eissn
0253-5068issn
1421-9735pii
000110568journal_volume
26pub_type
杂志文章,评审abstract::Thirty-four patients with end-stage renal disease requiring hemodialysis developed over the course of 7 years (1987-1994) severe ischemia in the extremity carrying the angioaccess secondary to arterial 'steal'. Seven of these patients were treated with access ligation, 4 with banding reducing the flow through the acce...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170286
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Abnormalities in fluid status in hemodialysis (HD) patients are highly prevalent and are related to adverse outcomes. SUMMARY:The inherent discontinuity of the HD procedure in combination with an often compromised cardiovascular response is a major contributor to this phenomenon. In addition, systemic infla...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000494583
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The number of patients with peritoneal dialysis (PD) in China has been increasing year after year, but there are still some challenge in the management of PD patients, and the efficient and effective method has yet to be developed. Multidisciplinary team (MDT) is to create a standardized, individualized, and...
journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000496823
更新日期:2019-01-01 00:00:00
abstract::To reduce the potential occurrence of hypotension during a dialysis treatment, intermittent infusion hemodiafiltration (I-HDF) using back filtration with an ultrapure dialysis fluid was developed. Under typical I-HDF treatment conditions, some 200-300 ml of ultrapure dialysis fluid was infused into the blood component...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000346371
更新日期:2013-01-01 00:00:00
abstract::Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in imp...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000485314
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:Secondary hyperparathyroidism (SHP) is characterized by high bone turnover and elevated serum bone remodeling markers. Elevation of serum interleukin-6 (IL-6) levels is also characteristic of end-stage renal disease. This study investigates the effects of intravenous calcitriol on serum bone resorptive ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000094899
更新日期:2006-01-01 00:00:00
abstract::A review is given of the conditions associated with peritoneal membrane failure, and the possible causes. Ultrafiltration failure is the most important manifestation. It is mostly associated with high transport rates of low molecular weight solutes suggesting the presence of a large vascular surface area. Enlargement ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000065202
更新日期:2002-01-01 00:00:00
abstract::While acute kidney injury (AKI) has been poorly defined historically, a decade of effort has culminated in a standardized, consensus definition. In parallel, electronic health records (EHRs) have been adopted with greater regularity, clinical informatics approaches have been refined, and the field of EHR-enabled care ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000458751
更新日期:2017-01-01 00:00:00
abstract::Evidence that protein restriction retards the progression of chronic renal failure in man is mostly derived from anecdotic data and retrospective studies with inappropriate controls and inferior methodology for evaluating renal function. Data from a prospective randomized study in Stockholm demonstrate that more frequ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000169562
更新日期:1988-01-01 00:00:00
abstract::To increase the efficiency of continuous arteriovenous hemofiltration (CAVH) in cases of severe catabolism, we used a modified CAVH treatment, called arteriovenous hemodiafiltration (AVHDF), in 4 patients. The transport of solutes was increased by providing the infusion of a counter current flow of urea-free solutions...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169454
更新日期:1987-01-01 00:00:00
abstract::In patients with chronic kidney disease (CKD), peptides and proteins circulate at altered concentrations versus in healthy individuals. We have characterized proteome samples from 7 pooled CKD stage 5 patients not yet on dialysis and with no known co-morbidities. We also analyzed pooled plasma samples from 7 healthy a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000178773
更新日期:2008-01-01 00:00:00
abstract::Reprocessing of used dialyzers with chemical disinfectants is practiced commonly in the United States and in some areas of Western Europe. Concern over residual toxic or allergenic agents has encouraged the search for other practical methods to disinfect or sterilize used hemodialyzers. The use of moist heat has been ...
journal_title:Blood purification
pub_type:
doi:10.1159/000170132
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND/AIM:The relationship between body mass index (BMI) and intradialytic hypotension (IDH) has been inconsistently reported, but no further research has investigated the correlation between body composition and IDH so far. This study aimed to determine whether the lean tissue index (LTI), fat tissue index (FTI),...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000504245
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMM...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000452703
更新日期:2017-01-01 00:00:00
abstract::Haemodialysis is associated with increased oxidant stress. This appears to be due to (1) an increased production of free radicals during haemodialysis, (2) a net reduction of many antioxidants and (3) factors intrinsic to the uremic state. These alterations can lead to cardiovascular disease and many of the pathologie...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000014384
更新日期:1999-01-01 00:00:00
abstract:INTRODUCTION:The coronavirus disease 2019 (COVID-19) pandemic led to increased demand nationwide for dialysis equipment, including supplies and machines. To meet the demand in our institution, our surge plan included rapid mobilization of a novel continuous renal replacement treatment (CRRT) machine named SAMI. The SAM...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000511726
更新日期:2020-11-10 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:BACKGROUND:Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000332394
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Anemia is a major complication of end-stage renal disease. Hemodialysis itself is regarded as a stimulus activating inflammation. Pro-inflammatory cytokines are able to suppress erythropoiesis. In this pilot study, we analyzed the changes in methylation status of promoters of immune response genes in cell-fr...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000356094
更新日期:2013-01-01 00:00:00
abstract::Recently, a new type of modified cellulosic membrane (Hemophan) has been made available for the first clinical trials. In contrast to cellulose acetate membranes only about 5% of the hydroxyl groups of cellulose are substituted by tertiary amino groups. Objective of the present study was to assess the compatibility pe...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169475
更新日期:1987-01-01 00:00:00
abstract::We have investigated the effect of the direction of the dialysate flow during continuous arteriovenous haemodialysis. Under similar conditions countercurrent flow was more efficient than concurrent flow in terms of both urea clearance (mean +/- SEM), 23.5 +/- 0.5 compared to 18.4 +/- 0.4 ml/min (p less than 0.001) and...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169987
更新日期:1990-01-01 00:00:00
abstract::During hemodialysis, amino acids (AA) are lost in the ultrafiltrate with consequent modification of their plasma profile. The aim of this cross-sectional study was to evaluate intradialytic changes of plasma AA levels during a single session of hemodiafiltration with endogenous reinfusion (HFR) versus acetate-free bio...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000320133
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Numerous studies have suggested a possible role for acute kidney injury (AKI) biomarkers in predicting renal recovery both before and after renal replacement therapy (RRT). However, definitions for recovery and whether to include patients dying but free of RRT may influence results. OBJECTIVES:To validate p...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000500423
更新日期:2019-01-01 00:00:00
abstract::In the last years, publications have questioned the classical dose of 35 ml/kg, but are those studies strong enough in terms of scientific power in order to change our practice? We will try to settle some recommendations for clinicians. Manipulation of dose, porosity, and combinations have yielded promising findings. ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000227282
更新日期:2009-01-01 00:00:00
abstract::Tranquilizers, analgetics and antidepressants are applied in different ranges in the treatment of patients on hemodialysis. Due to many different pharmacokinetic properties, no perfect rules for dosage in acute or chronic hemodialysis exist. Adequate applicable drugs without adaptation disregarding different states of...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169404
更新日期:1985-01-01 00:00:00
abstract::The use of bicarbonate dialysate and high-flux and reprocessed dialyzers has raised concerns about the reverse transfer of dialysate contaminants into the blood compartment. This in vitro study was performed to investigate the reverse transfer of soluble Pseudomonas aeruginosa bacterial products across a polyether sul...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014336
更新日期:1998-01-01 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:BACKGROUND:Satisfactory and noninvasive diagnostic tools for coronary artery disease (CAD) are not available in hemodialysis patients. We aimed to elucidate a reliable tool to diagnose CAD in these patients. METHODS:102 hemodialysis patients received 2D speckle-tracking echocardiography with left ventricular (LV) stra...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000323536
更新日期:2011-01-01 00:00:00
abstract::The central dialysis fluid delivery system (CDDS) has been working exclusively in Japan since 1970, a fact which proves that CDDS is useful in the multi-patient treatment with in-center regular hemodialysis. It is a cost-effective, labor-saving and time-tested system with 40 years of experience. Microbial safety is im...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000213494
更新日期:2009-01-01 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