Abstract:
:On September 11, 1945, Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI). The ingenious design of the first dialysis machine, made of cellophane tubing wrapped around a cylinder that rotated in a bath of fluid, together with the brave determination to treat patients with AKI, enabled the Dutch physician W.J. Kolff to save the life of the 67-year-old woman. By treating her for 690 minutes (i.e., 11.5 hours) with a blood flow rate of 116 ml/min, Kolff also set the coordinates of a renal replacement therapy that has enjoyed an unsurpassed renaissance over the last decade for treatment of severely ill patients with AKI in the intensive care unit (ICU). Prolonged dialysis time with low flow rates - these days, called extended dialysis (ED) - combines several advantages of both intermittent and continuous techniques, which makes it an ideal treatment method for ICU patients with AKI. This review summarizes our knowledge of this method, which is increasingly used in many centers worldwide. We reflect on prospective controlled studies in critically ill patients that have documented that small-solute clearance with ED is comparable with that of intermittent hemodialysis and continuous venovenous hemofiltration, as well as on studies showing that patients' cardiovascular stability during ED is similar to that with continuous renal replacement therapy. Furthermore, we report on logistic and economic advantages of this method. We share our view on how extended dialysis offers ample opportunity for a collaborative interaction between nephrologists and intensivists as the nephrology staff, enabling optimal treatment of complex critically ill patients by using the skill and knowledge of 2 indispensable specialties in the ICU. Lastly, we address the problem of ED intensity, which does not seem to have an impact on survival at higher doses, a finding that might be caused by the fact that we still adhere to dosing guidelines for antibiotics which are at best ineffectual but might also lead to potentially dangerous underdosing of these life-saving drugs.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Kielstein JT,Schiffer M,Hafer Csubject
Has Abstractpub_date
2010-09-01 00:00:00pages
494-501issue
5eissn
1121-8428issn
1724-6059pii
C2A198D8-AFD6-4BC5-939B-263E5855162Ajournal_volume
23pub_type
杂志文章,评审abstract::The relevance of the Salerno Medical School is examined through the contributions of Magister Maurus, Alfano I, Giovanni Plateario, Giovanni Afflacio, Bartolomeo and Urso of Calabria. An unpublished treatise on De Urinis in middlelatin and Italian volgare is introduced here for the first time by discussing the lapis o...
journal_title:Journal of nephrology
pub_type: 历史文章,杂志文章
doi:
更新日期:2004-03-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal pa...
journal_title:Journal of nephrology
pub_type: 杂志文章,实务指引
doi:10.1007/s40620-018-0523-1
更新日期:2018-10-01 00:00:00
abstract::The widely differing functions of vitamin D are based both on a wide diffusion of its specific receptor (VDR) and on the ability of many cells, in addition to renal tubular cells, to synthesize calcitriol for autocrine and paracrine functions. In the last few years, many published studies have added new insights into ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/JN.2011.7767
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:IgA nephropathy is one of the most common primary glomerulonephritides, and the clinical course of almost 40% of the patients progresses to end-stage renal disease (ESRD) within 20 years. Angiotensin-converting enzyme (ACE) inhibitors and/ or angiotensin II receptor blockers (ARBs) induce a marked renoprotec...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:No study has evaluated the efficacy of non-calcium-containing phosphate binders in slowing progression of cardiac valve calcification or deterioration of kidney function in patients with chronic kidney disease not on dialysis. This study addressed these issues. METHODS:Outpatients (n = 170) with stage 3-4 c...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000290
更新日期:2013-07-01 00:00:00
abstract::Some antihypertensive drugs may have a renoprotective effect, that is partially independent of their ability to reduce blood pressure. ACE-inhibitors are safe and effective agents that are capable of reducing proteinuria and preventing CRF progression. The results of the AIPRI extension study suggest that they may als...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Cell-free DNA (cfDNA) is present in the peritoneal effluent of stable peritoneal dialysis (PD) patients, but there are no data on cfDNA in PD patients with peritonitis. We investigated the variation of peritoneal cfDNA levels subsequent to peritonitis in PD patients. METHODS:We enrolled 53 PD patients: 30 w...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-015-0212-2
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:Mutations of the AGXT gene encoding the alanine:glyoxylate aminotransferase liver enzyme (AGT) cause primary hyperoxaluria type 1 (PH1). Here we report a molecular modeling study of selected missense AGXT mutations: the common Gly170Arg and the recently described Gly47Arg and Ser81Leu variants, predicted t...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-11-01 00:00:00
abstract::Rapidly progressive glomerulonephritis (RPGN) is a rare occurrence in IgA nephropathy (IgAN) in renal transplant patients on immunosuppressive therapy. RPGN post ischemia-reperfusion has not been previously reported. We report a 62 year old male patient on azathioprine therapy, 9 years after left cadaveric renal trans...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:The aim of this work was to investigate the benefit of basiliximab induction therapy in living-related-donor kidney transplantation. METHODS:One hundred adult recipients of a first kidney allograft were randomized into two treatment groups, one to receive basiliximab and the second as a control. All patient...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-05-01 00:00:00
abstract::We report a unusual case of idiopathic nodular glomerulosclerosis mimicking changes that develop in diabetic nephropathy. A 66-year-old non-diabetic female developed nephrotic range proteinuria and the work up was unremarkable. Light and electron microscopy showed mesangial expansion with Kimmelsteil-Wilson nodules an...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is an important risk factor for all-cause mortality. In the general population, physical activity is associated with reduced mortality. We examined the association of level of physical activity with mortality in patients with predominantly nondiabetic CKD stage 3-4. METHODS:We s...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2008-03-01 00:00:00
abstract::The combination of hypomagnesemia and hypocalciuria is the phenotypic signature of two distinct genetic renal tubular transport disorders: Gitelman's syndrome and autosomal dominant isolated renal magnesium wasting. In the past 5 years the genetic defects underlying these disorders have been elucidated through positio...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-01 00:00:00
abstract::One of the central functions of the kidney is to excrete low molecular weight, water soluble, plasma, waste products into the urine, whereas macromolecules, the size of albumin and larger, are retained. The flow of the glomerular filtrate is thought to follow an extracellular route, passing through the endothelial fen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Malnutrition is common and associated with poor outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Recently, the geriatric nutritional risk index (GNRI) was reported as a novel tool for evaluating nutritional status. However, the association between GNRI and renal outc...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-019-00676-1
更新日期:2020-08-01 00:00:00
abstract::Influenza is a commonly encountered and serious pathogen. Patients with end-stage renal disease are more susceptible to serious morbidity and mortality associated with influenza infection. Proper management of patients includes: vaccination, monitoring for symptoms and isolation of potentially infected patients as wel...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0407-9
更新日期:2018-04-01 00:00:00
abstract::Although several in vitro studies and clinical observations suggest that ACE-inhibitors (ACE-I) are a promising treatment for IgA nephropathy (IgAN), meta-analysis of published data is not yet conclusive. Therefore, a European double-blinded, prospective, randomized therapeutic trial was designed to evaluate ACE-I tre...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:In older patients with chronic kidney disease (CKD), the risk of progression to end stage renal disease and cardiovascular death both differ compared to younger patients. This likely reflects differences in case mix and co-morbid burdens. We sought to establish the extent to which age itself is an independen...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0529-8
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:A sensitive, feasible and reproducible marker for renal function is necessary to evaluate the clinical efficacy of enzyme replacement therapy (ERT) in Fabry nephropathy. Serum creatinine has some limitations and cystatin C has been proposed, in other nephropathies, as a useful marker of renal function. The u...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章
doi:
更新日期:2007-07-01 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::Toll-like receptors (TLRs) are a class of receptors of the innate immune system which detect pathogen-associated and danger-associated molecular patterns in order to initiate an inflammatory response. TLR2 and TLR4 downward signaling causes the production of proinflammatory cytokines that can induce insulin resistance...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0432-8
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The effect of uric acid on nocturnal dipping in hypertensive patients is unknown. We analyzed the specific relationship between uric acid and nocturnal dipping status in newly diagnosed essential hypertensive patients with normal renal function. METHODS:Two hundred fifteen patients with newly diagnosed esse...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2008-05-01 00:00:00
abstract::Preemptive isolated liver transplantation (PLTX) can cure the metabolic defect in primary hyperoxaluria type 1 (PH1) but there are no uniformally accepted recommendations concerning the timing of this transplantation procedure. We have performed PLTX successfully in 4 children (age 3-9 years) with PH1 with no mortalit...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:The ongoing necessity for systemic heparinization is a well-known disadvantage of continuous renal replacement therapies (CRRT), and alternative methods of anticoagulation may be required. Our aim was to evaluate, in patients with a high risk of bleeding, the possibility of an acceptable filter life with non...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:INTRODUCTION:Post-transplant malignancies are among the most important complications in organ transplantation. Hemangioblastoma (HB) is especially prevalent in the cerebellum. CASE REPORT:A 20-year-old male who first started dialysis therapy, and then underwent kidney transplantation from a living-relative donor. Five...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract::This review focuses on a series of risk factors involved in the pathogenesis of cardiovascular complications in patients undergoing Regular Dialysis Treatment (RDT). Many of them are not modifiable by any pharmacological strategies or dialysis therapy, others - such as phosphate overload - can be corrected successfull...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2006-01-01 00:00:00
abstract::End-stage renal disease (ESRD) is a significant global health problem that places a considerable burden on health care resources. The leading cause of death in ESRD patients is cardiovascular disease, which is often preceded by changes in cardiac geometry, including left ventricular hypertrophy (LVH). Treatments that ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/JN.2011.8422
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Different mitogens are involved in the pathogenesis of kidney damage after subtotal nephrectomy. One of them, TGF-beta, controls mesangial cell proliferation and interstitial fibrosclerosis. The transduction of the TGF-beta signal is controlled by intracellular signalling molecules such as Ras G monomeric pr...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::The kidney does not usually present specific lesions in cystic fibrosis (CF), although in recent years renal involvement has been reported, particularly amyloidosis and immune complex glomerulonephritis. IgA nephropathy is rare. We report four cases of IgA nephropathy out of five renal biopsies performed in the last t...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::The clinical manifestations of diabetic nephropathy are similar in type 1 and type 2 diabetes, while the renal lesions may differ. Indeed, diabetic glomerulopathy is the predominant renal lesion in type 1 diabetes, although also tubular, interstitial and arteriolar lesions are present in the advanced stages of renal d...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-020-00797-y
更新日期:2020-10-01 00:00:00