Abstract:
:Despite advancements in dialysis therapy, the subjective clinical examination still remains the standard of care in managing volume removal in chronic dialysis. While there is no definitive trial establishing that dry weight management guided by an assistive technology is superior to the clinical method, there is ample evidence that there is a need for these technologies to be developed. Mortality, cardiovascular morbidity, and sequelae of volume overload remain far too common under the current paradigm. Recent studies indicate that the mortality associated with volume overload is independent of hypertension, suggesting that if mortality is to be improved, then a measure of volume independent of blood pressure must be developed. Even when considered as an integrated whole, the clinical method is inaccurate at setting dry weight when compared to the use of assistive technologies. A recent secondary analysis of a randomized trial showed that relative plasma volume (RPV) slope is responsive to change in volume status and may be useful in guiding therapy for hypertension. The only large randomized trial to investigate the ability of an assistive technology to manage volume removal in hemodialysis patients is the Crit-Line Intradialytic Monitoring Benefit Study, which found harm associated with RPV monitoring. However, the design of this trial did not require the RPV group to actually receive this intervention. Assistive technologies offer an opportunity to improve on the subjective clinical exam for the setting of dry weight, but well designed and adequately powered clinical trials are needed.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Sinha ADdoi
10.1159/000321840subject
Has Abstractpub_date
2011-01-01 00:00:00pages
197-202issue
1-3eissn
0253-5068issn
1421-9735pii
000321840journal_volume
31pub_type
杂志文章abstract::The second law of thermodynamics applies with local exceptions to patient history and therapy interventions. Living things preserve their low level of entropy throughout time because they receive energy from their surroundings in the form of food. They gain their order at the expense of disordering the nutrients they ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000345755
更新日期:2013-01-01 00:00:00
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doi:10.1159/000218090
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journal_title:Blood purification
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doi:10.1159/000169968
更新日期:1990-01-01 00:00:00
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doi:10.1159/000503679
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Of 5 clinical trials testing dose response of continuous renal replacement therapy (CRRT) in acute kidney injury, 2 showed a benefit, 2 showed none, and 1 appeared equivocal. However, blood-membrane interactions may dominate macromolecule transport in continuous venovenous hemodiafiltration, reducing the imp...
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pub_type: 杂志文章
doi:10.1159/000266483
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000210038
更新日期:2009-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000334153
更新日期:2012-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169922
更新日期:1990-01-01 00:00:00
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journal_title:Blood purification
pub_type: 评论,杂志文章
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journal_title:Blood purification
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doi:10.1159/000066958
更新日期:2002-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000338923
更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000438821
更新日期:2015-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169976
更新日期:1990-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000316684
更新日期:2010-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000169982
更新日期:1990-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000046986
更新日期:2002-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000494584
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
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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
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000073440
更新日期:2003-01-01 00:00:00
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
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更新日期:2013-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000330337
更新日期:2011-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000321850
更新日期:2011-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096411
更新日期:2007-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000487223
更新日期:2018-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000474931
更新日期:2017-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000493521
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1988-01-01 00:00:00