Abstract:
:The number of geriatric patients on dialysis is increasing. This is due to demographic factors, a wider acceptance of elderly patients on dialysis, and an earlier start of dialysis in this patient group. Recent studies have questioned the effect of dialysis on quality of life in elderly patients with severe comorbidity and showed limited survival in this specific patient group. Therefore, the decision whether or not to start dialysis may be a difficult one for both the clinician and patient. Risk scores can be of help in facilitating shared decision making, but not as a tool to withhold dialysis. However, in the elderly patient with severe comorbidity, conservative care can sometimes be a reasonable alternative to dialysis. In the process of shared decision making, a balance should be pursued between life expectancy and quality of life. If the decision to initiate dialysis is taken, choices have to be made regarding dialysis modality and treatment prescription. If adequate support is provided, assisted peritoneal dialysis can be an acceptable alternative to hemodialysis. Care for the elderly with end-stage renal disease should be undertaken by a multidisciplinary team with special dedication to a multidimensional approach in this population.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Kooman JP,Cornelis T,van der Sande FM,Leunissen KMdoi
10.1159/000334153subject
Has Abstractpub_date
2012-01-01 00:00:00pages
171-6issue
1-3eissn
0253-5068issn
1421-9735pii
000334153journal_volume
33pub_type
杂志文章,评审abstract:BACKGROUND:Renal medullary hypoxia precedes the development of acute kidney injury in experimental sepsis and can now be assessed by continuous measurement of urinary oxygen tension (PuO2). OBJECTIVES:We aimed to test if PuO2 measurements in patients with septic shock would be similar to those shown in experimental se...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000501512
更新日期:2019-01-01 00:00:00
abstract::The present working hypothesis regarding adequacy issues in peritoneal dialysis is that dialysis is a major determinant of protein intake and therefore nutritional status in these patients. Present data however is controversial. This is in part due to differences in methodology and the calculations used for the data p...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170201
更新日期:1995-01-01 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: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::While the optimal vascular conduit for hemodialysis is undeniably an arterialized autogenous subcutaneous vein, only a minority of end-stage renal disease patients can count on such access: the remainder require implantation of a biomaterial conduit. This paper will briefly survey current biografts used for hemodialys...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170148
更新日期:1994-01-01 00:00:00
abstract::At present the treatment of hepatitis C virus infection (HCV) has improved because of combined treatment with interferon (IFN) and ribavirin. The association of these two drugs has obtained a positive response in 40-50% of naive patients treated. Patients with relapse after monotherapy with IFN also show positive resp...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000046996
更新日期:2002-01-01 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...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000266483
更新日期:2010-01-01 00:00:00
abstract::Medicare pays 80% of the cost of dialysis treatment and associated medications. Congress directed the Centers for Medicare and Medicaid Services (CMS) to develop both a process of regular and more or less "automatic" updates of composite rate setting and "bundling" as much of the laboratory and ancillary medications a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096390
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Omni® (B. Braun, Germany) is a new-generation, continuous renal replacement therapy (CRRT) machine designed to improve user interface, minimize downtime and optimize renal dose delivery. It was never tested in humans. METHODS:We used Omni® to provide CRRT in 10 critically ill patients. We collected therapy ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000451053
更新日期:2017-01-01 00:00:00
abstract::The biological processes governing vascular endothelial cell health are complex and highly redundant. The mechanisms involved in cell injury and repair remain an area of intense study. This paper attempts to review current knowledge regarding hormones such as vitamin D, erythropoietin and aldosterone within the contex...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000089436
更新日期:2006-01-01 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::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:The incidence of central venous catheter-related bloodstream infection (CRBSI) for continuous renal replacement therapy (CRRT) in kidney intensive care unit (ICU) patients is worthy of particular attention and recently, we analyzed clinical characteristics and risk factors of CRBSI for CRRT in our kidney ICU...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000495024
更新日期:2019-01-01 00:00:00
abstract::A 50-year-old man with the rare McLeod syndrome, associated with glomerular lesion to the end stage of chronic renal failure and death, is reported. McLeod syndrome is an X-linked recessive disorder on the basis of abnormal expression of the Kell blood group antigens and absence of erythrocyte surface Kx antigen. Most...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014353
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:Japan's aging population has prominent epidemiological and patient characteristics. The number of hemodialysis patients aged ≥70 years is increasing. Age-adjusted mortality is improving, but some cause-specific mortalities remain unchanged, including infectious disease and malignancy, requiring combativ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000496660
更新日期:2019-01-01 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:Dyslipidemia is a common metabolic complication in patients with chronic kidney disease and is detected as changes in lipoprotein concentrations in serum. SUMMARY:Recently, other features of lipid abnormalities have been described, such as alterations in serum n-3 polyunsaturated fatty acids, cholesterol me...
journal_title:Blood purification
pub_type: 评论,杂志文章
doi:10.1159/000441581
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. METHODS:We studied 210 prevalent CHD of 5 hemodialys...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000492919
更新日期:2019-01-01 00:00:00
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 gui...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000110568
更新日期:2008-01-01 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:AIMS:The aim of the study was to clarify the relationship between serum ferritin and infectious risks. METHODS:We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. RESULTS:Kaplan-Meier analys...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000445424
更新日期:2016-01-01 00:00:00
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 ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000078699
更新日期:2004-01-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline fo...
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
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:AIMS:This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. METHODS:A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-d...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000474931
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified. AIMS:Gain a better understanding of the association between hemodialysis (HD)-rela...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000368980
更新日期:2015-01-01 00:00:00
abstract::The study was made in vitro of reactions elicited by contact of granulocytes suspended in autologous plasma with three polymers: polyacrylonitrile (AN); polyetherpoly-carbonate (PC), and regenerated cellulose (Cu). Alterations in basal metabolism and biological function of the human blood granulocytes induced by inter...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170015
更新日期:1991-01-01 00:00:00
abstract::The greatest benefit of PD ist the continuous maintenance of a stable electrolyte and acid-base balance, as well as a continuous solute, sodium and water removal. Moreover, PD is effective in preserving residual renal function (RRF). However, when RRF declines, complications will occur if not compensated for by an inc...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000081871
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:This study was aimed at evaluating the efficacy and safety of regional citrate anticoagulation (RCA) versus no-anticoagulation continuous venovenous hemofiltration (CVVH) in acute severe hypernatremia patients with increased bleeding risk. MATERIALS AND METHODS:Acute severe hypernatremia patients with high ble...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000502937
更新日期:2020-01-01 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