Abstract:
BACKGROUND:We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could influence survival in a cohort of prevalent HD patients, controlled for multiple dialysis and clinical risk factors and followed for 3 years. METHODS:One hundred and eighty-two patients (117 men, age 65 ± 13 years) on regular HD treatment for at least 6 months [median 48 months (range: 6-366)] were followed from January 1, 2008 to December 31, 2010. Eighty-four patients (46%) did not achieve their prescribed dry body weight (dBW); their median edOW was 0.4 kg (range: 0.1-1.4). Ninety-eight died during observation, mainly from cardiovascular reasons (69%). Multivariate Cox regression analysis was utilized to evaluate the effect edOW, ultrafiltration rate (UFR), interdialytic weight gain (IDWG), age, sex, dialytic vintage, cardiovascular disease, antihypertensive therapy, diabetes, duration of HD, dBW, BMI, mean arterial blood pressure, Kt/V, and protein catabolic rate (PCRn) had on mortality. RESULTS:Age (HR: 1.04; CI: 1.03-1.05; p <0.0001), IDWG (HR: 2.62; CI: 2.06-3.34; p < 0.01), UFR (HR: 1.13; CI: 1.09-1.16; p< 0.01), PCRn (HR: 0.02; CI: 0.01-0.04; p <0.001), and edOW (HR: 2.71; CI: 1.95-3.75; p < 0.02) were independently correlated to survival. The relative receiver operating characteristic curve identified a cutoff value of 0.3 kg for edOW in predicting death. CONCLUSIONS:High edOW is independently associated with an increased long-term risk of all-cause and cardiovascular mortality in HD patients. Better survival was observed in patients with edOW <0.3 kg. For patients with higher edOW, longer or more frequent dialysis sessions should be considered in order to prevent the deleterious consequences of excessive body fluid expansion.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Movilli E,Camerini C,Gaggia P,Zubani R,Feller P,Poiatti P,Pola A,Carli O,Cancarini Gdoi
10.1159/000349931subject
Has Abstractpub_date
2013-01-01 00:00:00pages
370-7issue
4eissn
0250-8095issn
1421-9670pii
000349931journal_volume
37pub_type
杂志文章abstract::A comparative clinicopathological study was retrospectively performed in 61 children and 51 adults with IgA nephropathy. Hematuria and/or proteinuria as a chance finding was the most common initial clinical sign, being observed in 82.0% of the children and in 52.9% of the adults. At renal biopsy, hypertension and seve...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168080
更新日期:1990-01-01 00:00:00
abstract::To determine the effect of multiple dialyzer use on intradialytic symptoms, data from 26,592 successive dialyses on 147 patients were analyzed. Over the 26-month period of study 4,933 new dialyzers were used. All symptoms, considered together, occurred 1.3 times more frequently during the initial than during the subse...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167063
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HD patients, we conducted a meta-analysis of the pub...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000368722
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Fatigue is an important symptom to patients with advanced chronic kidney disease (CKD). The aim of this study is to examine the prevalence and severity of fatigue among non-dialysis-dependent CKD and end-stage renal disease (ESRD) patients, to examine the association of fatigue with subjective and objective ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000356939
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Oxidative stress and inflammation are known to play central roles in the development of diabetic nephropathy (DN). Febuxostat is a novel non-purine xanthine oxidase (XO)-specific inhibitor developed to treat hyperuricemia. In this study, we investigated whether febuxostat could ameliorate DN via renoprotecti...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000363421
更新日期:2014-01-01 00:00:00
abstract::The great Spanish military and orthopedic surgeon J. Trueta gained his field and clinical experience in the Spanish civil war (1936-1939) and in Britain during World War II. As part of his major contribution to traumatology, he searched for the causes of the characteristic oliguria of combat casualties. For this purpo...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013473
更新日期:1999-01-01 00:00:00
abstract:INTRODUCTION:Evidence using real-world data is sparse regarding the effects of oral anticoagulants (OACs) among patients with kidney disease. The aim of this study was to investigate the effects of kidney disease on ischemic stroke (IS) or systemic embolism (SE) among patients taking OAC, using large-scale real-world d...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000509567
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:Vitamin D insufficiency drives secondary hyperparathyroidism (SHPT) and is associated with increased cardiovascular mortality in patients with chronic kidney disease (CKD). SHPT is poorly addressed by current vitamin D repletion options. The present study evaluated a novel investigational vitamin D repl...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000369939
更新日期:2014-01-01 00:00:00
abstract::We have compared the renal effects of ioxitalamate, ioxaglate, and iopamidol in patients with chronic renal failure. Sixty consecutive patients with an estimated creatinine clearance (ECRCl) less than 60 ml/min were randomly assigned to receive either ioxitalamate, iopamidol, or ioxaglate. All patients received 500 cm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168328
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND/AIMS:A recent study suggests that inflammation and malnutrition are strongly associated with cardiovascular disease in dialysis patients. Endothelial lipase (EL) is a newly cloned physiological regulator of high-density lipoprotein cholesterol (HDL), which is associated with the progression of atherosclerosi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000144025
更新日期:2008-01-01 00:00:00
abstract::Obese Zucker rats spontaneously develop lipoprotein abnormalities, proteinuria, mesangial expansion and glomerulosclerosis. Previous studies have implicated these lipoprotein abnormalities in the pathogenesis of the progressive renal injury which these rats develop. The present study was designed to examine the chrono...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168588
更新日期:1993-01-01 00:00:00
abstract::Serum levels of vitamin A (VA) were measured in 71 hemodialysis (HD) patients and in 30 normal controls. 65 of the 71 patients were taking multivitamin preparations (MP) containing VA. The HD patients had significantly greater values: 7.81 +/- 2.86 mumol/l (224 +/- 82 micrograms/dl) versus 3.97 +/- 0.97 mumol/l (114 +...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167486
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Telomere attrition is a novel risk factor for cardiovascular disease. Studies of telomere length in relation to kidney function are limited. We explored the association of kidney function with telomere length and telomere shortening. METHODS:The Heart and Soul Study is a longitudinal study of patients with ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000343495
更新日期:2012-01-01 00:00:00
abstract::Atherosclerotic diseases (ASD) are the major cause of mortality and morbidity in patients on hemodialysis (HD). To evaluate the significance and usefulness of atherogenic indices, we examined lipoprotein(a) (Lp(a)), remnant-like particles cholesterol (RLP.C), homocysteine (Hcy), cardiac troponin T (TnT), and ankle-arm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013566
更新日期:2000-03-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013487
更新日期:1999-01-01 00:00:00
abstract::Whole plasma from 6 normolipidemic chronic renal failure (CRF) patients undergoing hemodialysis treatment was passed through the anti-apolipoprotein (Apo) AI immunosorbent column connected to the anti-Apo B immunoaffinity column. Apo AI and B containing particles were analyzed for lipid and Apo contents. The results w...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169011
更新日期:1996-01-01 00:00:00
abstract::The relationship between abnormalities in nocturnal penile tumescence (NPT) and autonomic function, measured by the Valsalva maneuver, was evaluated in 25 uremic patients and 22 normal subjects. NPT in uremic patients (45 +/- 6.8 min/night) was lower (p less than 0.01) than in normals (85 +/- 10.4 min/night). Valsalva...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166629
更新日期:1982-01-01 00:00:00
abstract::The pathogenesis of calciphylaxis, a potentially life-threatening condition, is not well understood. Several factors such as end-stage renal disease (azotemia), hyperparathyroidism, hyperphosphatemia, hypercalcemia, a high calcium-phosphate product, and the use of steroids and cytotoxic drugs after kidney transplantat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169021
更新日期:1996-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000320755
更新日期:2010-01-01 00:00:00
abstract::Extraskeletal tumoral calcinosis occur in uremic patients with high calcium phosphorus (Ca x P) product and progressive secondary hyperparathyroidism. However, cases are also described in which this association cannot be confirmed. The influence of aluminum, vitamins D and K, alkalosis, magnesium and local lesions is ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169078
更新日期:1997-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000489703
更新日期:2018-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166799
更新日期:1984-01-01 00:00:00
abstract::The glomerular ultrastructure was retrospectively reviewed from 45 renal transplant biopsies with the clinical and light microscopic diagnosis of acute rejection (25 cases) and chronic rejection (20 cases). Three grades of morphologic alteration were ultrastructurally defined. In acute rejection, capillary lumenal obl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166725
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND/AIMS:Advanced glycation end products (AGEs) induce epithelial mesenchymal transition (EMT) in renal proximal tubular epithelial cells (PTECs) by promoting the two EMT regulators, transforming growth factor beta (TGF-β) and connective tissue growth factor (CTGF). However, the exact signaling mechanism remains...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000381464
更新日期:2015-01-01 00:00:00
abstract::Acute hyperammonemia is an emergent cause of central nervous system dysfunction for which renal replacement therapy is advocated. We report the successful use of continuous venovenous hemodiafiltration in this metabolic emergency, and report the calculated ammonia clearances for both continuous venovenous hemofiltrati...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013400
更新日期:1998-01-01 00:00:00
abstract::Hepatic dysfunction was observed in 34 patients with nontraumatic rhabdomyolysis. The serum levels of lactic dehydrogenase were markedly elevated in all patients. The peak values occurred within 72 h of hospitalization. There was no significant difference among patients with (9,044 +/- 1,154 U/l) and without acute ren...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168053
更新日期:1990-01-01 00:00:00
abstract::A quantitative scoring method was designed to assess the extent of muscle damage. Technetium-99m pyrophosphate (99mTc-PYP) scintigraphy was performed for 9 patients experiencing crush injury in the Chichi (Taiwan) earthquake. The magnitude of muscle uptake of 99mTc-PYP was graded as follows: grade 0, less than bone ra...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046249
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND/AIM:Although clinical and immunological findings in steroid-sensitive nephrotic syndrome (SSNS) favor an immunopathogenesis, many issues remain unsolved. Comprehensive studies analyzing cellular and humoral immunity in SSNS are scarce, and few studies addressed the effect of steroids on immunological factors...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085357
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Insufficient evidenced-based information is available for the treatment of osteoporosis in hemodialysis (HD) patients. METHODS:In 102 HD patients, bone mineral density (BMD) was measured twice 16 ± 3 months apart. In the second BMD measurement 66 of them had a femoral neck (FN) T-score <-2.5. Of these 66 pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341864
更新日期:2012-01-01 00:00:00
abstract::Angiotensin-converting enzyme (ACE) inhibitor therapy has recently been shown to be effective in the treatment of post-renal transplant erythrocytosis (PTE). In an attempt to assess the effect of drug treatment on serum erythropoietin level, glomerular filtration rate, and urinary protein excretion, we prospectively e...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168856
更新日期:1995-01-01 00:00:00