Abstract:
BACKGROUND/AIMS:The elderly are the fastest growing subpopulation with end-stage renal disease. The goal of our study was to define characteristics of elderly patients who were considered ineligible for transplantation compared to those who were listed. METHODS:984 patients were referred for evaluation during a 2-year period. Records of patients ≥65 years of age (n = 123) were reviewed. Patients who were listed versus not listed were characterized. Factors associated with waitlisting were determined using standard statistical tools. RESULTS:Half of elderly transplant candidates were accepted for listing compared to 75.4% of those aged <65 years. In multivariable logistic regression, older age (OR 1.29 per year ≥65, 95% CI 1.14-1.45), coronary artery disease (OR 8.57, 95% CI 2.41-30.53), and poor mobility (OR 13.97, 95% CI 4.76-41.00) were independently associated with denial of listing. The receiver operating characteristic curve showed good discrimination for denial of listing (area under the receiver operating characteristic curve of 0.88). CONCLUSION:Elderly candidates carry a heavy burden of comorbidities and over half of those evaluated are deemed unsuitable for waitlisting. Better delineation of characteristics associated with suitability for transplant candidacy in the elderly is warranted to facilitate appropriate referrals by physicians and management of expectations in potential candidates.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Lenihan CR,Hurley MP,Tan JCdoi
10.1159/000354483subject
Has Abstractpub_date
2013-01-01 00:00:00pages
204-11issue
3eissn
0250-8095issn
1421-9670pii
000354483journal_volume
38pub_type
杂志文章abstract::Recent studies have focused attention on the possible role of zinc depletion in the pathogenesis of uremic symptoms such as dysgeusia and impotence. The present studies were undertaken to evaluate the prevalence of zinc deficiency and abnormalities of zinc metabolism in patients with end-stage renal disease. A total o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167247
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND/AIMS:Serum phosphorus levels have been associated with adverse long-term outcome in several populations, however, no prior studies evaluated short-term postoperative outcome. The present study evaluated the predictive value of phosphorus levels on 30-day outcome after vascular surgery. METHODS:The study inc...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000315856
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND/AIMS:Upregulation of transforming growth factor beta (TGF-beta)/Smad signaling has been implicated in the primary pathogenesis of renal fibrosis. The ubiquitin-proteasome pathway has an important influence on TGF-beta signaling through regulating Smad degradation. As E3 ubiquitin ligases, both Arkadia and Sm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000100518
更新日期:2007-01-01 00:00:00
abstract::Two patients who developed bilateral renal cortical necrosis as a consequence of Neisseria meningitidis infections are described: 1 patient had meningococcemia and the other had meningococcal meningitis. Both patients developed a Shwartzman-like reaction, disseminated intravascular coagulation and irreversible renal f...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168348
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Vascular calcification is seen in most patients on dialysis and is strongly associated with cardiovascular mortality. Vascular calcification is promoted by phosphate, which generally reaches higher levels in hemodialysis than in peritoneal dialysis. However, whether vascular calcification develops less in pe...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000494665
更新日期:2018-01-01 00:00:00
abstract::Awareness that sphygmomanometry is encompassed with serious limitations has led to the development of techniques that allow blood pressure (BP) to be monitored intraarterially or noninvasively during the day or over a 24-hour period. Although intraarterial BP monitoring allows an accurate evaluation of 24-hour BP mean...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167335
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Treatment of metabolic acidosis to target the higher serum bicarbonate level than guideline recommendation may downregulate muscle protein degradation and improve renal function among chronic kidney disease (CKD) patients. We conducted a study to test the effects of increased serum bicarbonate level on muscl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000504557
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:Hemodialysis treatment requires a well-functioning vascular access. Access patency is limited by the development of venous intimal hyperplasia, which predisposes to fistula stenosis and subsequent thrombosis. In animal models, the renin-angiotensin system has a major role in the development of intimal h...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000080464
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND/AIMS:Intradialytic hypotension is the most common complication of modern day haemodialysis (HD). Convective modalities, including haemodiafiltration (HDF) are reported to result in greater cardiovascular stability compared to standard HD, which has been suggested to be due to improved solute transport betwee...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349925
更新日期:2013-01-01 00:00:00
abstract::The platelet content of adenosine triphosphate (ATP), adenosine diphosphate (ADP), serotonin and ouabain-insensitive, magnesium-dependent adenosine triphosphatase (ATPase) was determined in patients with chronic renal failure, patients on chronic hemodialysis, and kidney transplant recipients. Platelet ATP content was...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166482
更新日期:1981-01-01 00:00:00
abstract::The use of Dacron cuff double-lumen permanent catheters for hemodialysis has become more common in the dialysis unit as patients await for creation or maturation of a permanent hemoaccess for various reasons. Placement of these catheters is often done by surgeons. Nephrologists skilled in the placement of temporary ce...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013425
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND/AIMS:Studies have shown that kidney injury molecule-1 (KIM-1) is upregulated in damaged renal proximal tubules. In this study, we examined KIM-1 expression in glomerular epithelial cells in diabetic glomerulopathy. METHODS:Renal histology, immunostaining and Western blot for protein level, and real-time PCR...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330187
更新日期:2011-01-01 00:00:00
abstract:PURPOSE:To explore the association between CYP3A4 and CYP3A5 gene polymorphisms and blood pressure response to amlodipine among participants from the African-American Study of Kidney Disease and Hypertension Trial randomized to amlodipine (n = 164). METHODS:Cox proportional hazards models were used to determine the ri...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000258688
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND/AIMS:Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare renal tubular disorder complicated by progressive renal failure during childhood or adolescence. Recently, causative mutations in the CLDN19 gene have been identified in FHHNC patients presenting with severe ocular involv...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330854
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:It has been demonstrated that phosphate uptake through the type III sodium-dependent phosphate co-transporter, Pit-1, induced apoptosis of aortic vascular smooth muscle cells and endothelial cells in vitro. However, the apoptotic effects of high phosphate (HP) level in human peritoneal mesothelial cells (HPM...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000329081
更新日期:2011-01-01 00:00:00
abstract::The influence of fluvastatin, a liver-selective, competitive inhibitor of the 3-hydroxymethyl-glutaryl-coenzyme A reductase, on the lipoprotein metabolism was investigated in 9 patients with nephrotic syndrome. All patients had biopsy-proven renal disease as cause of their nephrotic syndrome and exhibited severe hyper...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013504
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND/AIMS:Recent retrospective studies suggest an association of therapy with erythropoiesis-stimulating agents (ESAs) and increased mortality in renal transplant recipients (RTR). Large artery structure and function are significantly impaired in RTR which contributes to their high cardiovascular morbidity and co...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000343140
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Patients with primary hyperoxaluria (PH) overproduce oxalate which is eliminated via the kidneys. If end-stage kidney disease develops they are at high risk for systemic oxalosis, unless adequate oxalate is removed during hemodialysis (HD) to equal or exceed ongoing oxalate production. The purpose of this st...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000360624
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Kidney failure is believed to have a negative impact on cognitive function, and cognitive impairment is common among maintenance hemodialysis (HD) patients. Previous studies have shown a beneficial effect of kidney transplantation in certain cognitive tests but not across all cognitive domains assessed. But,...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330849
更新日期:2011-01-01 00:00:00
abstract::A young woman presented with nephrotic syndrome due to membranous nephropathy and a localized form of giant lymph node hyperplasia (Castleman's disease) occurring as a large intra-abdominal mass. Five months after surgical removal of the mass, only mild proteinuria persisted. Twenty months later a second kidney biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168127
更新日期:1990-01-01 00:00:00
abstract::To evaluate the determinants of rhabdomyolysis in the diabetic state, we compared biochemical and clinical features of diabetic patients with (group 1, 41 patients) and without (group 2, 36 patients) rhabdomyolysis. There was no difference in values for serum potassium, bicarbonate, phosphate and calcium between the t...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168357
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the effect of exercise on health is well established, nephrologists seldom consider physical activity in the treatment of chronic kidney disease (CKD) or CKD in the presence of diabetes mellitus (DM/CKD). The aim of the present study was to analyze the benefits of leisure-time physical activity...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000357133
更新日期:2013-01-01 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:BACKGROUND/AIMS:Insulin is synthesised as a pro-hormone with an interconnecting C-peptide, cleaved during post-translational modification. This review discusses growing evidence which indicates that C-peptide is biologically active, benefiting microvascular complications associated with diabetes. METHODS:To explore th...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000289864
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, has recently emerged as a predictor of survival and cardiovascular risk. Along with others, we have shown an independent association between PlGF and cardiovascular events in CKD patients, but not much is known ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000439187
更新日期:2015-01-01 00:00:00
abstract::To elucidate the prevalence and clinical implications of antineutrophil cytoplasmic antibody (ANCA) in lupus nephritis (LN), we examined ANCA by indirect immunofluorescence and by ELISA against antilactoferrin (anti-LF) and antimyeloperoxidase (anti-MPO) antibody. To discriminate perinuclear ANCA (pANCA) with antinucl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013557
更新日期:2000-01-01 00:00:00
abstract::Hyperkalemia is a commonly encountered problem in dialysis patients with end-stage renal disease. In this study we evaluated the effect of mineralocorticoid therapy (MCT; fludrocortisone 0.1-0.3 mg per os daily) on serum potassium of hyperkalemic end-stage renal disease patients. Consecutive monthly clinical and bioch...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168604
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Data concerning long-term mortality predictors among large, purely diabetic hemodialysis collectives are scarce. METHODS:We used data from a multicenter, prospective, randomized trial among 1,255 hemodialysis patients with type 2 diabetes mellitus (T2DM) and its observational follow-up study. The associatio...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000485842
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Hyperoxaluria may result from increased endogenous production or overabsorption of dietary oxalate in the gastrointestinal tract leading to nephrolithiasis and, in some, to oxalate nephropathy and chronic kidney disease. ALLN-177 is an oral formulation of a recombinant, oxalate specific, microbial enzyme oxa...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000448766
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Tacrolimus (FK) is currently widely used in transplant immunosuppression and the treatment of autoimmune diseases. However, FK induces nephrotoxicity which is characterized by functional and structural renal injury. The ubiquitous protein annexin A1 (ANXA1) has potent anti-inflammatory effects and protects a...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000309756
更新日期:2010-01-01 00:00:00