Abstract:
BACKGROUND:Elderly patients with cardiovascular comorbidities are more likely to die before progressing to the need for undergoing hemodialysis; so deferring their predialysis vascular access (VA) surgery has been suggested. However, recent declines in cardiovascular mortality in the US population may have changed this consideration. We assessed whether there has been a parallel decrease in cardiovascular comorbidity in elderly chronic kidney disease (CKD) patients undergoing predialysis access surgery, and whether this impacted clinical outcomes after access creation and cardiovascular events after hemodialysis initiation. METHODS:We identified 3,418 elderly patients undergoing predialysis VA creation from 2004 to 2009, divided them into 3 time cohorts (2004-2005, 2006-2007 and 2008-2009), and assessed their clinical outcomes during 2 years of follow-up. RESULTS:There was a progressive decrease in patients with history of peripheral vascular disease (from 66.5 to 59.7%, p < 0.005), heart failure (from 47.0 to 35.8%, p < 0.005), and myocardial infarction (from 6.5 to 3.3%, p < 0.001) from 2004 to 2009. Death before hemodialysis decreased from 17.5 to 12.6%, survival without hemodialysis increased from 14.5 to 19.0%, and hemodialysis initiation remained constant at ∼68% (p < 0.001). The incidence of death or cardiovascular event in the first year of hemodialysis decreased from 2004-2005 to 2008-2009 (HR 0.83, 95% CI 0.69-0.99; p = 0.04). CONCLUSION:In the context of a changing population from 2004 to 2009, a progressive decrease in cardiovascular comorbidities in elderly CKD patients undergoing predialysis VA surgery was associated with a decrease in death before hemodialysis and cardiovascular events after starting hemodialysis. These insights should be translated into more thoughtful consideration as to which elderly patients should undergo predialysis access surgery.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Lee T,Thamer M,Zhang Q,Zhang Y,Allon Mdoi
10.1159/000446159subject
Has Abstractpub_date
2016-01-01 00:00:00pages
334-40issue
5eissn
0250-8095issn
1421-9670pii
000446159journal_volume
43pub_type
杂志文章abstract:BACKGROUND/AIMS:HFE protein controls iron absorption and cycling, and HFE mutations influence iron status. The aim was to evaluate the effect of the HFE genotype on the need for iron and erythropoietin in Italian hemodialysis patients. METHODS:Ninety-six prevalent patients were evaluated at the time of enrolment and p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111387
更新日期:2008-01-01 00:00:00
abstract:AIM:To study the role of the caliceal system in urine flow. METHODS:Eight patients (6 men, 2 women; mean age 42.6 +/- 7.6 years) with an upper polar renal mass (6 renal cysts; 2 hypernephromas) which did not encroach on the pelvicaliceal system were studied. After mass removal, a manometric catheter was introduced int...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013391
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Serum protein profiling patterns can reflect the pathological state of a patient and therefore may be useful for clinical diagnostics. Here, we present results from a pilot study of proteomic expression patterns in hemodialysis patients designed to evaluate the range of serum proteomic alterations in this po...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000077409
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Malnutrition-inflammation score (MIS) is a comprehensive and quantitative system to assess malnutrition-inflammation complex syndrome, and a strong correlation between MIS and morbidity/mortality in maintenance hemodialysis (MHD) patients had been demonstrated. However, there is no cut-off value of MIS to ca...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000137684
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Dietary sodium may influence cognitive function through its effects on cerebrovascular function and cerebral blood flow. METHODS:The aim of this study was to evaluate the association of dietary sodium intake with cognitive decline in community-dwelling older adults. We also evaluated the associations of die...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000486580
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Protein-energy wasting (PEW) is common and associated with poor outcome in hemodialysis patients. In hemodialysis patients, geriatric nutritional risk index (GNRI) and decoy receptor 3 (DcR3) have been shown as the nutritional and inflammatory markers, respectively. The present study aimed to assess the pred...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000366457
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Apoptosis contributes to cyclosporine (CsA)-induced renal cell death. This study tested the effects of CsA-induced endoplasmic reticulum (ER) stress on apoptotic cell death in an experimental model of chronic CsA nephropathy. METHODS:CsA (15 mg/kg per day) was given to rats for 7 or 28 days. The ER str...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000127432
更新日期:2008-01-01 00:00:00
abstract::Man-made or massive natural disasters may be followed by 'epidemics' of the muscle crush syndrome. The first descriptions of the crush syndrome were in the German-language literature following the earthquake of Messina in 1909 and World War II. On the threshold of World War II, the English-language literature was stil...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000169127
更新日期:1997-01-01 00:00:00
abstract::Collapsing glomerulopathy is a pattern of renal injury that is seen in association with human immunodeficiency virus (HIV) infection. Patients with this HIV-associated nephropathy (HIVAN) present nephrotic syndrome and rapid deterioration of the renal function. There is no proven effective therapy for HIVAN, and the m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065229
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Renal insufficiency is a well-described risk factor for perioperative morbidity and shortened survival after major vascular procedures. Due to the potential inaccuracy of serum creatinine levels alone in measuring kidney function, our aim was to determine whether estimated creatinine clearance more consisten...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000098150
更新日期:2006-01-01 00:00:00
abstract::Peritoneal sclerosis, a disorder similar to that previously identified in nonuremic patients, is being noted in peritoneal dialysis patients with increasing frequency. The etiology in dialysis patients remains unknown. An association with previous or ongoing peritoneal inflammation or irritation suggests that the inci...
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: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::There is still debate as to the preferred extracorporeal treatment modality for severe lithium intoxication. Because lithium is readily diffusable, intermittent hemodialysis is usually performed. However, this bares the risk of a post-dialysis rebound concentration and, in the case of severe lithium poisoning collapse...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013627
更新日期:2000-09-01 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::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
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 AND AIM:Robust evidence about dialyzer reuse effects on mortality is not available. Our aim was to summarize the evidence for the effectiveness of dialyzer reuse compared to single use in patients with end-stage renal disease. METHODS:We searched MEDLINE, Embase, CINAHL, SciELO, LILACS, USRDS ADR, universit...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000336532
更新日期:2012-01-01 00:00:00
abstract::Investigations of biopsy material from human kidneys with different forms of glomerulonephritis (n = 1,240) and with diabetic glomerulosclerosis (n = 406) performed in order to find changes caused by hyperperfusion of the kidney tissue gave the following results: (1) Hyperperfusion injury occurs in the different forms...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167579
更新日期:1988-01-01 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:BACKGROUND:Growth hormone (GH) resistance in CKD is partly due to increased expression of SOCS2, a GH signaling negative regulator. In SOCS2 absence, body growth is exaggerated. However, GH overexpression in mice causes glomerulosclerosis. Accordingly, we tested whether lack of SOCS2 improves body growth, but accelerat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000508224
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:Current status of primary hyperoxaluria (PH) has not been surveyed in Japan. METHODS:Japanese patients with PH were reviewed in the published literature. RESULTS:Fifty-nine patients were diagnosed as PH from 1962 to 2003. The median ages both at diagnosis and at the onset of initial symptoms were 17 (...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086361
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:Anthropometric parameters may play a role in modulating the risk of kidney dysfunction. The aim of this study was to evaluate whether anthropometric indices and the metabolic syndrome are associated with alterations of the renal resistive index (RI) in normoalbuminuric type 2 diabetic (T2DM) patients. METHOD...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000109239
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK b...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000491552
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:More than 50% of American adolescents and adults report having used illicit drugs in their lifetime. We examined the association of lifetime opiate and cocaine use with reduced kidney function, albuminuria and rapid kidney function decline among urban-dwelling adults. METHODS:Our prospective cohort included...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000452348
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:To evaluate the predictive value of dialysate interleukin-6 (IL-6) representing local subclinical intraperitoneal inflammation for the development of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS:Stable prevalent CAPD patients were enrolled in this prospective study. IL-6...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000489271
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:The present study tested the hypothesis that chronic hypoxia adversely affects renal development in the ovine fetus. METHODS:Kidneys were collected from near-term fetuses of pregnant ewes maintained at sea level or high altitude (3,801 m, PaO(2): approx. 60 mm Hg) for 110 days (n = 6 for each group). ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000259901
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics. METHODS:Arterial vascular properties were qua...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000110091
更新日期:2008-01-01 00:00:00
abstract::During the period from April 4, 1988, to April 20, 1988, nine pyrogenic reactions and five gram-negative bacteremias occurred in 11 patients undergoing dialysis. All pyrogenic reactions and gram-negative bacteremias occurred among patients in whom a reprocessed dialyzer was used. The rate of pyrogenic reactions or bac...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168155
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND/AIM:Slc26a6 (PAT1, CFEX) is a major chloride/base exchanger located on the apical membrane of the kidney proximal tubule. The purpose of the present study was to examine the effect of Slc26a6 deletion on the apical Na+/H+ exchanger 3 (NHE3) in the straight segment (S3) of the proximal tubule, which is the ma...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111826
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Hyperkalemia is common in patients receiving maintenance hemodialysis. However, few studies have examined the association between serum potassium level and mortality. METHODS:This study used annual cohorts of hemodialysis patients during 2007-2010. To determine hyperkalemia prevalence, monthly hyperkalemia ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000448341
更新日期:2016-01-01 00:00:00