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: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::The treatment of the bleeding diathesis of renal failure remains unsatisfactory. 1-Deamino-8-D-arginine vasopressin (DDAVP) has recently been shown to shorten the prolonged bleeding time of renal failure and may as a result diminish the risk of clinical hemorrhage. We describe 2 cases where DDAVP was used successfully...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166773
更新日期:1984-01-01 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/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::John Bostock has a reasonable claim to being one of the first chemical pathologists. Most of his work was done before that of William Prout, with whom both he and Bright were in contact. Bostock's work was done about the same time as that of his friends and colleagues Marcet and Wollaston. Although other, notably Crui...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000168749
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND/AIMS:Previous studies have shown that L-type Ca2+ channel (LCC) blockers prevent the afferent arteriolar (AA) vasoconstriction elicited by angiotensin II (Ang II), but do not influence its vasoconstrictor effect on efferent arterioles (EA). The present study tested the hypothesis that Ang II-mediated constri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000082946
更新日期:2004-11-01 00:00:00
abstract::In 1828, Friedrich Wöhler, a German physician and chemist by training, published a paper that describes the formation of urea, known since 1773 to be a major component of mammalian urine, by combining cyanic acid and ammonium in vitro. In these experiments the synthesis of an organic compound from two inorganic molecu...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013463
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:2009 influenza A has spread globally. Respiratory complications and renal failure have been the leading causes for hospitalization and critical illness. We describe the risk factors and complications of acute kidney injury (AKI) in patients with influenza A. METHODS:Observational study of adult patients tes...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000328386
更新日期:2011-01-01 00:00:00
abstract::A variety of histologic changes have been observed in the kidneys of patients with light-chain deposition disease. We report 3 cases with kappa light chain deposition who presented with diverse clinical, histological, and ultrastructural features. All the cases were diagnosed by the presence of monoclonal kappa light ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167600
更新日期:1988-01-01 00:00:00
abstract::Ion-selective electrodes have been designed for determining the ionized concentration of magnesium in blood, the biologically active form of this ion. The effect of acute acidosis induced by ammonium loading on circulating and urinary magnesium was investigated in 11 volunteers. No changes in plasma total and ionized ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013342
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The impact of socioeconomic factors on arteriovenous fistula (AVF) creation in hemodialysis (HD) patients is not well understood. We assessed the association of area and individual-level indicators of poverty and health care insurance on AVF use among incident end-stage renal disease (ESRD) patients initiate...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000441804
更新日期:2015-01-01 00:00:00
abstract::Two patients are reported who presented within the first 3 months posttransplantation with acute bone pain where serial magnetic resonance imaging (MRI) allowed differentiation between bone edema, which resolved spontaneously, and avascular necrosis (AVN) requiring core decompression. Case 1 had ill-defined images con...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013305
更新日期:1998-01-01 00:00:00
abstract::Tuberculosis associated with dialysis was studied at the Artificial Kidney Unit (AKU) in Abha, Saudi Arabia. There were 13 tuberculosis patients out of 270 patients on maintenance hemodialysis from August 1986 to July 1993, a prevalence of 4.8%. Ten (77%) were female and 3 (23%) were male, mean age of 51.23 +/- 11.62 ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169068
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND/AIMS:Evaluation of the risk factors, and phenotype-genotype correlation of familial Mediterranean fever (FMF) gene (MEFV) and serum amyloid A1 (SAA1) gene polymorphisms in renal amyloidosis. METHODS:We investigated MEFV and SAA1 genotypes (alpha, beta, and gamma isoforms) in 50 FMF patients and 50 healthy c...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000087824
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient satisfaction during the HDVW. METHODS:The HDVW was a multicenter single...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000503439
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cisplatin (CIS) induces nephrotoxicity partly through renal vasoconstriction and decreased glomerular filtration effects thought to involve adenosine acting on adenosine A(1) receptors (A1Rs). We studied the effect of the orally active, A1R antagonist tonapofylline (BG9928) on biochemical measures of re...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000248762
更新日期:2009-01-01 00:00:00
abstract::The purpose of our study was to investigate the feasibility of using lactate as a complete or partial substitute for acetate in hemodialysis solutions. Six patients, each serving as his own control, were dialyzed once against a dialysis solution containing 40 mM acetate, once against a dialysis solution containing 40 ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000167515
更新日期:1987-01-01 00:00:00
abstract::The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the co...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168491
更新日期:1992-01-01 00:00:00
abstract::In general, nonrheumatic atrial fibrillation is associated with a high risk of stroke. However, its impact on stroke in the setting of chronic hemodialysis treatment is insufficiently addressed in the literature. We assessed the incidence of stroke among 430 chronic hemodialysis patients and the impact of atrial fibri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046216
更新日期:2001-01-01 00:00:00
abstract::Skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046263
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:The prognostic value of the anti-neutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis (GN) classification has been demonstrated in several cohorts with sclerotic class having the worst renal outcome. Relevant published data on factors predicting outcomes in sclerotic ANCA GN is limited. METH...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.1159/000494840
更新日期:2018-01-01 00:00:00
abstract::Autopsy reports on 155 successive end-stage renal disease (ESRD) patients and 147 control patients without ESRD, matched for age, race and gender, were collected. Cystic transformation of the kidneys was noted in 58% of the ESRD patients and 13.6% of the control patients. There were 25 ESRD patients with renal adenoma...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167988
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:The objective of this study was to investigate the role of bone morphogenetic protein (BMP) signal transduction in the pathogenesis of calciphylaxis. METHODS:Skin biopsy specimens were obtained from 18 patients with, and 12 patients without, calciphylaxis. Tissue sections were stained with antibodies direct...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000484418
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:African Americans (AAs) suffer the widest gaps in chronic kidney disease (CKD) outcomes compared to Caucasian Americans (CAs) and this is because of the disparities that exist in both health and healthcare. In fact, the prevalence of CKD is 3.5 times higher in AAs compared to CAs. The disparities exist at al...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000479481
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Hepcidin synthesis in hepatocytes is modulated in response to anemia, hypoxia or inflammation. A cross-sectional study was performed to assess hepcidin correlations with markers of iron status, erythropoietin therapy and markers of inflammation in hemodialyzed patients and in the healthy volunteers. METHODS...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000089266
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND/AIMS:There is a critical need for more noninvasive biomarkers to identify nephritis in patients with systemic lupus erythematosus (SLE). Recent studies in a model mouse and an adult SLE patient cohort suggest that anti-basement membrane antibody levels correlate well with lupus activity and kidney injury. Th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000381965
更新日期:2015-01-01 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::Renal disease is a common complication in malaria infection. In acute falciparum malaria renal involvement is usually mild, but in severe disease acute renal failure is a major problem. Acute renal failure has been attributed to ischaemic tubular necrosis from hypovolaemia resulting from vasodilatation due to endothel...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013611
更新日期:2000-07-01 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:The outcome-predictability of baseline and instantaneously changing serum calcium in hemodialysis patients has been examined. We investigated the mortality-predictability of time-averaged calcium values to reflect the 'cumulative' effect of calcium burden over time. METHODS:We employed a Cox model using up-...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000319861
更新日期:2010-01-01 00:00:00