Abstract:
:Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant interest over the last decade with treatments that focus on clinical criteria rather than prespecified Kt/Vurea targets. Incremental peritoneal dialysis (PD) has traditionally focused on the sum of residual renal and peritoneal clearances to achieve a specific Kt/Vurea value. Gradual increases in the PD dose were prescribed as the residual kidney function declined. Adopting a new approach to incremental PD similar to what has been done for incremental HD would obviate the need for Kt/Vurea and focus exclusively on clinical criteria. New incremental PD may be considered less disruptive to incident dialysis patients, and may be more likely to be accepted as treatment. It will also reduce our obsession with small solute kinetics and enhance encounters with patients by focusing instead on the holisitc clinical assessment.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Auguste BL,Bargman JMdoi
10.1111/sdi.12712subject
Has Abstractpub_date
2018-09-01 00:00:00pages
445-448issue
5eissn
0894-0959issn
1525-139Xjournal_volume
31pub_type
社论abstract::Home hemodialysis is not a new therapy; rather it is a therapy in which interest has been rekindled due to both the continually growing end-stage renal disease population and concern about poor outcomes in patients on conventional thrice-weekly in-center dialysis. The practical issues to be considered when starting a ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00239.x
更新日期:2007-01-01 00:00:00
abstract::Hemodialysis patient outcomes are often suboptimal, with one-sixth of patients receiving an inadequate dialysis dose, one-fourth using catheters for vascular access, and more than one-half being malnourished. This review describes a four-step approach for improving dialysis patient outcomes. First, select an outcome t...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2002.00013.x
更新日期:2002-01-01 00:00:00
abstract::Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can infl...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12045
更新日期:2013-07-01 00:00:00
abstract::Hypermagnesemia is an uncommon electrolyte abnormality, due to the fact that magnesium toxicity is only seen in the setting of a massive exposure to exogenous magnesium, often in the setting of renal insufficiency. Here, we report a case of severe hypermagnesemia that resulted in complete paralysis that was secondary ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12479
更新日期:2016-05-01 00:00:00
abstract::A good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-139X.2012.01050.x
更新日期:2012-09-01 00:00:00
abstract::Depression has been documented as the most frequently encountered psychological problem in end-stage renal disease (ESRD) patients and has been correlated with both mortality and morbidity in these patients. Previous work by our group has shown that clinical depression is treatable with psychotropic medications in the...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2003.16094.x
更新日期:2003-11-01 00:00:00
abstract::Diabetes mellitus (DM) is a common and devastating disease, affecting up to 19.3 million Americans. It is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States. Diabetic patients with ESRD have a high incidence of cardiovascular disease and death. For those kidney tr...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2010.00708.x
更新日期:2010-03-01 00:00:00
abstract::Dialysis remains the predominant form of renal replacement therapy in the United States, but the optimal timing for the initiation of dialysis remains poorly defined. Not only clinical factors such as signs/symptoms of uremia, co-existing cardiovascular disease, and presence of diabetes but also key demographic charac...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12130
更新日期:2013-11-01 00:00:00
abstract::Dialysate leakage represents a major noninfectious complication of peritoneal dialysis (PD). An exit-site leak refers to the appearance of any moisture around the PD catheter identified as dialysate; however, the spectrum of dialysate leaks also includes any dialysate loss from the peritoneal cavity other than via the...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00014.x
更新日期:2001-01-01 00:00:00
abstract::Few elderly patients with end-stage renal disease (ESRD) are treated with peritoneal dialysis (PD). Among dialysis patients >or=65 years of age reported by the U.S. Renal Data System (USRDS), the percentage treated with chronic peritoneal dialysis (CPD) is lower than in any other age group. To evaluate the effectivene...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2002.00106.x
更新日期:2002-11-01 00:00:00
abstract::Catheter recirculation (CR) occurs when blood returning from the venous limb of the catheter re-enters the arterial limb of the catheter without passage through the circulation. Adequacy of dialysis is influenced by the degree of access recirculation. In this study we evaluate factors influencing the degree of dialysi...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00442.x
更新日期:2008-05-01 00:00:00
abstract::Hyperkalemia is common in patients with end-stage renal disease, and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Intravenous insulin and nebulized albuterol lower serum potassi...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00312.x
更新日期:2007-09-01 00:00:00
abstract::The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients o...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12671
更新日期:2018-03-01 00:00:00
abstract::The specialty of Nephrology, by virtue of its relationship with the dialysis procedure, is highly vulnerable to litigation. As is the case with all nephrologists, a dialysis unit medical director is not immune to medical malpractice suits, and can be held liable for any act of perceived or potential harm to any dialys...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12174
更新日期:2014-09-01 00:00:00
abstract::Many dialysis machines can compute dialyzer sodium clearances at multiple time points during a dialysis treatment using conductivity. For a given treatment, the average dialyzer sodium clearance (K), when combined with treatment time (t), and the estimated urea distribution volume (V, usually based on either anthropom...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12750
更新日期:2018-11-01 00:00:00
abstract::The 180 l of glomerular filtrate formed each day contain some 1100 g (2.5 pounds) of sodium chloride, of which only 5-10 g are excreted in the urine--95% is reabsorbed by the tubules. Some 425 g (nearly a pound) of sodium bicarbonate and 145 g of glucose are filtered, and more than 99% of both are reabsorbed. Also fil...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2010.00788.x
更新日期:2010-11-01 00:00:00
abstract::To prevent pyrogenic reactions during hemodialysis, it is recommended that bacteria and endotoxin in dialysate not exceed 100-200 colony forming units (CFU)/ml and 0.25-2 endotoxin units (EU)/ml, respectively. While these limits are adequate to prevent acute pyrogenic reactions, data are accumulating to suggest they m...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.0894-0959.2004.17617.x
更新日期:2004-11-01 00:00:00
abstract::Central vein catheters for dialysis have become an integral and unavoidable access modality for providing hemodialysis therapy despite all their major drawbacks. We report a clinical decision dilemma that every nephrologist will encounter while considering an ideal dialysis access for the steadily aging dialysis popul...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00475.x
更新日期:2009-09-01 00:00:00
abstract::This publication comments on the recently published findings of a study by Eloot et al. (cJASN, 6: 1266-1273, 2011) that evaluated the correlation between several formulae for calculating estimated GFR (eGFR) and different low molecular weight uremic toxins; eGFRs were based on serum creatinine (SCrea), cystatin C (Cy...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2011.01003.x
更新日期:2012-01-01 00:00:00
abstract::It has been nearly 100 years since the first published report of advanced glycation end products (AGEs) by the French chemist Maillard. Since then, our understanding of AGEs in diseased states has dramatically changed. Especially in the last 25 years, AGEs have been implicated in complications related to aging, neurod...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2012.01081.x
更新日期:2012-09-01 00:00:00
abstract::Dialysis-related amyloidosis (DRA) is a serious complication in long-term dialysis patients, and presents with carpal tunnel syndrome, cystic bone lesions, destructive spondylarthropathy, diffuse arthritis and periarthritis, systemic organ involvement, and dialysis-related spinal canal stenosis (DSCS). Recently a new ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00031.x
更新日期:2001-03-01 00:00:00
abstract::Treatment of thrombosed dialysis ateriovenous (AV) grafts in the radiology interventional suite requires percutaneous mechanical thrombectomy, along with angioplasty of the underlying stenotic lesion. We analyzed the anatomic reasons for unsuccessful percutaneous thrombectomy of AV grafts, and assessed the feasibility...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2007.00397.x
更新日期:2008-03-01 00:00:00
abstract::In healthy individuals, vitamin D produced in the skin or derived from nutritional sources is converted to 25-hydroxyvitamin D (25[OH]D) in the liver, and then 1,25-dihydroxyvitamin D (1,25[OH](2)D) by 1 alpha-hydroxylase in the kidney. Chronic kidney disease (CKD) is accompanied by a progressive decline in the abilit...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2010.00751.x
更新日期:2010-07-01 00:00:00
abstract::Dysfunction of arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) contribute significantly to morbidity and hospitalization in the dialysis population. Despite advances in endovascular techniques, the incidence of vascular access stenosis remains problematic. Currently, the role of endovascular stent placemen...
journal_title:Seminars in dialysis
pub_type: 杂志文章,meta分析
doi:10.1111/sdi.12314
更新日期:2015-05-01 00:00:00
abstract::Concern over the inherent inefficiency of solute removal by conventional peritoneal dialysis (PD) has led to renewed interest in continuous flow PD (CFPD). We present clinical data from two experiences with CFPD. In the first, two catheters were used to recirculate a fixed intraperitoneal volume through an external ci...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2001.00099.x
更新日期:2001-09-01 00:00:00
abstract::Parathyroidectomy (PTX) remains an important intervention for dialysis patients with poorly controlled secondary hyperparathyroidism (SHPT), though there are only retrospective and observational data that show a mortality benefit to this procedure. Potential consequences that we seek to avoid after PTX include persist...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12833
更新日期:2019-11-01 00:00:00
abstract::Nephrologists offer renal replacement therapy (RRT) to patients who are unlikely to benefit in part because of our discomfort discussing goals of care in the setting of an uncertain prognosis for a given individual. Permanent neurological impairment, terminal illness (life expectancy <6 months), medical conditions pre...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12492
更新日期:2016-07-01 00:00:00
abstract::Calcific uremic arteriolopathy (CUA) is a rare but serious life-threatening complication of CRF that manifests as painful nonhealing eschars in association with panniculitis and dermal necrosis. This condition is being increasingly recognized and reported as a contributing factor to death in dialysis patients. The pat...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00263.x
更新日期:2007-03-01 00:00:00
abstract::Obesity is a major epidemic in the general population and has added unique challenges to renal replacement therapy as choice of access, dialysis adequacy, and preparation for kidney transplantation may all be affected. There are few clinical studies on managing obese patients with end-stage renal disease (ESRD) and no...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.01017.x
更新日期:2012-05-01 00:00:00
abstract::Secondary hyperparathyroidism almost universally accompanies end-stage renal disease (ESRD). In some, but not all studies, elevated serum parathyroid hormone (PTH) concentrations are associated with increased fracture rates, cardiovascular disease, and mortality in ESRD. The serum concentration of PTH required for opt...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/sdi.12457
更新日期:2016-05-01 00:00:00