Abstract：
:Parenteral iron is used to restore the body's iron pool before and during erythropoiesis-stimulating agent (ESA) therapy; together these agents form the backbone of anemia management in end-stage renal disease (ESRD) patients undergoing hemodialysis. ESRD patients receiving chronic intravenous iron products, which exceed their blood loss are exposed to an increased risk of positive iron balance. Measurement of the liver iron concentration (LIC) reflects total body iron stores in patients with secondary hemosiderosis and genetic hemochromatosis. Recent studies of LIC in hemodialysis patients, measured by quantitative MRI and magnetic susceptometry, have demonstrated a high risk of iron overload in dialysis patients treated with IV iron products at doses advocated by current anemia management guidelines for dialysis patients. Liver iron overload causes increased production of hepcidin and elevated plasma levels, which can activate macrophages of atherosclerotic plaques. This mechanism may explain the results of 3 long-term epidemiological studies which showed the association of excessive IV iron doses with increased risk of cardiovascular morbidity and mortality among hemodialysis patients. A more physiological approach of iron therapy in ESRD is needed. Peritoneal dialysis patients, hemodialysis patients infected with hepatitis C virus, and hemodialysis patients with ferritin above 1000 μg/L without a concomitant inflammatory state, all require specific and cautious iron management. Two recent studies have shown that most hemodialysis patients will benefit from lower maintenance IV iron dosages; their results are applicable to American hemodialysis patients. Novel pharmacometric and economic approaches to iron therapy and anemia management are emerging which are designed to lessen the potential side effects of excessive IV iron while maintaining hemoglobin stability without an increase in ESA dosing.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Rostoker Gdoi
10.1111/sdi.12732subject
Has Abstractpub_date
2019-01-01 00:00:00pages
22-29issue
1eissn
0894-0959issn
1525-139Xjournal_volume
32pub_type
社论,评审abstract：BACKGROUND:The aim of the present study was to perform a comparative analysis of peritoneal dialysis catheter (PDC) insertion between blind and surgical methods by nephrologists. PATIENTS AND METHODS:The present study enrolled 249 peritoneal dialysis patients who received first-time PDC insertion. All PDC insertions w...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12904
更新日期：2020-07-23 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：:In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2009.00600.x
更新日期：2009-07-01 00:00:00
abstract：:Tunneled dialysis catheters (TDC) become dysfunctional because of placement problems, infection, thrombosis, and fibrin sheath formation. Occasional patients who are catheter dependant develop frequent catheter dysfunction because of thrombosis or thrombosis associated with fibrin sheath formation. This article attemp...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.1525-139X.2010.00802.x
更新日期：2010-11-01 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：: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 inter...
journal_title：Seminars in dialysis
pub_type： 社论
doi：10.1111/sdi.12712
更新日期：2018-09-01 00:00:00
abstract：:A thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant--15 fistula, and 7 pr...
journal_title：Seminars in dialysis
pub_type： 杂志文章,收录出版
doi：10.1111/j.1525-139X.2011.00923.x
更新日期：2011-11-01 00:00:00
abstract：:Dialysis patients are at high risk for fracture, with published rates in excess of a 20% probability of fracture over the next 10 years of dialysis. Unfortunately, there is no accepted methodology for quantifying this risk in advance of the first fracture; conventional bone densitometry performs unreliably in this rol...
journal_title：Seminars in dialysis
pub_type： 社论
doi：10.1111/j.1525-139X.2010.00817.x
更新日期：2011-01-01 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：:Physical, psychosocial, and lifestyle disturbances, along with physical and emotional symptoms, have been shown to impact the health-related quality of life (HRQOL) of those dependent on renal replacement therapy. The value of HRQOL measurement as a tool to improve clinical care has been recognized by patients, clinic...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2005.18206.x
更新日期：2005-03-01 00:00:00
abstract：:Antibiotic prophylaxis has been employed to reduce the risk of infection. Many reports have documented the role of prophylactic antibiotics on the subsequent development of infection in patients undergoing surgical as well as a variety of percutaneous interventions including cardiac, vascular, biliary, genitourinary, ...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.1525-139X.2009.00607.x
更新日期：2009-05-01 00:00:00
abstract：:Meta-analyses of the published literature are increasingly being used, allowing similar clinical trials to be combined quantitatively, thereby increasing the precision of the estimation of treatment effect. Four meta-analyses were recently published comparing the impact of dialysis membranes or dialysis modality on cl...
journal_title：Seminars in dialysis
pub_type： 社论,评审
doi：10.1046/j.1525-139x.2003.16071.x
更新日期：2003-09-01 00:00:00
abstract：:In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12658
更新日期：2018-05-01 00:00:00
abstract：:The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness a...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12901
更新日期：2020-09-01 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：:Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12675
更新日期：2018-05-01 00:00:00
abstract：:Until the discovery of calcimimetics, the management of secondary hyperparathyroidism (SHPT) relied exclusively on treatment with phosphate binders, vitamin D derivatives or surgical parathyroidectomy with limited success. The therapeutic use of calcimimetic agents, together with a better understanding of the pivotal ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12357
更新日期：2015-09-01 00:00:00
abstract：:Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological tre...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/sdi.12132
更新日期：2013-11-01 00:00:00
abstract：:The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2005.00078.x
更新日期：2005-09-01 00:00:00
abstract：:In this article we deal with three aspects of acidosis in patients with chronic renal insufficiency: clinical characteristics, pathophysiology, and therapeutic approach. ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1046/j.1525-139x.2000.00064.x
更新日期：2000-07-01 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：:Computed tomographic (CT) peritoneography has been widely used as reference standard to evaluate continuous ambulatory peritoneal dialysis-related complications. However, given the varying CT peritoneography approaches used across different institutions, there is no standard value for non-ionic iodinated contrast medi...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/sdi.12867
更新日期：2020-03-01 00:00:00
abstract：:Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fr...
journal_title：Seminars in dialysis
pub_type： 社论
doi：10.1111/j.1525-139X.2011.00979.x
更新日期：2011-09-01 00:00:00
abstract：:Increasing the use of arteriovenous fistulae in dialysis patients requires a specific strategy. In order to properly select patients for an arteriovenous fistula (AVF), it is essential that the nephrologist become knowledgeable about the subject and that an organized approach be followed. Both the arterial and venous ...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1046/j.1525-139x.2000.00079.x
更新日期：2000-09-01 00:00:00
abstract：:Elderly individuals comprise an ever-increasing proportion of patients on renal replacement therapy (RRT). As in younger patients, cardiovascular events are the major cause of death in the elderly on RRT, although the relative proportion succumbing to cardiovascular events is similar to that in young patients. An impo...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1046/j.1525-139x.2002.00037.x
更新日期：2002-03-01 00:00:00
abstract：:Acute kidney injury (AKI) is common in patients with multiple myeloma (MM), most commonly caused by cast nephropathy resulting from precipitation of free light chains (FLC) in renal tubules. AKI may be irreversible and require dialysis and predicts a poor prognosis. Reduction in serum FLC concentration is thought to b...
journal_title：Seminars in dialysis
pub_type： 社论
doi：10.1111/j.1525-139X.2010.00814.x
更新日期：2011-01-01 00:00:00
abstract：:Malnutrition is a frequent complication in hemodialysis patients and is associated with increased mortality and morbidity. Interventions such as oral or intravenous nutritional supplements have often failed to improve nutritional status. We report here the effect that daily dialysis, practiced in our center since 1997...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.0894-0959.2004.17205.x
更新日期：2004-03-01 00:00:00
abstract：:Arteriovenous fistula (AVF) nonmaturation is currently a significant clinical problem; however, the mechanisms responsible for this have remained unanswered. Previous work by our group and others has suggested that anatomical configuration and the corresponding hemodynamic endpoints could have an important role in AVF...
journal_title：Seminars in dialysis
pub_type： 杂志文章
doi：10.1111/j.1525-139X.2012.01112.x
更新日期：2013-03-01 00:00:00
abstract：:Peritoneal dialysis (PD) is a simple, safe, gentle, and efficient renal replacement therapy (RRT) method. It is able to correct acute kidney injury (AKI)-induced metabolic, electrolytic, and acid-base disorders and volume overload both in and out the intensive care unit setting. Some PD modalities, such as high-volume...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1111/j.1525-139X.2011.00868.x
更新日期：2011-03-01 00:00:00
abstract：:There is abundant evidence that chronic renal failure (CRF) and end-stage renal disease (ESRD) alter drug disposition by affecting protein and tissue binding and reducing systemic clearance of renally cleared drugs. What is not fully appreciated is that CRF can significantly reduce nonrenal clearance and alter the bio...
journal_title：Seminars in dialysis
pub_type： 杂志文章,评审
doi：10.1046/j.1525-139x.2003.03011.x
更新日期：2003-01-01 00:00:00
