Abstract:
:There has been a dramatic, worldwide expansion in life expectancy across the last century. This has resulted in a progressively more elderly and comorbid population. It is increasingly recognized that healthcare in this group needs to move to the concept of "adding life to years". Recognition and assessment of frailty is vital in changing our approach in elderly patients. Current guidelines in dialysis have a limited evidence base across all age groups, but particularly the elderly and serve them poorly. Moreover, the burden of guidelines for each comorbidity of the multimorbid patient is increasing and can be conflicting. Finally, there is increasing evidence relating to the harm associated with the delivery of conventional dialysis. In dialysis patients, frailty is the overwhelming determinant in relation to patient-specific outcomes rather than modality of treatment; therefore, the focus should be on promoting quality of life. We need to focus on new priorities of care when we design guidelines "for people not diseases". Patient-centered goal-directed therapy, arising from shared decision making between physician and patient, should allow adaption of the dialysis regime to maximize opportunities while minimizing treatment-related morbidity and concentrating on alleviating symptoms.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Corbett RW,Brown EAdoi
10.1111/sdi.12744subject
Has Abstractpub_date
2018-11-01 00:00:00pages
607-611issue
6eissn
0894-0959issn
1525-139Xjournal_volume
31pub_type
杂志文章,评审abstract:INTRODUCTION:Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. METHODS:Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end-to-side variety. Parameters st...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12907
更新日期:2020-09-01 00:00:00
abstract::Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, exces...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12527
更新日期:2016-11-01 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::For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12691
更新日期:2018-05-01 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::Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis pa...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12194
更新日期:2014-09-01 00:00:00
abstract::Recombinant human erythropoietin (rHuEPO, epoetin) revolutionized the treatment of anemia in patients with chronic kidney disease (CKD) when it was approved for use in the United States in 1989. Among dialysis patients, the mean hemoglobin (Hb) in patients undergoing dialysis rose from 7-8 g/dl prior to 1989 to 11-12 ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18105.x
更新日期:2005-01-01 00:00:00
abstract::Cardiac resynchronization therapy with or without a defibrillator (CRT(D)) and implantable cardioverter defibrillator (ICD) may reduce the risk of arrhythmia or heart failure-specific mortality and improves the prognosis of patients with chronic kidney disease (CKD) or dialysis. The aim of this study was to perform a ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12937
更新日期:2020-12-09 00:00:00
abstract::In response to rapid alkali delivery during hemodialysis, hydrogen ions (H+ ) are mobilized from body buffers and from stimulation of organic acid production in amounts sufficient to convert most of the delivered bicarbonate to CO2 and water. Release of H+ from nonbicarbonate buffers serves to back-titrate them to a m...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12779
更新日期:2019-05-01 00:00:00
abstract::The National Kidney Foundation (NKF) has recently published clinical practice guidelines for bone metabolism and disease in chronic kidney disease (CKD) patients (the Kidney Disease Outcomes Quality Initiative [K/DOQI]). Data from the literature show that the majority of dialysis patients treated with traditional calc...
journal_title:Seminars in dialysis
pub_type: 社论,指南,实务指引
doi:10.1111/j.0894-0959.2004.17354.x
更新日期:2004-09-01 00:00:00
abstract::The development of many electrolyte disturbances in the ICU can be prevented by attention to the use of intravenous fluids and nutrition. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. Formulae have been devised to guide t...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2006.00212.x
更新日期:2006-11-01 00:00:00
abstract::Bacteremia is a common infectious complication in hemodialysis patients. Metastatic sites of infection including infective endocarditis, vertebral osteomyelitis, spinal epidural abscess, and septic arthritis occur relatively frequently. These complications are associated with increased morbidity and mortality in hemod...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12031
更新日期:2013-01-01 00:00:00
abstract::Dialysis is measured as Kt/V, which scales the dose (Kt) to body water content (V). Scaling dialysis dose to body surface area (S(dub)) has been advocated, but the implications of such rescaling have not been examined. We developed a method of rescaling measured Kt/V to S(dub) and studied the effect of such alternativ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00482.x
更新日期:2008-09-01 00:00:00
abstract::Renal osteodystrophy (ROD) is a bone disorder that occurs in chronic kidney disease (CKD) patients and is associated with 2- to 14-fold increased fracture risk compared to the general population. Risk of fractures is also increased in kidney transplant recipients especially within the first 5 years after transplantati...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12423
更新日期:2015-11-01 00:00:00
abstract::Managing an end-stage renal disease (ESRD) patient is complex and presents many ethical challenges for the physician. Ownership of dialysis facilities has shifted over the past decade from largely nonprofit organizations to large companies whose shareholders are primarily interested in the profitability of their inves...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139x.2004.17102.x
更新日期:2004-01-01 00:00:00
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::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::Dialysis-dependent chronic kidney disease (CKD) is an expanding problem for healthcare systems worldwide. The prevalence of end-stage renal disease (ESRD) has increased by 20% since 2000 and stands at 1699 per million people in the USA. ESRD is associated with an increased risk of cardiovascular comorbidity, increased...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.00856.x
更新日期:2011-05-01 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::There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end-stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12368
更新日期:2015-07-01 00:00:00
abstract::The risk of intradialytic hypotension (IDH) is determined by various factors, among them dialysis modality and dialyzer membrane. We conducted a literature search in PubMed on November 1, 2016 and selected relevant randomized controlled and cross-over trials, and prospective and retrospective cohort studies published ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12636
更新日期:2017-11-01 00:00:00
abstract::Vancomycin, a glycopeptide antibiotic, has remained a popular antimicrobial agent throughout the past five decades, and is often included in empiric antibiotic regimens. With gram-positive coverage, it has found a niche in the treatment of methicillin-resistant Staphylococcus aureus. Although vancomycin has been in ex...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00333.x
更新日期:2008-01-01 00:00:00
abstract::New advances in the pathogenesis of renal osteodystrophy (ROD) change the perspective from which many of its features and treatment are viewed. Calcium, phosphate, parathyroid hormone (PTH), and vitamin D have been shown to be important determinants of survival associated with kidney diseases. Now ROD dependent and in...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00300.x
更新日期:2007-07-01 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::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::The increased frequency of cardiovascular disease observed in hemodialysis patients is secondary to the combination of many traditional (age, male sex, hypertension, smoking, diabetes mellitus, and dyslipidemia) and novel and uremia-related (inflammation, uremic toxins, adipokine imbalance, coagulation disorders, prot...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12345
更新日期:2015-05-01 00:00:00
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::Renal osteodystrophy (ROD) represents a spectrum of bone lesions ranging from a high-turnover to a low-turnover state. The expression of the histologic bone lesions is modulated by parathyroid hormone (PTH), vitamin D, calcium, phosphorus, and aluminum that act as major regulators of osteoblastic activity and bone for...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18404.x
更新日期:2005-07-01 00:00:00
abstract::The decision to provide dialytic support and choosing the ideal moment to initiate therapy are common impasses for physicians treating patients with acute kidney injury (AKI). Although renal replacement therapy (RRT) has been extensively used in clinical practice for more than 30 years, there is a paucity of evidence ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12128
更新日期:2013-11-01 00:00:00
abstract::The control of serum phosphorus by dialysis is made difficult by the fact that intradialytic blood levels tend to be low, and because phosphorus is removed almost exclusively from the plasma during its passage through the dialyzer. The most practical way to increase phosphorus removal is to extend dialysis time, altho...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12439
更新日期:2015-11-01 00:00:00