Abstract:
BACKGROUND/AIMS:Japan's aging population has prominent epidemiological and patient characteristics. The number of hemodialysis patients aged ≥70 years is increasing. Age-adjusted mortality is improving, but some cause-specific mortalities remain unchanged, including infectious disease and malignancy, requiring combative strategies. However, survival trends for patients aged 90 years or older are not known. METHODS:We examined annual data reported by the -Japanese Society for Dialysis Therapy Renal Data Registry for the period 1987-2014 to determine survival trends. RESULTS:Survival in the super-aged group (≥90 years) is still mostly unimproved. In terms of cause-specific survival, especially death due to heart failure differs distinctly between this group and the remaining elderly patients, indicating that improving their survival is difficult. Alternative dialysis goals could therefore be considered. The major dialysis objective in this population could be to maintain quality of life and limit functional impairment. CONCLUSION:Survival of the super-aged population has not improved in the last 2 decades. Thus, withholding or withdrawing dialysis and providing conservative management without dialysis treatment could be an important option for patients aged 90 years or older.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Sakurai S,Hanafusa N,Nomura T,Tsuchiya K,Nitta K,Nangaku Mdoi
10.1159/000496660subject
Has Abstractpub_date
2019-01-01 00:00:00pages
95-105eissn
0253-5068issn
1421-9735pii
000496660journal_volume
47 Suppl 2pub_type
杂志文章abstract:BACKGROUND:We estimated the flow of endotoxins (ET) from dialysates into the blood of patients on hemodialysis (HD) using limulus amebocyte lysate (LAL) assays and endotoxin activity (EA) determined by neutrophil respiratory burst activity. METHODS:A cross-sectional study compared groups given ultrapure bicarbonate (n...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000322622
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a clear association between one allele of the interleukin-1 receptor-antagonist gene (IL-1RN) and inflammatory diseases in which IL-1 is implicated. We evaluated patient survival and technique survival of peritoneal dialysis (PD) patients, while analyzing independent risk factors, in a PD progr...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000088988
更新日期:2005-01-01 00:00:00
abstract::Reprocessing of used dialyzers with chemical disinfectants is practiced commonly in the United States and in some areas of Western Europe. Concern over residual toxic or allergenic agents has encouraged the search for other practical methods to disinfect or sterilize used hemodialyzers. The use of moist heat has been ...
journal_title:Blood purification
pub_type:
doi:10.1159/000170132
更新日期:1993-01-01 00:00:00
abstract::The study was made in vitro of reactions elicited by contact of granulocytes suspended in autologous plasma with three polymers: polyacrylonitrile (AN); polyetherpoly-carbonate (PC), and regenerated cellulose (Cu). Alterations in basal metabolism and biological function of the human blood granulocytes induced by inter...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170015
更新日期:1991-01-01 00:00:00
abstract::Secondary hyperparathyroidism (SHPT) occurs in patients with chronic renal failure complicated with renal bone disease and soft tissue/vascular calcification. In dialysis patients with severe SHPT, medical treatment may fail and parathyroidectomy (PTX) is indicated for definitive treatment. Severe hypocalcemia from hu...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000479616
更新日期:2017-01-01 00:00:00
abstract::Chronic kidney disease-mineral and bone disorder is a new term defining a complex syndrome which underlines the need of a systemic approach to disturbances of calcium and phosphate metabolism in patients with renal failure. In recent years, the availability of new phosphorus binders and the appearance of new selective...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000209250
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:Optimization of vascular access use in the 'fistula first' era requires comprehension of its clinical behavior. Little is known about mature arteriovenous fistula (AVF) performance and the role of fistula location. Widely used access flow (Qa) was used to analyze complication risks and functionality aft...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000197561
更新日期:2009-01-01 00:00:00
abstract::In this work we investigated the acute effects of hemodiafiltration with endogenous reinfusion (HFR therapy) on the removal of free immunoglobulin light chains (FIgLCs), which may be considered members of the family of uremic toxins. In two groups of patients - group 1 (polyclonal FIgLCs production) and group 2 (monoc...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000316684
更新日期:2010-01-01 00:00:00
abstract::Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICU). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy their metabolic demands or to be able to provide adequate nutrition. The decision to begin dialys...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000345186
更新日期:2013-01-01 00:00:00
abstract::Peritoneal transport rates, a critical determinant of peritoneal dialysis efficiency, vary widely among patients and may be easily categorized by standardized peritoneal equilibration test. Measurements of creatinine and glucose transfer are particularly useful in selecting optimal dialysis prescription. Patients with...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000169582
更新日期:1989-01-01 00:00:00
abstract::The recent interest in the role of the intestine in the cardiovascular stability of uremic patients, specifically on dialysis, but potentially also in chronic kidney disease, must be seen against the background of the recent great interest in the role of the gut in chronic heart failure [Curr Opin Clin Nutr Metab Care...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000321848
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Extended haemodialysis (EHD) has been associated with better outcomes compared to conventional (CHD) regimes. The cardiovascular (CV) profile of these patients has not been assessed in detail. METHODS:We report baseline demographic and CV phenotype of 36 CHD and 36 EHD participants to a longitudinal multice...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000485231
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The mortality rate of peritoneal dialysis (PD) patients is still high and controversies persist regarding the mortality predictor. This study was designed to identify the predictability of the extracellular water/intracellular water ratio (E/I) on mortality in PD patients. METHODS:227 incident PD patients w...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000101699
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Interleukin-10 (IL-10), a potent regulatory monokine produced by activated mononuclear cells, provides an efficient autocrine mechanism for controlling proinflammatory cytokine synthesis. We hypothesized that defective synthesis of IL-10 could contribute to the inflammatory state in hemodialysis (HD) patient...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000066958
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Omni® (B. Braun, Germany) is a new-generation, continuous renal replacement therapy (CRRT) machine designed to improve user interface, minimize downtime and optimize renal dose delivery. It was never tested in humans. METHODS:We used Omni® to provide CRRT in 10 critically ill patients. We collected therapy ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000451053
更新日期:2017-01-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline fo...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000321850
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Diffuse hyperpigmentation is common in patients with chronic renal failure undergoing hemodialysis (HD) or peritoneal dialysis (PD). We previously reported that serum levels of 5-S-cysteinyldopa (5SCD, a pheomelanin precursor) and pheomelanin were significantly elevated in HD patients. METHODS:Skin color wa...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000230812
更新日期:2009-01-01 00:00:00
abstract::The administration of intravenous fluids is perhaps the most common treatment given in the intensive care unit. According to biologic rationale, ongoing fluid losses should be replaced to maintain fluid homeostasis and relative or absolute deficiencies in circulating blood volume should be prevented or rapidly correct...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000047015
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Secondary hyperparathyroidism (SHP) is characterized by high bone turnover and elevated serum bone remodeling markers. Elevation of serum interleukin-6 (IL-6) levels is also characteristic of end-stage renal disease. This study investigates the effects of intravenous calcitriol on serum bone resorptive ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000094899
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND/AIMS:Chronic kidney disease (CKD) and periodontitis (PD) are serious public-health concerns. Vitamin D is a fat-soluble steroid hormone that interacts with its nuclear receptor (VDR) to regulate a variety of biological processes, such as bone metabolism, immune response modulation and transcription of severa...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000109235
更新日期:2007-01-01 00:00:00
abstract::Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that thresh...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000287776
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The relationship between predialysis blood pressure (BP) and hemodialysis (HD) patient outcomes is controversial. We report the evolution of predialysis BP in incident patients treated with the dry weight method and its relationship with patients' outcomes. METHODS:Between January 2000 and 2009, 308 patient...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000337101
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Glucose absorbed from conventional peritoneal dialysis (PD) solutions contributes to unfavorable metabolic effects. Its replacement with a glucose-free osmotic agent such as icodextrin (ID) or amino acids (AA) may have some benefit on glucose and lipid metabolism. METHODS:Serum lipids, insulin sensitivity a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000086553
更新日期:2005-01-01 00:00:00
abstract::Uremic patients suffer from a secondary form of complex dyslipidemia consisting of quantitative and qualitative abnormalities in serum lipoproteins resulting in altered lipoprotein composition and metabolism. The most prominent are an increase in serum triglyceride levels (due to elevated very-low-density lipoprotein ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000063557
更新日期:2002-01-01 00:00:00
abstract::In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169411
更新日期:1985-01-01 00:00:00
abstract::The present working hypothesis regarding adequacy issues in peritoneal dialysis is that dialysis is a major determinant of protein intake and therefore nutritional status in these patients. Present data however is controversial. This is in part due to differences in methodology and the calculations used for the data p...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170201
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Calcium (Ca) is an essential element that plays a critical role in many biological processes. In dialysis patients, the regulation of Ca balance is highly complex, given the absence of kidney function, endocrine disturbances and the use of drugs such as phosphate binders, vitamin D analogues, and calcimimeti...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000494584
更新日期:2019-01-01 00:00:00
abstract:AIMS:This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. METHODS:A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-d...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000474931
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Dyslipidemia is a common metabolic complication in patients with chronic kidney disease and is detected as changes in lipoprotein concentrations in serum. SUMMARY:Recently, other features of lipid abnormalities have been described, such as alterations in serum n-3 polyunsaturated fatty acids, cholesterol me...
journal_title:Blood purification
pub_type: 评论,杂志文章
doi:10.1159/000441581
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified. AIMS:Gain a better understanding of the association between hemodialysis (HD)-rela...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000368980
更新日期:2015-01-01 00:00:00