Abstract:
BACKGROUND:Numerous studies have suggested a possible role for acute kidney injury (AKI) biomarkers in predicting renal recovery both before and after renal replacement therapy (RRT). However, definitions for recovery and whether to include patients dying but free of RRT may influence results. OBJECTIVES:To validate plasma neutrophil gelatinase-associated lipocalin (pNGAL) as a useful biomarker for predicting or improving the ability of clinical predictors alone to predict recovery following AKI, including in our model plasma B-type natriuretic peptide (pBNP) to account for cardiovascular events. METHODS:We analyzed 69 patients enrolled in the Acute Renal Failure Trial Network study. pNGAL and pBNP were measured on days 2, 7, and 14. We analyzed their predictive ability for subsequent recovery, defined as alive and independent from dialysis in 60 days. In sensitivity analyses, we explored changes in results with alternative definitions of recovery. RESULTS:Twenty-nine patients (42%) recovered from AKI. Neither pNGAL nor pBNP, alone or in combination, was accurate predictors of renal recovery-the best area under the receiver-operating characteristics curve (AUC) was for pNGAL using the largest relative change (AUC 0.59, 95% CI 0.45-0.74). The best clinical model achieved superior performance to biomarkers (AUC 0.69, 95% CI 0.56-0.81). The AUC was greatest (0.75, 95% CI 0.60-0.91) when pNGAL + pBNP on day 14 were added to the clinical model but this increase did not achieve statistical significance. However, integrated discrimination improvement analysis showed that the addition of pNGAL and pBNP on day 14 to the clinical model significantly improved the prediction of renal recovery (p = 0.008). CONCLUSIONS:pNGAL and pBNP can improve the accuracy of clinical parameters in predicting AKI recovery and a full model using biomarkers together with age achieved adequate discrimination.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Fiorentino M,Tohme FA,Murugan R,Kellum JAdoi
10.1159/000500423subject
Has Abstractpub_date
2019-01-01 00:00:00pages
253-261issue
3eissn
0253-5068issn
1421-9735pii
000500423journal_volume
48pub_type
杂志文章abstract:BACKGROUND:Erythropoiesis-stimulating agent (ESA) resistance remains incompletely understood among hemodialysis (HD) patients. METHOD:A retrospective, multicenter study was designed to analyze data from 1,934 patients followed for up to two years. The outcome measure was the erythropoietin resistance index (ERI), defi...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000335256
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cardiovascular diseases (CVD) are the leading cause of mortality in hemodialysis (HD) patients. Recently, non-alcoholic fatty liver disease (NAFLD) has been recognized as a new risk factor for adverse CVD events in the general population. Our aim was to analyze the incidence of NAFLD in HD patients by u...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000360270
更新日期:2014-01-01 00:00:00
abstract::Recently, a new type of modified cellulosic membrane (Hemophan) has been made available for the first clinical trials. In contrast to cellulose acetate membranes only about 5% of the hydroxyl groups of cellulose are substituted by tertiary amino groups. Objective of the present study was to assess the compatibility pe...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169475
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/AIMS:Peritonitis remains a significant problem for patients on peritoneal dialysis (PD). There is a certain amount of controversy as to whether peritoneal modality is itself a risk factor for peritonitis, with one modality higher than another. METHODS:A literature review was done (August 2009) searching und...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000245641
更新日期:2010-01-01 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::One of the main problems in low protein diet is patient's noncompliance and the risk of both depression and reduced quality of life. A pilot study investigated the life-style and the state of mood before and during low protein diet. The results show a deterioration in the life-style and the state of mood. Conclusions ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169572
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Of 5 clinical trials testing dose response of continuous renal replacement therapy (CRRT) in acute kidney injury, 2 showed a benefit, 2 showed none, and 1 appeared equivocal. However, blood-membrane interactions may dominate macromolecule transport in continuous venovenous hemodiafiltration, reducing the imp...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000266483
更新日期:2010-01-01 00:00:00
abstract::The factors involved in choosing a treatment modality for the infant, child and adolescent with endstage renal disease (ESRD) are different than those utilized when counseling an adult patient. Age at the time ESRD develops, mental status, psychosocial status and the primary renal disease must be taken into considerat...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169450
更新日期:1987-01-01 00:00:00
abstract::In hemodialysis patients, C-reactive protein (CRP), an acute-phase reactant, is a sensitive and independent marker of malnutrition, anemia, and amyloidosis. The aim of the present studies was to evaluate CRP and interleukin 6 levels in plasma samples from long-term hemodialysis patients on different extracorporeal mod...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000014405
更新日期:2000-01-01 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
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000381006
更新日期:2015-01-01 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
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journal_title:Blood purification
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000497447
更新日期:2019-01-01 00:00:00
abstract::There is a wide variability in the utilization of peritoneal dialysis throughout Europe that cannot be explained by differences in medical factors alone. Over the last years, the utilization of peritoneal dialysis has even changed in individual countries. The main factors of this variation are not medical, but rather ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000089446
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND/AIMS:Sudden K removal is thought to be implicated in ECG alterations observed during hemodialysis (HD). The effects of the K removal rate on ECG-derived parameters have been investigated. METHODS:Two different hemodiafiltration (HDF) schedules were used for 10 HD patients: the dialysate K concentration was ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000073440
更新日期:2003-01-01 00:00:00
abstract::Numerous experimental and clinical studies suggest that uric acid might have pathobiologic implications in the development and progression of hypertension, kidney disease, and coronary heart disease, among others, resulting in renewed interest in uric acid as a potential pathogenic mediator in these clinical condition...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000360520
更新日期:2014-01-01 00:00:00
abstract::The recent recognition that hyperphosphatemia is a strong predictor of survival on dialysis has rekindled interest in the regulation and control of serum phosphate. In incipient renal failure hyperphosphatemia is prevented by increased fractional renal phosphate excretion mediated via an increase in parathyroid hormon...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000082004
更新日期:2005-01-01 00:00:00
abstract::The central dialysis fluid delivery system (CDDS) has been working exclusively in Japan since 1970, a fact which proves that CDDS is useful in the multi-patient treatment with in-center regular hemodialysis. It is a cost-effective, labor-saving and time-tested system with 40 years of experience. Microbial safety is im...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000213494
更新日期:2009-01-01 00:00:00
abstract::Cuprophane hemodialysis is associated with an early fall of leukocyte counts and an intradialytic rise in serum beta 2-microglobulin (beta 2M), in contrast to dialysis with more compatible dialyzers. It has been suggested that these two phenomena may be related. This study sets out to verify this hypothesis by compari...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169922
更新日期:1990-01-01 00:00:00
abstract::Guidelines have been developed in nephrology and medicine developed to assist practitioners and patients in making decisions about healthcare for specific clinical circumstances. There has been a proliferation of guidelines over the last decade in all areas of medicine, including nephrology. Many of the nephrology gui...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000110568
更新日期:2008-01-01 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:It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. SUMMARY:Recently, 5 different clin...
journal_title:Blood purification
pub_type: 评论,杂志文章
doi:10.1159/000441582
更新日期:2015-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000458751
更新日期:2017-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000093680
更新日期:2006-01-01 00:00:00
abstract::During hemodialysis, amino acids (AA) are lost in the ultrafiltrate with consequent modification of their plasma profile. The aim of this cross-sectional study was to evaluate intradialytic changes of plasma AA levels during a single session of hemodiafiltration with endogenous reinfusion (HFR) versus acetate-free bio...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000320133
更新日期:2010-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170294
更新日期:1996-01-01 00:00:00
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 combativ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000496660
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000362106
更新日期:2014-01-01 00:00:00
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journal_title:Blood purification
pub_type: 社论
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更新日期:2018-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2002-01-01 00:00:00