Abstract:
BACKGROUND:Recent advances enable the direct measurement of small molecule clearance, Kecn, during each dialysis. Average Kecn and treatment length, t, are multiplied giving total clearance, Kt. The body surface area (BSA) is a fixed transformation of height and weight and is a well recognized measure of body size. This project was conceived to search for clinical outcome-based functions for measured Kt in terms of BSA to enable simple Kt prescription guidelines for clinicians who are able to measure Kecn, and to provide foundations for future clinical research. METHODS:The data came from Fresenius Medical Care (NA) files and included more than 32,000 patients with height, weight, and paired Kecn and t measurements during December 2002. Measurements were averaged for the month and used as predictor measures in Cox models of survival time during 2003. Candidate Kt values from 30 L/treatment through 70 were examined to determine the best statistical fit for quintile and decile delimited BSA groups evaluating the best fit Kt treatment target for each group. Functional forms representing the relationship between target Kt values and mean BSA of the groups were then evaluated to determine the best fit. RESULTS:Kt targets increased with BSA in a curvilinear way such that the rate of increase is greater at low BSA than high. The best statistical fit was a double reciprocal form, Kt = 1/(a + b/BSA); "a" and "b" are statistically derived coefficients. The form has an appealing mathematical property; Kt approaches 0 as BSA approaches 0. Other forms fit the data nearly as well, however, and can be used to estimate Kt targets for patients with different BSA. CONCLUSION:Empirical, outcome-based functions of measured Kt in terms of BSA exist and can be used as aids for prescribing and judging hemodialysis treatment.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Lowrie EG,Li Z,Ofsthun N,Lazarus JMdoi
10.1111/j.1523-1755.2005.00533.xsubject
Has Abstractpub_date
2005-09-01 00:00:00pages
1344-54issue
3eissn
0085-2538issn
1523-1755pii
S0085-2538(15)50967-8journal_volume
68pub_type
杂志文章abstract::Lipid abnormalities have been suggested as a major cause of the accelerated atherosclerosis and the high incidence of coronary heart disease in chronic renal failure patients. In the present work the postprandial lipoprotein metabolism was studied in chronic dialysis patients with or without fasting hypertriglyceridem...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1992.411
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Home nocturnal hemodialysis is an intensive form of hemodialysis, where patients perform their treatments at home for about 7 hours approximately 6 nights a week. Compared with in-center conventional hemodialysis, home nocturnal hemodialysis has been shown to improve physiologic parameters and reduce health ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00157.x
更新日期:2003-09-01 00:00:00
abstract::A recent clinical trial in patients with chronic kidney disease (CKD) and diabetic nephropathy demonstrated that bardoxolone methyl (CDDO-ME) increases estimated glomerular filtration rate (eGFR) by an unknown mechanism. The paper by Ding et al. suggests that short-term administration of a CDDO-ME analog increases GFR...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2013.38
更新日期:2013-05-01 00:00:00
abstract::The influence of transforming growth factor beta 1 (TGF-beta 1) and of dexamethasone on fibronectin (FN) synthesis of human renal tubular epithelial cells in culture (TEC) was studied. Cocultivation with TGF-beta 1 increased the steady state level of FN RNA within 24 to 48 hours. By PCR and Northern blotting it was fo...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1995.479
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The long-term prognostic associations of pre- and post-dialysis blood pressures, interdialytic weight gain, and antihypertensive use in hemodialysis patients are unclear. METHODS:The United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Waves 3 and 4 Study, a randomly generated sample of ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00636.x
更新日期:2002-11-01 00:00:00
abstract::The association between dietary sodium and potassium intake with the development of kidney disease remains unclear, particularly among younger individuals. Here, we determined whether dietary sodium and potassium intake are associated with incident chronic kidney disease (CKD) using data from 1,030 adults (age 23-35 i...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2020.02.037
更新日期:2020-07-01 00:00:00
abstract::The hypercalcemia of malignancy is mediated by complex and heterogeneous mechanisms. Once thought of as a simple paraneoplastic syndrome mediated by the effects of tumor production of PTH, it is now clear that multiple mechanisms are involved and that these mechanisms involve abnormalities in calcium transport in bone...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1987.21
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Microarray technology is a powerful tool that can probe the molecular pathogenesis of renal injury. In this present study microarray analysis was used to monitor serial changes in the renal transcriptome of a rat model of mesangial proliferative glomerulonephritis. Administration of anti-Thy1 antibody result...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00661.x
更新日期:2005-12-01 00:00:00
abstract::This report of the NIH-supported National Continuous Ambulatory Peritoneal Dialysis (CAPD) Registry summarizes data on 7,404 patients treated with CAPD during the three-year period 1981 through 1983, or nearly one-half of patients treated in the USA who were treated with CAPD during this time. While age and diabetes m...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1985.141
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the renoprotective effect as reflected by short-term changes in albuminuria of ultrahigh doses of irbesartan in type 2 diabetic patients with microalbuminuria. METHODS:This double-masked randomized crossover trial included 52 (41 males) hypertensive type 2 diabetic ...
journal_title:Kidney international
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1523-1755.2005.00511.x
更新日期:2005-09-01 00:00:00
abstract::Electron microprobe analysis on freeze-dried cryosections was used to determine the effect of the loop diuretics torasemide and furosemide on intracellular electrolyte concentrations in individual cells of the outer and inner stripe of the outer medulla and on cell rubidium uptake, the latter a measure of basolateral ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1992.359
更新日期:1992-10-01 00:00:00
abstract::Hemodynamic pressure in glomerular capillaries (GCP) and in first order peritubular capillaries (EAP) in superficial nephrons of mutant Wistar rats with surface glomeruli was measured by micropuncture with a servo-nulling device in the following conditions: 1) control;2) norepinephrine infusion (NE); 3) epinephrine in...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1976.61
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:Unilateral ureteral obstruction (UUO) leads to interstitial fibrosis of the obstructed kidney, and TGF-beta is considered to play an important role in this fibrotic process. Smad7 has been recently identified as an antagonist of TGF-beta signaling. To investigate whether this novel molecule can be exploited ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.0610s1094.x
更新日期:2002-01-01 00:00:00
abstract::The safety of dietary protein and phosphorous restriction was evaluated in the Modification of Diet in Renal Disease (MDRD) Study. In Study A, 585 patients with a glomerular filtration rate (GFR) of 25 to 55 ml/min/1.73 m2 were randomly assigned to a usual-protein diet (1.3 g/kg/day) or a low-protein diet (0.58 g/kg/d...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1038/ki.1997.395
更新日期:1997-09-01 00:00:00
abstract::Vascular calcification is recognized as a major contributor to cardiovascular disease (CVD) in end stage renal disease (ESRD) patients. Susceptibility to vascular calcification is genetically determined and actively regulated by diverse inducers and inhibitors. One of these inducers, hyperphosphatemia, promotes vascul...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2008.644
更新日期:2009-05-01 00:00:00
abstract::Cystinosis as a clinical entity is a progressive dysfunction of multiple organs caused by the accumulation of cystine in the tissues, leading, for example, to end-stage renal failure, diabetes, hypothyroidism, myopathy, and central nervous system deterioration. Brodin-Sartorius and colleagues present a long-term study...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2011.301
更新日期:2012-01-01 00:00:00
abstract::Toward an etiological classification of developmental disorders of the kidney and upper urinary tract. There are a large number of developmental disorders and syndromes that affect the kidney and upper urinary tract. These have generally been classified according to morphological criteria established decades ago. Alth...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1046/j.1523-1755.2002.00086.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:While tubular cell death is a characteristic of acute renal failure (ARF), the molecular mechanisms that modulate this cell death are unclear. Cell fate in acute renal failure hinges on a balance of survival and mortality factors in a changing environment. We further explored this issue by studying selected ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2000.00925.x
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Autosomal-dominant medullary cystic kidney disease (ADMCKD), a hereditary chronic interstitial nephropathy, recently attracted attention because of the cloning or mapping of certain gene loci, namely NPHP1, NPHP2 and NPHP3 for familial juvenile nephronophthisis (NPH) and MCKD1 and MCKD2 for the adult form of...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2002.kid581.x
更新日期:2002-10-01 00:00:00
abstract::Determination of serum oxalate concentration is important for the diagnosis and monitoring of hyperoxalurias, and extends to patients with all types of renal disease. Approximately 5 to 10 ml of blood is required for each test by conventional methods, and the test is not adapted for use in children. We developed a hig...
journal_title:Kidney international
pub_type:
doi:10.1038/ki.1997.505
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the most frequent cause of mortality in chronic renal failure (CRF). Therefore, it is important to identify appropriate treatment measures. The antioxidant N-acetylcysteine (NAC) has been shown to reduce cardiovascular events in hemodialysis patients. Here we examine a possible dire...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00332.x
更新日期:2005-06-01 00:00:00
abstract::Nephrin is a slit diaphragm protein critical for structural and functional integrity of visceral glomerular epithelial cells (podocytes) and is known to be tyrosine phosphorylated by Src family kinases. We studied the role of phosphoinositide 3-kinase (PI3K), activated via the phosphorylation of nephrin, in actin cyto...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5002691
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Adrenomedullin (ADM) exerts antiproliferative effects on rat mesangial cells in vitro and, therefore is a possible renoprotective agent. In contrast, nitric oxide (NO) is capable of exerting both cytoprotective and cytotoxic actions. It was the objective of the present study to examine whether NO stimulates ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00330.x
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Increased venous pressure (VP) and decreased access flow (Qa) are predictors of dialysis access graft thrombosis. VP is easily obtainable. Qa assessment requires a special device and takes more time. The aims of our randomized multicenter studies were to compare outcome in patients with grafts monitored by V...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1523-1755.2001.0590041551.x
更新日期:2001-04-01 00:00:00
abstract::To assess in vitro erythropoietic cultures as a tool to discriminate between patients whose anemia improves with and those whose anemia fails to improve with androgens, bone marrows of 24 anemic patients receiving maintenance hemodialysis in hormone-depleted plasma clots were cultured. While erythroid colony prolifera...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1982.186
更新日期:1982-10-01 00:00:00
abstract::Prior studies showed conflicting results regarding the association between 25-hydroxyvitamin D (25(OH)D) levels and mineral metabolism in end-stage renal disease. In order to determine whether the bioavailable vitamin D (that fraction not bound to vitamin D-binding protein) associates more strongly with measures of mi...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2012.19
更新日期:2012-07-01 00:00:00
abstract::To investigate the cause and the mechanisms responsible of the compulsive thirst and excessive fluid intake observed in many patients on chronic dialysis treatment, we measured plasma antidiuretic hormone (ADH), angiotensin II (Ang II) and some hemodynamic parameters in seven polydipsic and in six normodipsic patients...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1993.219
更新日期:1993-07-01 00:00:00
abstract::It has been proposed that one of the primary events in the development of essential hypertension is a growth-related process initiated as early as during fetal development. Differences in kidney size have been observed between most rat models of hypertension and their respective controls. In this study, we analyzed re...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1998.00938.x
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Metabolic acidosis caused by increased rates of fixed acid production is associated with increased urinary excretion of Ca and negative Ca balances. Metabolic acidosis caused by a reduced capacity of the kidneys to excrete acid contributes to the development of bone disease in the course of chronic renal fai...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2000.00282.x
更新日期:2000-09-01 00:00:00
abstract::The cytokine interleukin-6 (IL-6) is a major cell regulatory factor that may play an important role in the bone remodeling of patients with renal failure. IL-6 exerts its action by binding to its receptor (IL-6R), which leads to transduction of a second messenger cascade within cells. In vitro as well as in vivo data ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.343
更新日期:1996-08-01 00:00:00